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What The Founding Fathers Would Say About HR 3962

DrRich has not read the healthcare reform bill (HR 3962) passed by the US House of Representatives late Saturday night, and he does not plan to. He spent far too much time this summer wading through the prior version of the bill (HR 3200), only to conclude that it did not say anything in particular, but rather, was intentionally vague on most key points. The new bill, being nearly twice the length of HR 3200, must necessarily be twice as vague.

So that anyone hoping for DrRich’s analysis of the new bill won’t go away disappointed, he offers here an observation on the new bill, which, he asserts, you can take to the bank.

The observation originates from James Madison, the primary architect of the US Constitution (and ironically, a founder of the Democratic Party). It is an observation DrRich quoted this past summer in reference to HR 3200. It holds doubly well here:

“It will be of little avail to the people, that the laws are made by men of their own choice, if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood…” – The Federalist #62 Read more »

*This blog post was originally published at The Covert Rationing Blog*

Preventive Medicine – Is It Now Politically Correct To Brush It Aside?

As a class of human beings, cardiologists do not enjoy subtlety or nuance. Indeed, the reason most of them chose to specialize in cardiology, as opposed to specializing in some other organ system, is that the heart is the most unsubtle organ in the body. Unlike, say, the liver or the kidneys or even the brain (which, after all, just sit there), the heart does something quite obvious, and furthermore it does it 50 – 100 times per minute (so that even a physician with a very short attention span is likely to notice).

So perhaps it is not surprising that cardiologists seem to have entirely failed to mark certain emerging – and quite subtle – currents in the “preventive health” movement, and accordingly, continue to unabashedly seek more and more “preventive tools,” whatever the cost, with all the sensitivity and social awareness of the cousin who obliviously shows up at the funeral of the family priest wearing a pro-choice lapel pin. Read more »

*This blog post was originally published at The Covert Rationing Blog*

Healthcare Reform – A Guide For the Perplexed

As the great campaign to reform the American healthcare system heats up and enters an important new phase – the phase in which key legislative leaders take the five bills that have been passed, here and there, by sundry Congressional committees, and, behind closed doors, attempt to cobble together a compromise bill which they believe they can threaten and/or bribe a majority of Congresspersons into supporting – many Americans find themselves confused about what it all means. What, after all, are we attempting to accomplish here? How much will it cost, and who will pay for it?  Why does the whole process seem so darned difficult and confusing?

Fear not. As a public service, DrRich will now explain healthcare reform in a very simple way, so that – whether you study the issue closely on a day-to-day basis, or just accidentally come across some relevant headlines now and again as you look for the sports page – you will always know what’s going on. For, once you understand a few key concepts, this thing is really pretty easy to follow. Read more »

*This blog post was originally published at The Covert Rationing Blog*

The Health Plan Lobby’s War For Survival

This past weekend, AHIP – the American Health Insurance Plan trade group – seemed to turn at last against healthcare reform. For nearly a year the AHIP stood silently by, and indeed often made noises in support of the administration’s reform efforts, despite being cast by reformers as the chief villains of American healthcare. Then suddenly, a few days ago AHIP released a study produced for them by Price Waterhouse Cooper which concluded that healthcare reform (at least as advanced by the Baucus Senate Finance Committee) would result in massive increases in insurance premiums for Americans.

Becoming an apostate has always been far worse than being a mere infidel, and the AHIP action (seen as a act of betrayal and not merely an expression of opposition) has invoked the wrath of the powers that be. Democrats and progressives everywhere have quickly responded. Read more »

*This blog post was originally published at The Covert Rationing Blog*

Threat Of Medical Malpractice Is The Only Force Opposing Healthcare Rationing

DrRich’s conviction that covert rationing is the engine that drives many (if not most) of the bizarre behaviors we see in the American healthcare system leads him to take positions on certain contentious issues that do not endear him to either his progressive or his conservative friends.

One of these issues is malpractice liability reform.

DrRich wrote about this some time ago (here and here), and as a result managed to alienate more than a few of his readers, especially the ones who are doctors. So if he were smart, DrRich would leave it alone. (After all, a lot of readers have long since forgotten precisely why they do not like DrRich, and merely harbor toward him a vague sense of unease and distrust. This, DrRich finds, he can live with.)

But a couple of things prompt DrRich to take up this topic once again.  Read more »

*This blog post was originally published at The Covert Rationing 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?

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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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