Whether rejoicing or mourning, millions of Americans awoke on January 21st feeling suddenly at the threshold of a new and uncertain era. However, in public safety-net emergency departments across the nation -- like Harborview Medical Center in Seattle, where we work -- the service of healing continued seamlessly, paying no heed to the national drama that has unfolded for the past several months. That day and into the night, there were ...

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Eight years ago when the tumultuous health care reform journey began, we couldn't have imagined the roller-coaster ride it would take. The Affordable Care Act passing without a single Republican vote, surviving the Supreme Court ruling by the vote of a Republican-appointed judge, a disastrous roll-out of HealthCare.gov, thriving for four years with Obama's re-election, and now its inevitable repeal with Donald Trump’s win. So it may help to look back ...

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It's been a rough past couple of months not only for millions of Americans whose health care futures depend on decisions to be made by the new Congress and the Trump administration but for those of us who teach about the U.S. health system for a living. As one health policy expert I follow tweeted only half-facetiously, on election night: "Dear students: all that stuff I taught you about the ...

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The call came at 4:30 a.m. I answered when she called the second time, as I was too late to answer the first. “Dr. Harper. I think I need to go to the hospital. I just feel so weak.” It was Bessie, a patient I have known for over 15 years. She’s been struggling for a few week, and while we are working through this struggle, we are clearly not doing ...

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Dear Dr. Price, Congratulations on your upcoming appointment as the new Health and Human Services Secretary under President Trump. As a physician myself, it’s great to know that a fellow physician will head up the agency. I’m sure you understand too, having been a practicing orthopedic surgeon, how disheartening and frustrating it is to have non-clinical “experts” making key decisions about health care. I’m sure you’ve also seen the news about how ...

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An excerpt from Flatlining:  How Healthcare Could Kill the U.S. Economy. In recent history, the U.S. economy has experienced the near catastrophic failure of two major market segments. The first was the auto industry and the second was the housing industry. While each of these reached their breaking point for different reasons, they both required a significant government bailout to keep them from completely melting down. What is also ...

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The Republican congressional leadership appears to be determined to move forward with a high-risk “repeal, delay and replace” plan, very early in the new 115th Congress to repeal (at least on paper) the Affordable Care Act’s key coverage provisions—Medicaid expansion, subsidies to make private insurance sold through the exchanges affordable, the individual and employer mandates, and the taxes to pay for coverage—by a simple majority vote, while delaying when the ...

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President Barack Obama, whether wittingly or not, invested his entire political capital in reforming health care in America. He gambled and lost. Not because he had nefarious intentions, but because he left the gory details to a corrupt Congress and a shady cadre of lying and conniving technocrats, ending up with something vastly different from what he campaigned on. From everything I’m reading now, President-elect Donald Trump is about to ...

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The Affordable Care Act is perhaps the biggest overhaul of the U.S. health care system in many decades. Enacted by President Barack Obama in 2010, it made health care attainable and affordable to millions of Americans. Individuals with pre-existing medical conditions cannot be denied health care coverage; insurance companies have to cover essential health care needs including mental health and preventive services, children can be covered under their parents’ plans ...

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If you’re like me, you’re getting a bit restless hearing about what may or may not happen to the Affordable Care Act (Obamacare). As doctors, we are trained to act. While administrators plan new quality improvement programs, we take each day as an opportunity to improve our practice and work more closely with our teams. While our clinics and hospitals try to figure out how to streamline workflows in our EHRs, ...

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