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The Republican Healthcare Plan: The Good, The Bad, And The Ugly

I am all for any proposal that will improve heath care in America. Improvement means controlling costs, covering all Americans so no one has to worry about going bankrupt to pay for health care. Improvement means access to quality care without having to worry about losing your job, which means losing your coverage. Improvement means a system where all incentives are aligned to prevent disease, rather than using expensive technologies and hospitals to treat disease after the fact. Any proposal that gets us there has my vote.

In the GOP “Path to Prosperity” budget for 2012, they propose a few things that are good and a few big things that are bad…really really bad. First the good. Capping the medical malpractice lawsuits for “pain and suffering” would be a huge step forward. Patients should be compensated for medical errors but the “hit the lottery” windfalls for pain and suffering are costly drivers that make no sense. There is no place in the world, besides the USA, that has such onerous medical malpractice lawsuits. And they drive up cost for everyone. Read more »

*This blog post was originally published at EverythingHealth*

Healthcare Reform: The State Of The States

States are varying in their reactions to healthcare reform:

Wisconsin is creating an office of healthcare reform to develop its health insurance exchange and explain changes to constituents.

Tennessee won a court ruling to remove 100,000 from its Medicaid rolls.

— Leaders in 18 states vow to challenge the new law in court. But in Idaho, a challenger for the governor’s office proposes instead taking advantage of a federal waiver that exempts states that enact reforms that control costs and improve access better than the federal laws do. (Milwaukee Wisconsin Journal Sentinel, Kaiser Health News, Reuters, Idaho Reporter)

At the federal level, President Obama and supporters continue to try to sell the reforms to Americans while the opposition tries to figure out its next steps. “Soak the rich” might be one phrase to revive, but they’d do best to distance themselves from the tea-baggers, who have spiraled out of control. (The Hill, Los Angeles Times, USA Today)

*This blog post was originally published at ACP Internist*

Good Health Doesn’t Come From Good Insurance

The CDC has put out an interactive map of heart disease and stroke so you can compare your state or even county with the rest of the country.  It offers data on mortality, hospitalizations and  even penetration of  generalist and subspecialist availability.

What I found interesting was the lack of definitive association between access to generalists or subspecialists and mortality.  While rural areas with a low penetration of physicians generally had a higher mortality than urban centers,  many urban centers with a high penetration of generalists and subspecialist also had a high mortality as well. One could presume that rural America has many factors separate and independent of health care that affects their mortality rate.  The same could be said for urban America. Read more »

*This blog post was originally published at The Happy Hospitalist*

The Battle Begins Between States And Feds Over Control Of Health Insurance

The battle between the states and federal government begins.

Yesterday, Illinois Insurance Director Michael McRaith told an audience that state insurance regulation is “under attack,” but that the states will prevail because they “do it better.”

Following a line of reasoning I highlighted last week, McRaith suggested adding federal regulation onto the existing state system would be duplicative, burdensome and fraught with the potential for conflict.  McRaith said that insurance was such a uniquely local business that the states were best suited to regulate it. Read more »

*This blog post was originally published at See First Blog*

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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