Medicine
Welcome to my blog
I've started this Blog as a medium for sharing my thoughts on health and health care. Obviously, health is a personal issue, but these days health care is a very public issue subject to heated debate, especially in my home town of Washington, DC. There's a lot of talk about how the plans currently being debated will "ration" health care, as if rationing is inherently a bad thing. But that view would be a reasonable one if you believed that health care isn't already rationed - which it is. Just lost your job and can't afford COBRA? No health care for you! Have a pre-existing condition? Then pay your own way. Can't afford the copay for that procedure? That's rationing too. And the inherent problem with our current "non-system" of care is that it's, well, irrational, as Peter Singer describes eloquently in a recent article in the New York Times Magazine.
Politicians like to talk about the health care "safety net," consisting of clinics who care for the uninsured or uninsurable (e.g. undocumented immigrants). The heroic efforts of clinicians and staff who run these clinics, often for low pay and exceptionally long hours, do indeed make a difference and save lives. But for every patient who manages to make it to a free or low-cost clinic, there are 3 more who end up in an emergency room, often with diseases that are preventable with routine, relatively low-cost visits to the doctor when well. For a quick primer on the value of prevention in health care, see Pauline Chen's NYT column from yesterday.
That's all for now. I plan to post to this blog at least once per week, so please check back (or sign up to follow new posts) if you'd like to hear more.
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Medicare: Consumer Choice Or Choosing Your Poison? How About Coverage For Everyone?
It is now after December 7th, and Medicare recipients have had their open enrollment period and made their choices for next year. Good or bad, affordable or bank-breaking, is something they will find out during the coming year. Will their policy allow...
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Immigrant And Refugee Health
The New York Times (March 29, 2008) has a front-page story about the challenges faced by clinics caring for large numbers of immigrants and refugees.[1] It focuses on the International Clinics at Hennepin County Medical Center in Minneapolis, MN, and...
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Striking Back At The True Rationers Of Health Care
In February, I predicted that Don Berwick would not survive the partisan politics surrounding his recess appointment as administrator of CMS (Centers for Medicare and Medicaid Services), and regrettably, Dr. Berwick indeed stepped down from that position...
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Don Berwick On Patient-centered Health Care
I'm a big fan of Don Berwick, the current administrator of the Centers for Medicare and Medicaid Services who last week was on Capitol Hill being grilled by a congressional committee on his views. Although Dr. Berwick (a pediatrician by training)...
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Outsiders' Perspectives On Primary Care
You've probably had the experience of going to see a primary care physician and wondering about the many aspects of that visit that just didn't make sense. Why is it so important for me to arrive on time when, in reality, I won't be called...
Medicine