We all know that health care costs in the U.S. are too high.  But why is American health care so expensive?  Some experts blame the desire for profit.  Russell Andrews, a  neurosurgeon and author of Too Big To Succeed laments “the morphing of American medicine from a function of a humanitarian society into a revenue stream for health care profits, drug and medical device companies, hospitals, and insurance companies.  In essence, ...

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There is a new report out from the Congressional Budget Office (CBO) titled “The Slow Recovery of the Labor Market,” and as its title implies, it predicts a slow recovery from a labor perspective. Among other things, the CBO report is now making headlines in the political game of Obamacare because it forecasts a 2.5 million job reduction by 2024 due to the effects of the health care ...

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Even the best of families have skeletons: the uncle who had some shady business dealings, the cousin in drug rehab, brother with the messy divorce and custody fight, or the adult kids who are maxed out on their credit and behind in their mortgage payments but have to “keep up appearances” with their expensive suburban lifestyle.  When these things happen, there is a tendency to “keep it all in the ...

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As the patient-centered medical homes (PCMHs) train charges forward along with implementation of the Affordable Care Act, dollars are taken directly out of our health care system to certify providers in a method with no proven benefit. And, while there is a marked shortage of primary care providers nationwide, funds that could be used toward providing the direct provision of, or access to, health care are instead devoted to accreditation, ...

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Is Obamacare unraveling? Rumors have been circulating in the marketplace all week that the administration was thinking of extending the individual health insurance policies that Obamacare was supposed to have cancelled for as much as three more years. Those rumors have now come out into the open with Tom Murphy's AP story that began running recently. That the administration might extend these polices shouldn't come as a shock. My sense has always been ...

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A little over a month ago, my family of five moved to a more spacious and modern house in the same neighborhood. I'm slowly getting adjusted to our new place -- the locations of the light switches, how to operate the refrigerator's automatic ice maker, which cycle to choose among the dozen different options displayed on our high-end washing machine. It still takes me a few minutes longer to get ...

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In describing why Cooper Union, a unique college that offers absolutely free education to students, would effectively die if it starts charging tuition, Kevin Slavin wrote:

For many of us, Cooper wasn't even the cheapest way to go to school...So the question is: why did we go? We went not because of the financial value of free--that is, zero tuition--but rather, because of the academic value of free. At Cooper Union ...

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A primary criticism of the Affordable Care Act is that it creates incentives for employers to hire fewer full-time employees. One of the House’s attempts to repeal the ACA even referenced it as the “job-killing healthcare law.” It’s true that there are some provisions in the ACA that employers may exploit in order to minimize the cost of doing business. At the same time, it’s also true that the ...

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Trauma surgeons earn their patients’ respect every day, acting decisively in the face of calamity and uncertainty, heroically beating back death with steel blades and iron wills. Primary care physicians, however, have traditionally been at a relative disadvantage with regard to public opinion. After all, reconciling medication lists, reviewing lab results, and discussing health behaviors simply aren’t as exciting. In fairness, though, surgeons have always had one other advantage: anesthesia. ...

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Next in a series. Primary care physicians (PCPs) have too little time per patient which means too many referrals to specialists, too little time listening and thinking, no time to delve into the stress or emotional causes of many symptoms and substantial frustration by PCP and patient alike. Previously in this continuing series on primary care, I described a patient with a straight forward if unusual symptom who was bounced ...

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