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When You Get Sick: The Character Of Those Around You

There’s an endless list of bad things about being sick. But what happens to the relationships you have with people around you when you become ill?

Let me tell you about a man I know. I will call him Bill, even though that’s not his real name.

Bill is a vital man in his 60s with two grown daughters. A few years ago, he was diagnosed with a serious illness. His illness isn’t going to kill him right away, but it has profoundly affected his ability to work and enjoy all the things he used to enjoy. Worse, he has had a difficult time with his doctors figuring out what exactly is wrong and the best way to proceed.

But all of this isn’t really the hardest part for Bill. The hard part for Bill is how his friends and family have reacted. Read more »

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

Health Insurance And “Medical Loss Ratio” Foolishness

Like Ezra Klein, smart people keep saying foolish things about the health insurance business. This time it’s a pair of bloggers talking about the largest expense that health insurers face — their “medical loss ratio.”

According to Richard Dale at the Venture Cyclist:

[W]hy do they call it Medical Loss Ratio? Why is looking after me (or you) called “Medical Loss,” when the whole point of a healthcare system is to look after me (or you)?

(Sigh.)

Alan Katz, one of the leading health insurance bloggers, surprisingly links to this with approval, saying “words matter.” The problem? The word “loss” is probably one of the four oldest words in the insurance industry. I’d say the others are probably “premium,” “commission,” and “profit.” Should we start outlawing these words, too? Read more »

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

Will Large Employers Dump Healthcare Coverage?

Fortune magazine has made some news recently about the impact of healthcare reform on large employers:

Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill’s critics predicted, and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the healthcare coverage they provide to their workers in exchange for paying penalty fees to the government.

The only trouble? There’s no way these employers are seriously thinking about doing this.

I can understand why the employers would do the math. According to healthcare reform law, penalties for failing to provide health coverage are a small fraction of the cost of that coverage. But as with most everything else in healthcare, there’s much more to it than just a simple math equation. Here’s what I mean. Read more »

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

Why Creating Healthcare “Consumers” Won’t Work

I [recently] gave a speech at the Midwest Business Group on Health’s (MBGH) 30th Annual Conference. The MBGH is one of the country’s leading organizations on healthcare, and its members include the leading innovators and thought leaders on healthcare in America. It was a privilege to present to them.

I spoke about why healthcare just isn’t a consumer business in spite of all of the effort to turn people into healthcare “consumers.”

At Best Doctors, we have a closeup view of what happens to people when they try to find their way through the healthcare system. It’s not a pleasant picture. Healthcare consumers –- if you can call them that –- are often lost, confused, frustrated, alone. Read more »

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

When Healthcare Incentives Go Wrong

Giving people “incentives” to spend their money wisely is a growing part of the solution to rising healthcare costs. Give people financial responsibility for their healthcare decisions, the thinking goes, and they’ll make cost-effective choices.

It’s usually done by having people pay part of the cost of their employer-provided health coverage, and through things like higher deductibles and co-pays. Today, on average, people in the private sector pay 20 percent or more of the cost of their coverage. The trend is for this number to go up. But it’s not true everywhere. 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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