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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Where We Should Focus
Apr18

Where We Should Focus

In a recent essay Michael Dowling, the CEO of Northwell, the massive health system with 21 hospitals in metropolitan New York and Long Island, points out that the most frustrating aspect of the current healthcare debate is that “it is ideological and not practical.” He describes the debate as “…contentious, tumultuous and exhausting to keep up with.” These comments set the stage for his central contention that through it all and...

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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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Information for Responsible Resistance
Jan24

Information for Responsible Resistance

A few weeks ago those of us who had experienced a few moments of unfounded hope based on positive comments that President Trump had made about the ACA had our hopes dashed when he announced that Representative Dr. Tom Price of the 6th Congressional District of Georgia would be the next Secretary of Health and Human Services.  It is my assumption that after the Senate Finance Committee (Senate home of the ACA) grills Representative...

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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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Old Fashioned Values Applied to Complex Times in Healthcare
Sep13

Old Fashioned Values Applied to Complex Times in Healthcare

  An “Interested Reader “ and friend recently sent me a eulogy that he delivered at his father-in-law’s funeral. Let me give it to you to read, and then invite you to think with me about Don Berwick’s recent call for Era 3, the “Moral Era” of healthcare.   I have been thinking about my nearly 50-year long relationship with Granddad, …Charlie to work colleagues, friends and neighbors. He brings to mind Churchill’s...

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Foundational Principles for the Future of Care Delivery
Jun01

Foundational Principles for the Future of Care Delivery

How will the way we deliver care in ten years be similar to the way deliver care today and how will the future be different? One thing that is already in transition is the expectation of patients. Patients want a more “horizontal” and collaborative connection with their doctors and care team. That many patients receive care from a team of providers is itself a future oriented change. Are we ready for the the real digitalization of...

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Persuasion or Compulsion as Drivers for Value Over Volume
May17

Persuasion or Compulsion as Drivers for Value Over Volume

Following the recent “Healthcare Musings” weekly letter where I described my experience participating in “healthcare war games” a very faithful “Interested Reader” wrote to me: An uncharacteristically downbeat letter, Gene, but interesting and challenging. I sent you a response a while ago about the usually very powerful forces behind any status quo, and this is an excellent, though not in a good way, example of that point. The 19th C...

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