As we enter year two of the Affordable Care Act, we have seen many issues arise during implementation.  Through both executive order and executive memorandum, President Obama has unilaterally changed the law more than 100 times in order to advance his political agenda. When it became important to publicize enrollment and increased coverage of the uninsured, the president, and the ACA provided for an increased payment scale for patients with Medicaid. ...

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I wish lowering health care costs was as easy as “cost awareness,” but as one patient put it, “I never pay the first few bills, because the amount changes every time a new bill is sent.”  The payment system is so fragmented that it’s hard to know what will become an expense with any given illness.  Even the savviest of consumers of health care have difficulty with hospital payment systems.  ...

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Part of the fun of ringing in the New Year is looking back on the achievements of the previous one. And in 2014, there were plenty of health care success stories to celebrate: major medical advances, new technologies and the Affordable Care Act’s unexpectedly good first year. At the same time, many of the health care changes in 2014 yield potential risks for patients, employers and the nation as a whole. ...

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shutterstock_22140319 If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. ...

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I recently spent time at the New York eHealth Collaborative's Digital Health conference. The meeting was full of interesting seminars, informational sessions, presentations on innovative technology looming on the horizon, and talk about the future digital face of health care. The hallways outside the conference rooms were full of administrators, legislators, consultants, and representatives of companies building and designing new resources to help transform the health care system as they see it. Over and ...

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You couldn't invent a worse health care system than the nightmare we have created in the U.S. Our medical costs are almost twice as high per person as they are in most other similar countries but produce only mediocre outcomes. There is massive overtreatment of people who don't need it, while many who desperately do have no coverage at all. The payment incentives for doctors are perversely misaligned to produce the wrong ...

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Last year, hospitals and health systems underwent 98 consolidations, a 51 percent increase from 2010.  Many of these mergers and acquisitions arose in response to declining government reimbursement and the Affordable Care Act.  Smaller hospitals are having increasing difficulties maintaining a margin and many face high debt burdens, bankruptcy or even closure. But is consolidation the clear-cut answer? Here are 4 reasons bigger actually may not be better for all hospitals: 1. Disparate ...

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In the giddy days after the passage of ACA, I was chatting with a PhD student in health economics. He was in love with the ACA. He kept repeating that it would reduce costs, increase quality and increase access. Nothing original. You know the sort of stuff you heard at keynotes of medical meetings; "Healthcare post-Obamacare" or "Radiology in the new era." Talks warning us that we were exiting the ...

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An excerpt  from The Myths of Modern Medicine: The Alarming Truth about American Health Care (Rowman & Littlefield). Myth 1: "The United States boasts the best health care in the world." Betsy Lehman trusted her life to the American health care system. An award-winning journalist, Lehman was a rising star at the ...

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One of the most pernicious lies about Obamacare is that it establishes “death panels” to ration needed care, especially care of seniors.  Although thoroughly discredited by independent fact checking sites, the death panel falsehood remains a staple of attacks on the Affordable Care Act. But it isn’t just that Obamacare doesn’t have death panels or anything remotely like them (the law actually prohibits denying benefits based on cost); we now have strong evidence ...

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