Mr. President, Please Read Chapter 6, “The Affordable Care Act in Hindsight”
May23

Mr. President, Please Read Chapter 6, “The Affordable Care Act in Hindsight”

In August 2015 I gave a talk on the history of the evolution of health insurance that was part of a seminar entitled “Practicing in the Era of Healthcare Reform.”  I concluded my talk with a slide labeled “Persistent Problems.” I recently reviewed the presentation and was surprised by how appropriate the list still is as we face the continuing dilemma of “repeal and replace.”   Persistent Problems: [As of August 2015] Healthcare...

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The Joy of Working in an Integrated System of Care That Is Continuously Improving
Apr11

The Joy of Working in an Integrated System of Care That Is Continuously Improving

I believe that better care that is economically sustainable and available to everyone while producing healthier communities without unacceptable personal sacrifices from individual health professionals is only possible in a professional environment and culture that respects the contributions of all health professionals. When I use the phrase “I to we” I am talking about everyone who is employed in healthcare from the staff that parks...

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The Search For a Better Future State
Apr04

The Search For a Better Future State

The failure of the president and House Republicans to launch a credible process to “repeal and replace” the ACA creates a moment of opportunity for those who would like to contribute to the search for a better future state for healthcare. The challenge of providing affordable, quality care to all Americans has flummoxed politicians, healthcare policy experts, clinicians, healthcare administrators, insurance executives, employers, and...

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The President’s Prediction of the Explosion of the ACA
Mar28

The President’s Prediction of the Explosion of the ACA

The announcement of the death of the AHAC and the president’s prediction of the “explosion” of the ACA broke in an unusual way. Robert Costa of the Washington Post got the word directly from the president and then tweeted that the AHAC was being withdrawn before Paul Ryan had a chance to meet with Republican House members to tell them of the big decision. Costa published an article about the surprising call he...

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A Time to Renew and Expand Our Sense of Professionalism
Mar21

A Time to Renew and Expand Our Sense of Professionalism

Retirement is a time of reflection. Most of one’s agency lies in the past. I must organize opportunities to transfer bits of experience, insight and wisdom to those who still do the work if I am to have the joy of continuing to contribute to the dream of a future where we enjoy   …Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support...

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Understanding “Ryancare”, the AHCA
Mar14

Understanding “Ryancare”, the AHCA

With Paul Ryan’s  launch of his “repeal and replace” bill , which he calls the American Health Care Act (AHCA) and I prefer to call “Ryancare,” he initiated a new phase of the healthcare debate. Finally, we are seeing the focused discussion of the complex issues of care, coverage, and cost that should have been a central part of the debate before the election. Talk show hosts and comedians are demonstrating a grasp for the complexity...

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