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Another Reason To Reform Employment-Linked Healthcare

Free Agent Nation.jpgAn article by Paul Davidson in this morning’s USA Today reminded me of another reason why we need health care reform in the United States, or at least a move away from employment-linked health coverage: temporary employees may soon comprise 25% of the national workforce.

An encouraging jobs report Friday underscored the growing prominence of temporary workers who some experts predict could constitute up to a quarter of the workforce in a few years.

A big reason employers shed a far-less-than-expected 11,000 jobs last month is that temporary staffing agencies found slots for 52,000 additional workers, the most since 2004, the Bureau of Labor Statistics (BLS) said.

Temp workers don’t draw full health benefits from most employers and must therefore seek high-cost personal policies or pray that their spouse has family health coverage. Read more »

*This blog post was originally published at Terra Sigillata*

Geographic Variation & Healthcare Reform

On the heels of the American Hospital Association’s recent demonstration of gross discrepancies in the Dartmouth group’s data, MedPAC released its December 2009 report to Congress showing the same. Confirming data for 2000 (reported in their 2003 report), MedPAC demonstrated much less variation among states and metropolitan statistical areas (MSAs) than described by Dartmouth for states or hospital referral regions (HRRs). Closer scrutiny of MedPAC’s data reveals even more. Read more »

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

Is This A Healthcare Crisis Or A Culture Problem?

I got an email today laying out the reality of our current health care debate.  Is it a crisis of culture or a health care crisis.  I am a firm believer in taking responsibility for one’s actions.  I believe those who chose not to practice healthy lifestyles should pay more for the consequences of their actions than those who do.  I believe the solution to our health care finance quandary lies not in controlling the  cost of treating disease, but rather in upholding the personal responsibility all Americans have to themselves and their country.

What does the distribution of health care dollars look like among the American population?  While we know that 50% of our population spends only 3% of health care dollars, we also  know that 50% of our health care dollars are spent by 5% of our population, a population of chronic disease sufferers who’s diseases  are, by and large,  a direct result of the personal decisions they chose to make on a daily basis.  For the most part, genetics alone is no longer an excuse.  We knew very well that lifestyle directly affects the expression of disease by genes. Read more »

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

Hidden Costs In The Healthcare Reform Bills: How To Fake Budget Neutrality

President Obama said he will not sign a healthcare reform bill that was not budget neutral. You can view this statement at 3.50 minutes into this video clip.

The only way that can happen is if the healthcare expenses in both bills are hidden, unrealistic expense estimates are or expenses deflected to other areas in the budget. The Senate and House bill do both. Read more »

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

It’s All the Same: Love The Docs, Hate The System

I’ve spent the last few days with much of our European team, today in Madrid, Spain.

Here are a few quick observations, as the American reform process continues.

1.  Every country’s health care system has developed in the unique circumstances of its history.  That is, the health care system of each country is the result of a collection of changes, fixes, restrictions, reforms, market developments and whatever else has happened over the last several decades.   The result in each country are systems that work better or worse, but which in most all cases are very confusing to the people that work in them or get care from them. 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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