Why You Should Look to Lean Between Repeal and Replace
Nov29

Why You Should Look to Lean Between Repeal and Replace

President Elect Trump has said what he will do with the ACA. What will you do if he carries through with his intent? I can’t answer that question for you, but I am delighted to give you unsolicited advice. I was recently reminded of how important it is to remind ourselves of things for which we are “fanatical”. Let me digress. For several years I have been trying to read David Foster Wallace’s Infinite Jest. I thought that Joyce’s...

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Donald Trump’s Promise
Nov22

Donald Trump’s Promise

Where Does The Real Controversy Lie? The Democratic position on healthcare and the philosophy expressed in Paul Ryan’s “A Better Way” and the brief paper that the Trump campaign had on their website agree on more than you might expect. Both sides focus on the immediate need of lowering the expense of healthcare. The differences are in the path to solution. A close reading of what is available leads to the conclusion that everyone says...

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I Was Not So Surprised
Nov15

I Was Not So Surprised

The election outcome should not have been a surprise. We should have recognized the uncertainty produced by anger and deep divisions on many issues. The “establishment” Republican party seemed to be in shambles. The Democratic party did not recognize that it had lost its traditional labor base. Donald Trump was an unusual candidate who won by presenting himself as an agent of change to a new coalition of voters. He was not encumbered...

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Pursuing the Triple Aim With An “I-Thou” Mindset
Nov08

Pursuing the Triple Aim With An “I-Thou” Mindset

You might think that I am at a disadvantage posting this article on election day. The analysts and most of the polls suggest that Clinton will probably be the winner, but all of them are hedging their calls. I place the most confidence in Nate Silver at 538. I am writing with the belief that what will make the biggest difference to patients over the next four years will not be determined by the election or in Washington, but will be...

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Healthcare Costs Too Much
Nov01

Healthcare Costs Too Much

Recently when I was writing about IBM’s Watson as an innovation that could help reduce waste and lower the cost of care I made the statement, “…the greatest threat to the future health of the nation… [is] our continuing inability to reduce the cost of care.”   I have complained about the lack of discussion of healthcare in the election. Then to my surprise a few days after the last debate on October 19 was in the can,...

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