Senator Alexander, Please Play the Right Tune
Jun13

Senator Alexander, Please Play the Right Tune

Hours before James Comey appeared before the Senate Intelligence Committee, David Leonhardt issued a warning in an editorial in the New York Times entitled “Uh oh, Health Care Edition.”   James Comey’s testimony today will reveal President Trump’s blatant disregard for the rule of law…I realize it will be hard to pay attention to any other political story this week, but I urge you to find the extra attention span, because...

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Where Do We Go From Here?
Dec20

Where Do We Go From Here?

Dan Burns, is a former colleague who served on the Harvard Vanguard and Atrius boards with me, my dermatologist, and the person who became CEO of Harvard Vanguard after I retired three years ago. I most recently saw Dan, and we had a brief conversation during a visit I made to the Wellesley practice of Atrius Health. I was there for advice from orthopedics regarding a recent shoulder injury. (I injured my shoulder in a fall while...

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What do the primaries mean for health care’s future?
Mar10

What do the primaries mean for health care’s future?

From the get go the pundits have been puzzled by this year’s Presidential primaries season. The confusion goes back to last June when Donald Trump announced his candidacy for the office of President. At first, the predictions were that Trump’s candidacy was a self-limited process of narcissistic personal promotion. On the Democratic side, the word was that Hillary Clinton was a “shoo-in” this time around and would not be challenged by...

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Looking Forward with the Triple Aim
Feb25

Looking Forward with the Triple Aim

It is surprising that we have no good metrics to track our progress toward the Triple Aim. We have lagging numbers on what we spend as a nation and debatable public health indicators of gross population metrics. No one knows how many healthcare organizations have incorporated the Triple Aim into their strategic plans. We have very little to help us judge what organizations are accomplishing and no way of comparing their results to...

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Where Healthcare Should Focus in 2016
Jan20

Where Healthcare Should Focus in 2016

I have been looking forward to 2016 and asking myself where healthcare should focus in the year ahead. In this connection, Don Berwick’s speech at the 27th Annual IHI Forum had a profound effect on me. You can watch it on YouTube. I appreciated his insightful and historically astute descriptions of Era 1 and Era 2 of healthcare. The first era goes all the way back to Hippocrates and Galen and was dominated by clinical autonomy and...

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The ACA, Five Years In
Jan14

The ACA, Five Years In

A recent article in the New England Journal of Medicine offers us food for thought as we contemplate the Affordable Care Act (ACA) at five years and look forward to its next challenges in 2016. If you have not read it, the article is entitled “Health Care Reform’s Unfinished Work- Remaining Barriers to Coverage and Access”, by Dr. B. D. Sommers from the Department of Health Policy and Management, Harvard T.H. Chan School of Public...

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Optimism or Hope?
Jan07

Optimism or Hope?

During the week after I had given a very positive review of the 27th IHI Forum in my weekly “Healthcare Musings” I received an email comment from one of the regular readers who wrote to me saying that he admired my optimism, but he just did not feel it. The comment caught me by surprise because although I thoroughly enjoyed the Forum and was energized by the speakers and excellent sessions, I remain painfully aware of the huge...

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Attorney General Maura Healey Leads Healthcare Reform
Oct15

Attorney General Maura Healey Leads Healthcare Reform

As a member of the Advisory Council to the Health Policy Commission in Massachusetts, I was very interested in following the internet broadcast of the annual HPC Cost Trends Hearings early in October. At the core of the presentations was a debate about healthcare costs. For me the high point came when Attorney General Maura Healey and her staff made the sort of leadership statements that suggested to me that she was not in harmony...

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