• America’s Healthcare Split Personality – Insurance, Fees and Care

    A whole series of contradictions are apparent in the national consciousness about health care insurance and costs.  Some of these have always been at or near the surface, while others have emerged because of the looming apparition of Obamacare. For years people spoke about the …

  • Drugs, Medicare, Physicians, and Using Computers for Better Care

    A couple of years ago there was a report by ABC news that Americans used more prescription painkillers than the whole rest of the world. (World News with Diane Sawyer, Jim Avila, and Michael Murray, April 20, 2011). The United States has 4.6% of the …

  • President Obama Should Follow Willie Sutton to the Money

    Recently, the president of the Kaiser Family Foundation called for realism on health care costs.(Altman & Levitt, “We still have a health-care spending problem,” Washington Post. WSJ 4/22/13).  He challenged the idea that health care costs have now been contained and pointed out that in …

  • No Shiny Object? Execute on the Fundamentals

    This country has lacked a national health insurance system, something found in all other developed countries, but not universally accepted as necessary in the United States. On March 23, 2010, President Obama signed into law, the Patient Protection and Affordable Care Act to provide health …

  • Accountable Care is Accountable to Whom?

    A big part of Obamacare is to encourage the development of accountable care organizations in order to realign “provider incentives with patient needs for better care at lower cost.” To do this will require physicians “to seek employment with health systems or large physician groups.” …

  • Flesh-Eating Bacteria: How Regularly Do You Wash your Hands?

    Recently in a health club, a young woman finished on a rowing machine and used a conveniently placed bottle of disinfectant and a cloth to wipe off the sliding seat, but not the hand bar that she used to pull.  Shortly thereafter, an older woman …

  • How Much is that Doctor in the Window?

    The shortage of physicians, the high cost of a doctor visit, and the need of retail pharmacies to increase profitability have combined to produce a series of phenomena that were largely unimaginable a few years ago.  And, this has happened before the more acute physician …

  • Oh Concierge! Medical Care S’il Vous Plait!

    During the debate of 2009-2010, a major purpose of Obamacare was to make medical care available to large numbers of people who could not otherwise afford access to primary care physicians.  A key factor overlooked in this discussion was the existing and expanding shortage of …

  • A State Response to Runaway Medicaid Costs

    Recently, the emphasis on trying to control health care costs has shifted to put providers together into Accountable Care Organizations, Medical Homes, and now, from Oregon, Community Care Organizations. (“Oregon’s governor bet $1.9 billion that he could fix Medicaid,” Washington Post,  1/20/13).  In one way …

  • TB Remains Ever Present, Virulent, Ready To Kill

    There is a passage in Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, by Tracey Kidder (Random House,  2004 ), the  story of Dr.Farmer and his work in Haiti and in confronting multi-drug resistant tuberculosis (TB) in …

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