Respecting What Justin Has to Say While Overcoming the Barriers to The Triple Aim
May30

Respecting What Justin Has to Say While Overcoming the Barriers to The Triple Aim

While walking I often listen to podcasts from Tom Ashbrook’s weekday morning shows on NPR. The first hour on most Friday mornings is usually the “week in review.” A recent Friday broadcast provided food for thought. Tom Gjelton, veteran NPR reporter was sitting in for Ashbrook. I have transcribed what I heard at about 25 minutes into the conversation.   Tom Gjelton: Let’s go now to Justin who is on the line from Texas. Justin, I...

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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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Puerile High Fives in the Rose Garden After the House Votes to Repeal and Replace the ACA
May09

Puerile High Fives in the Rose Garden After the House Votes to Repeal and Replace the ACA

I have watched my favorite teams lose championship games. I remember the sinking feeling that I experienced when Richard Nixon was elected for the second time, even after it was really pretty clear that he was a crook. I suffered when Jimmy Carter, one of the most honest and earnest men ever to enter politics, lost to Ronald Reagan who was the champion of making America feel good about its defects. I read Bush One’s lips and was...

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Let’s Keep Trying to Save the Gains of the ACA
May02

Let’s Keep Trying to Save the Gains of the ACA

It may seem strange to you, but each time I hear that the president and the Republican leadership are making an effort to resuscitate their attempt at repealing and replacing the ACA, I immediately think of the surprising last scene from “Fatal Attraction,” the terrifying 1987 movie with Glenn Close and Michael Douglas. You may remember that in the chilling last scene Douglas is attacked with a butcher knife by Close. She is obsessed...

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Perhaps an Explosion Would Be the Most Efficient Route to the Triple Aim
Apr25

Perhaps an Explosion Would Be the Most Efficient Route to the Triple Aim

After the failure of Paul Ryan’s American Health Care Act to get passed over the internal squabbling of House Republicans despite their forty four vote majority, David Brooks wrote an interesting tongue in cheek column entitled “The Coming Incompetence Crisis.” He articulated his concern:   …I worry that at the current pace the Trump administration is going to run out of failure. So far, we’ve lived in a golden age of...

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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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