A few good MEN

"Now, some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question – I ask how we can afford not to." [Barack Obama, today.]

On the occasion of Barack Obama's rollout of his health policy team, and given that, according to a couple of pieces of paper I have around here somewhere, I'm a doctor, this seems a good time to spout off -- yet again -- on the state of health care in the US. What it really boils down to is this: we need to reduce cost and raise quality. As long as the discussion is only about paperwork, ie, single payer vs current insurers, electronic vs paper records; and as long as the only real efforts to control costs are in reducing payments to providers, we'll be getting nowhere. As usual.

I've written about why I favor single-payer, and have acknowledged that among physicians I'm in a distinct minority. I've said pretty much all I know about that aspect of it. Moreover: as controversial as it is, it's really only nibbling around the edges. Solutions --REAL solutions -- will come from fundamentally changing the nature of care itself, and how we provide it. And if you think addressing insurance is complicated and daunting, you ain't seen nothin'

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The HMO Death Watch 2 - How Shall We Regard Medicare Advantage?
December 12th, 2008 by DrRich

DrRich has never really understood the government’s rationale for funding Medicare Advantage.

Being a Milton Friedman capitalist, DrRich is all in favor of having plenty of robust, profit-seeking entities knocking about within the American economy, even within the healthcare sector of the economy. In principle, he is even in favor of giving for-profit health insurance companies a chance to prove that they can deliver quality healthcare with greater efficiency and better outcomes than certain non-profit entities, such as, say, the government. If the insurance companies can give us good healthcare at lower cost,

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