Public Health & Policy

Americans are not fans of socialized medicine. Sure, some people want socialized health care payment, including many people who are fans of Medicare for all. But even most Bernie Sanders supporters probably aren't in favor of socializing the entire U.S. health care system, thereby making hospitals and medical clinics into government property. Americans are proud of the high quality of care offered by non-government providers, from their local community ...

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Karen smiled nervously, her swollen belly peeking out from under her stretched silver tank top. Six months pregnant with her first child, the eighteen-year-old had come to the WIC (Women, Infants, and Children) office for help with getting enough to eat. As a medical student with a background in nutrition advocacy and a future in pediatrics, I had asked to observe the WIC enrollment process.

Karen and ...

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In an earlier post, I pointed out that there is no better chance of passing a Medicare for all health care plan through Congress in the coming years than there was in 1977, or 1993, or 2009. Then Elizabeth Warren showed us just how politically unrealistic single-payer health care is when she released her funding plan and then quickly backtracked to the public option ...

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I think it’s time for physicians to end the assault on the clinical practices of PAs and NPs. Are you worried about PAs and NPs taking your job? If you’re a good doctor, you should stop worrying. Great PAs and NPs are everywhere, and I think it’s time physicians embraced them. PAs and NPs have excellent skills My first rotation as a third-year medical student was in the emergency department. There was a ...

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Of the nation’s 3.5 trillion in annual health care spending, 90 percent is for people with chronic and mental health conditions. How long can this continue? Can health care institutes afford not to engage in the 2020 wave of preventative care health care disruption? For those riding the disruption wave, the answer is simple. CMS alone is providing more than 80 billion in ...

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“Listen to your patient; he is telling you the diagnosis.” This quote from famous physician William Osler is as true today as it was 100 years ago. And yet the latest version of President Trump’s executive order on Medicare threatens what patients overwhelmingly want: a physician involved in their care. Section 5-C of the President’s order focuses on payment parity and supervision of mid-level providers. Changes to either issue would create unintended ...

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Throughout my career, I've contemplated what it means to be a good doctor. While I still cannot fully articulate it, I know a good doctor when I see one. She's the masterful diagnostician who can solve any medical mystery. He's the physician-scientist who spends countless hours on finding a cure for HIV. She's the colleague on my right, arguing on the phone with a patient's insurance company to get a ...

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The practice of medicine is limited by what we can control. As students, we are taught to believe in the power of science, the importance of hard work, and the momentum of technological advancement as prime determinants in our patients’ outcomes. However, as we get further along in our careers, we come to realize that many of the factors that contribute to poor health are beyond our control at ...

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There are certain paradoxes of life that are beyond the realm of rational explanation. To me, one of such is that a country that figured out how to defy gravity and conquered the cosmos has time and time again proven to be incapable of taking care of the most basic human need, namely: a commonsense health care delivery system. U.S. spending on health care in 2016 was estimated at about 17.2 ...

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Empathizing with others' suffering is one of the most human expressions in life. For empathy to nurture, like any other emotion, it needs time and space, and in none other professions, this maxim is codified as profoundly as in medicine. Even in the times of pre-modern medicine, humans had the temptations to heal fellow humans' suffering from ailments about which they knew little and had no therapeutics to offer. Nevertheless, ...

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Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate. I was, however, honored ...

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The standard business model around which our world revolves has no place in the “business” of human life, which is what the commercialized industry of health care has become. To be the most successful, businesses work to optimize profits by minimizing their operating costs, which include material resources and all the steps involved in distributing their product. This business model, in some form, is applied universally from the manufacturing and ...

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At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites. Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a ...

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The Republicans don't yet have a health care plan less than a year before the 2020 elections. But based upon their 2017 Obamacare repeal and replace efforts, as well as a major document recently issued by the House Republican Study Committee, what might a Republican plan look like? First, let's review the plan House Republicans passed in 2017 during their failed repeal and replace efforts. House Republicans would have repealed the Medicaid expansion ...

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As the year winds down and must-pass year-end spending bills are completed -- and with that, any chance of attaching and approving health care legislation -- the special interests have won big, and consumers have lost big. Employers, unions, and insurance companies won big with the repeal of the "Cadillac" tax on high cost-benefit plans at a cost of $200 billion over ten years as well as the repeal of the ...

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Next in a series. The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or insurers) have a natural incentive to fulfill each of those jobs. Those incentives arise naturally, but the big challenge is shaping ...

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Over the past 40 years, the number of U.S. hospitals declined by 12 percent, from more than 7,100 in 1975 to 6,200 in 2017, according to the latest American Hospital Association survey. And, yet, despite shuttering nearly 1,000 facilities, hospitals remain the nation’s largest source of health care spending, accounting for $1.1 trillion annually (or 33% of all national health care expenditures). Much of that money goes ...

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Fixing Obamacare and adding a public option is the health care policy territory first staked out by Democratic Presidential candidate Joe Biden. Writing about Biden's plan recently on my blog, I said:

If the Democrats capture the White House, keep the House, and take over the Senate, no matter who they elect as President, this Biden health care outline, not Medicare for all, will likely be the plan Democrats ...

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As presidential hopefuls debate health care reform, it is becoming increasingly difficult to distinguish statements rooted in fact from fiction. According to PolitiFact, only 27% of politicians’ media statements regarding health care — whether from Democrats or Republicans — are true or mostly true. Discerning the truth in a growing state of convolution is becoming increasingly difficult. In such a medical and political quagmire, it behooves health ...

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