Category: Policy

Is there a link between readmission and a hospital’s non-profit status?

It was the middle of winter in downtown Chicago in 1995, and I was sitting across from an apologetic alcoholic holding a slimy NG tube. Mr. Smith, an emaciated man in his sixties, had been on my service for three days with acute pancreatitis, and this …

Negotiating lower drug prices in America: The tradeoffs are worth it.

Negotiating lower drug prices in America could possibly stifle pharmacological innovation. But it would reduce health care cost for most Americans — and that should be all that matters. If the United States began to regulate drug prices, medications wo…

The climbing rates of maternal mortality in Black women

To put it simply, I’m scared by news headlines and conversations about the climbing rates of maternal mortality among Black women. I’m not surprised, however. As an internist, I regularly marvel at the advances that have been made in Western medicine, …

The gender imbalance in nursing

The gender imbalance in nursing, our nation’s largest profession, is a slow-to-change and complex problem steeped in stereotypes, economics, unconscious bias, power, and privilege in health care and society. Along with other diversity gaps in the nursi…

Why are we failing to solve burnout?

How would you make sense of the following vignette: Over a 40-plus-year period, a disease (“X”) is diagnosed, its causes are defined, and effective treatments are prescribed 30-50+ percent of people working in your organization are currentl…

What would an optimal government-run health care system look like?

The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or in…

There is a profound lack of self-esteem in the medical profession

I have noticed a profound lack of self-esteem in our profession. I am concerned. Concerned for us, and for our patients. We are the most noble of professions. However, we have compromised our morals, values, ethics, and virtues. We are now living, oper…

What would an optimal single-payer health care system look like?

Next in a series. The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care syste…

What would an optimal libertarian health care system look like?

Next in a series. In prior posts, I described my Healthcare Incentives Framework. If you haven’t read those, I recommend you check them out first to have the full context for this post. But here’s a refresher of the main points of the framework without…

Where have all the doctors gone?

As my husband passed the milestone birthday of 40, he thought it would be a good idea to get a physical exam as it had been several years since he saw a physician. Easy task, right? We soon came to find that the landscape of health care had been changi…