April 1st, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
No Comments »
The larger the bureaucracy the more inefficient a system becomes. Several things can happen in the decision making process.
1. The decision making process can become opaque rather than transparent.
2. Decisions are made by a committee by consensus.
3. Consensus committee decisions might not sharply define the original goals.
4. Blame for errors gets dissipated.
5. Decisions are only as good as the information that is gathered.
6. Changing a wrong decision can be difficult and costly.
President Obama’s healthcare reform law is creating 256 new agencies to gather information and recommend decisions for other agencies to write regulations.
The following decision is being made by an agency in Washington state. It is not only the wrong decision, but is a decision that will set back the care of Type 2 Diabetes Mellitus 15 or 20 years. It is a decision being made using the wrong information. Read more »
*This blog post was originally published at Repairing the Healthcare System*
January 10th, 2011 by RyanDuBosar in Better Health Network, Health Policy, News
No Comments »
Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate.
But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal.
Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. House Speaker John Boehner said, “I don’t think anyone in this town believes that repealing Obamacare is going to increase the deficit,” although Republicans have already exempted a repeal of the healthcare law from new rules prohibiting legislation from adding to the federal debt. (Politico, Kansas City Star, [Aurora, Ill.] Beacon-News, USA Today, CNN)
*This blog post was originally published at ACP Internist*
December 6th, 2010 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion
1 Comment »
Flush from their big win in the midterms, the Boehners are vowing to repeal and replace the Big O’s health reform law. They pose a legitimate threat, but an even larger one lies in the courts, where suits challenging the constitutionality of the law have been popping up like fireflies on a late August night.
In Virginia for example, Republican-appointed Federal District Court Judge Henry Hudson has indicated that the Individual Mandate — a key provision of the law that has been challenged in a suit filed in his court by the state’s Republican Attorney General — might not pass his sniff test.
Hudson said he’d rule on the matter this month. If he deems the provision to be unconstitutional, he might (it’s unlikely, but he might) enjoin the law altogether until higher courts rule on the matter. Holy Kazakhstan, Batman!
An official at Camp Obama, who spoke with the New York Times under the condition that his name not be WikiLeaked, acknowledged that Hudson’s thumbs appear to be pointing downward, indeed. Read more »
*This blog post was originally published at Pizaazz*
November 25th, 2010 by DrRich in Better Health Network, Health Policy, Humor, Opinion, True Stories
No Comments »
In what has become a tradition over the past few years, DrRich proudly reprises his annual Thanksgiving message to his beloved readers:
Gathered around the Thanksgiving table, DrRich’s large extended family, carrying out a longstanding tradition, each offered in their turn one reason for being thankful on this most reflective of American holidays. DrRich listened respectfully as each of his loved ones, and each of the ones he was obligated to tolerate benignly because they had married (or in some other manner had committed to) one of his loved ones, recounted a cause for thanks.
There is no need for DrRich to recite their utterances here, because they were all perfectly predictable and fairly mundane, having mostly to do with items such as maintaining good health, finding a job, being able to afford one’s mortgage payments, getting a passing grade in French, receiving a new puppy, Mr. Obama’s remarkable presidency, the apparent continued structural integrity of the Universe despite Mr. Obama’s presidency, etc., etc.
When it was at last DrRich’s turn, he, in retrospect perhaps somewhat inadvisedly, was unable to refrain from displaying his keen insight and superior analytical abilities on matters related to healthcare (a topic, anyone would have to admit, about which most of us would very much like to feel thankful). Lifting his glass, DrRich pronounced that he was most deeply and humbly thankful for the 47 million Americans without health insurance.
And further, especially thankful that their ranks must surely be growing, given the recession, advancing unemployment, imminent collapses of businesses and indeed entire industries, etc. And even though Obamacare promises to significantly reduce that number, DrRich went on to express his fervent wish that large numbers of the uninsured might still be with us a year and two years and even ten years hence, for the great and good benefit of us all. Read more »
*This blog post was originally published at The Covert Rationing Blog*
November 8th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
No Comments »
“So, what do you think about the election?”
“So, what do you think about Obamacare?”
“What do you think about this healthcare situation?”
I get these questions throughout my day. My patients are mostly suburban and white, so their view is overall on the conservative side. Yet I have found that few see the results of the election as a hopeful sign for healthcare. I don’t either.
Anyone who reads this blog regularly knows that I am a “flaming moderate” when it comes to politics. I don’t have much faith in anyone who identifies too strongly with one party of the other. I am really angry with congress and their lack of gonads to work on really coming up with solutions. Interestingly, my patients, regardless of their political leaning, agree with much of what I say. Here are the things they all seem to agree with:
1. Congressional politics is hurting us. Members of congress (both sides are equally guilty) are more focused on what is good for their party than what is good for those who they represent. If a democrat is elected to this district, I expect him/her to represent all of the people in that district, not just the democrats (the same is obviously true for republicans). This doesn’t mean they must lose all of their ideology, but ideology should be a means, not an end. The reason to hold an ideology is to come to solutions to problems with that ideology as a vehicle. The goal is to help the people you represent through your ideology, not bang them over the head with it. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
