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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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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Thinking About ACOs Again For the First Time
Jan10

Thinking About ACOs Again For the First Time

I am proud to be a member of Whittier Street Health Centers Foundation Board and was delighted when our very able CEO, Frederica Williams, recently asked me to talk to the organization about ACOs at their Grand Rounds. Whittier Street is an exceptional example of a practice that will be sorely tested by the chaos that Jonathan Oberlander describes in his “Perspective” article, “The End of Obamacare”, in the January 5, 2017 issue of...

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What To Do When You Don’t Know What To Do
Jan03

What To Do When You Don’t Know What To Do

Are you wondering what you and your practice or hospital should be doing while living in the ambiguity of “repeal and replace?” Focus on getting better. That is the short answer. With or without the ACA the challenge to create  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 caregiver wellness  …does not go away. The Triple Aim long...

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Population Health, Sustainability and The Triple Aim
Dec13

Population Health, Sustainability and The Triple Aim

Since the early nineties nothing has challenged physicians grounded in the traditional culture and practice of medicine more than the introduction of the “radical” concept of population health. One could argue that the Affordable Care Act is the legislative expression of the tenets of population health. The reduction of healthcare costs that will lead to sustainability of expanded coverage and the Triple Aim can not be achieved...

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