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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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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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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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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Looking Underneath the President’s Comments About “Repeal and Replace”
Mar07

Looking Underneath the President’s Comments About “Repeal and Replace”

As the “talking heads” who analyzed the President’s speech and Governor Beshear’s Democratic party response were fading into the 11 o’clock news, Verizon offered an advertisement that contained as much or more wisdom than anything that I had heard over the previous two hours.       Why promise something that you can not deliver? (Verizon Ad)   The President seems intent on the delivery of everything that he promised...

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It’s Still The Truth, Ten Years Later
Feb14

It’s Still The Truth, Ten Years Later

In the January 29th New England Journal of Medicine Foller, et. al. published an interesting article, “Population Health–A Bipartisan Agenda for the Incoming Administration from State Leaders.” The first paragraph said a lot.   The common goal of health policy leaders at the level of state government in the United States is promoting the health and well-being of all populations to the greatest extent possible within fixed...

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Repeal and Replace and the Angst of “The Loyal Opposition”
Jan17

Repeal and Replace and the Angst of “The Loyal Opposition”

Readers of these postings are familiar with my use of the term VUCA, an acronym that is derived from the realization that we live in a world that is volatile, uncertain, complex and ambiguous. I have asserted before that our state of uncertainty about the future of healthcare in the era of repeal and replace complies with the spirit of VUCA. VUCA is a strategic concept. Since the term was introduced to strategic thinkers in the mid...

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