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Large Hospital Systems Are Driving Up Healthcare Costs

The primary stakeholders in the healthcare system are patients and physicians. Without patients or physicians there would not be a healthcare system.

Patients should be the drivers of the healthcare system. They are not. The primary drivers are the government and the healthcare insurance companies.

Hospital systems play the next largest role in driving up the costs of the healthcare system. Large hospital systems are constantly playing a game of chicken with the government and the healthcare care insurance industry.

Somehow, large hospital systems have been able to stay under the radar.  They have been able to avoid the responsibility of the rising costs of healthcare.

Large hospital systems and large hospital chains know that insurers need them to service their network of patients.  The healthcare insurance companies know that the hospital systems can hold them hostage to increased reimbursement.

When a large hospital system demands an increase in reimbursement the healthcare insurance industry simply increases premiums.

An example is the Read more »

*This blog post was originally published at Repairing the Healthcare System*

Healthcare, Finance, And Poverty: Fault Lines Intersected

Solutions to problems are generally sought from within the problems themselves. Two recent examples are healthcare and finance. In both cases, the solutions are believed to be better-structured and regulated systems. In blogs, articles and speeches, I have stressed that — while there are myriad ways that healthcare can be improved — the real solutions to high healthcare spending lie outside of healthcare.

Poverty and its associated manifestations are at the core of the healthcare spending crisis. The high costs of caring for the poor will continue to overwhelm the system, no matter how it’s structured and improved. Rather than looking for solutions through changes in process and regulation, the major solutions to healthcare’s excessive spending reside in areas such as K-12 education, neighborhood safety, and the creation of jobs that can lift low-income families from the cycle of poverty.

Simply stated, the U.S. does not and will not have the resources to provide equitable care for those among us who confront inequitable circumstances in every other aspect of their lives. Read more »

*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*

KevinMD Suggests Insurance Companies Pay Primary Care Physicians More

I’ve often given doctors too little credit when it comes to business decisions.

But, in an op-ed published at Reuters, physician Ford Vox argues otherwise.

He notes that doctors, indeed, have tremendous business sense:

How can anybody say that doctors don’t have business sense, when not only do most American physicians forge their way in small private practices, but new doctors lay their cards on the table every year? The competitiveness of residencies, where doctors train to become a pediatrician or a cardiologist, correlates strongly with the field’s earnings potential. Read more »

*This blog post was originally published at KevinMD.com*

Why You Should Contribute To The Health Insurance Risk Pool

Gather round boys and girls. Today’s lesson is on “risk pools.”

Before you pull out your iPhone to ward off the boredom you assume will come, know this: the concept of risk pools is at the heart of today’s healthcare reform debate.

To understand risk pools, you first have to understand the basic concept of insurance. Insurance is something you buy in case something happens. The more people buying the same type of insurance, the less risk the insurer faces that it will have to pay out for that aforementioned “something.” Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine and Health Care*

Waste In The Healthcare System: An Allegory

AUTHOR’S NOTE: I am very frustrated with a system that increases cost dramatically and yet reduces what I get paid. The rest of the money is going somewhere, and since it is not improving the overall quality of care, it is mostly waste. We are enamored with MRI scans, stents, and expensive cancer treatments, with little to show for them except increased expenses and a lot of third parties getting rich off of this waste: drug and device manufacturers, medical imaging companies and other para-healthcare industries. This story, which originally appeared at Musings of Distractible Mind, is prompted by my frustration with waste and how it spurs unneeded health care delivery.

Once upon a time there was a land on the ocean. The people lived off of the food from the ocean and were very happy. But as they grew bigger, they had a problem: They made a lot of waste! Yuk! Nobody likes waste. What could they do about all of this that stuff that nobody needed? Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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