And that's precisely what's obstructing any meaningful reform. Princeton economist Uwe Reinhardt talks about how the American people wants to have their cake and eat it too, and devises an "all-American wish list" of what ideal reform should look like to the American public. It includes such items as, "Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to ...

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Here are the top posts from the past month, based on the number of times they were viewed. 1. Did propofol, or Diprivan, kill Michael Jackson? 2. The AMA and Sermo break up, and how it’s getting ugly 3. Improve primary care access before guaranteeing universal health coverage, my address at the National Press Club 4. America’s failed attempt at a single-payer system, the Indian Health Service 5. Can doctors ...

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The following is part of a series of original guest columns by the American Medical Association. by J. James Rohack, M.D. american medical associationAs members of Congress return to their districts this month, it should be a time for thoughtful dialogue on health system reform so that when lawmakers return to Washington they can complete their work. Physicians nationwide are ...

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In the spirit of the vigorous town hall meetings across the country discussing health care reform, I'll be taking your questions on the topic today at 12:15pm Eastern. I'll open up the forum a few hours before; just click on the Live Q&A window below. You can ask your question when the Q&A opens, in the comments of this post, or Tweet them to #kevinmdqa. I'll try, but cannot guarantee, ...

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Is eliminating the presence of all disease a worthy goal? Gilbert Welch is part of the Dartmouth group of physicians and policy experts who advocate that we're doing too much testing and finding too many diseases. He asks, what exactly does "health" mean, and should it be defined as the absence of disease? Over time, the definition of "normal" has narrowed. For instance, more patients are being diagnosed with ...

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The United States is often compared, unfavorably, to health care systems of other countries. But it's refreshing to read that, yes, there are indeed countries that are worse off than we are. (via Ezra Klein) Like Russia, which allocates significantly less than the World Health Orgnaization's recommendation of 5 percent of government spending to health care. It's a hybrid public-private system gone wrong:

Ninety percent of Russians are technically covered. But, ...

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That's a controversial question that emergency physician Edwin Leap asks in a recent column. What's missing in the current health reform proposals is language enforcing one's sense of personal responsibility. So, as Dr. Leap writes, "there are people who really don't deserve health care reform . . .The 'elephant in the room' is that some patients (rich and poor alike) do nothing to care for themselves, take no responsibility for ...

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And it's not always because, as is portrayed in the media, that they get rich from doing so. I, or many other doctors, do not make a dime if I send a patient for an MRI. Rather, it's because there is financial incentive to see and churn through as many patients as humanly, or in some cases inhumanely, possible. Chris Rangel has a nice list, giving 10 reasons why doctors order ...

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Reducing health spending, as Congress is finding out, is difficult. Some health economists have pointed to medicalization of common complaints, like erectile dysfunction and attention deficit hyperactivity disorder, as one reason. Indeed, Dartmouth researchers, who are cited as favorites of the current administration, feel that an "epidemic of diagnoses" is what's making us sick. But, Darshak Sanghavi writes in Slate that this may be a red herring, and clouds what's ...

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Among physicians, there's tremendous contention as to who represents the "true" voice of doctors. There are indeed various lobbying groups, but as Stanford's Abraham Verghese writes in a recent WSJ column, "Our esteemed medical societies and academies aren't speaking for medicine; they are lobbyists, defending their financial self-interests, lining up for or against the latest bill being proposed," and that, "our great academic institutions and our esteemed medical schools have ...

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