1) In response to declining primary care numbers, Bernie Sanders (Ind.-Vt.) proposed expanding funding for government programs to forgive loans for physicians that agree to practice primary care in under-served areas.

My take: That’s like using a thumbtack to plug a bursting dam. The solution needs to be significantly more dramatic to gain the attention of medical students gravitating towards better paying specialties.

Two things need to happen: i) all student loans need to be forgiven for new doctors choosing to enter a primary care specialty, regardless of setting, and ii) salaries between generalists and specialists need to be fairly reconciled.

Expect nothing to change unless those points are addressed.

2) Despite spending more money, patients with spinal problems feel worse in 2005 than they did in 1997.

My take: Another example where more medicine may be less. Patients have a hard time understanding this. The public is conditioned that “something needs to be done” for their symptoms, and the fact that less treatment may have equivocal results is a hard concept to grasp.

3) Blue Cross of California asks physicians to rat out patients lying on their insurance forms.

My take: Insurance companies expect physicians to do their dirty work for them. What insurers really need some basic lessons in PR. But I guess when you’re already at rock bottom, there is nothing to lose by pulling a stunt like this.