First in a series. Way back as a business strategy undergrad and then as a medical student, I developed a framework for understanding health care systems. I call it the Healthcare Incentives Framework, and I believe it clarifies the big-picture compone…
Category: Policy
When we ignore a child’s preventable suffering, we lose a piece of our humanity
Sometimes an image captures the heart of a nation by putting a face on a human crisis. The one of Óscar Alberto Martínez Ramírez and his 2-year-old daughter Valeria lying face down in the Rio Grande after drowning was powerful. Their family had been …
Expensive Medicare patients aren’t who you think
Over half of Medicare spending is concentrated in 10 percent of patients. With Medicare expenditures rising at an unsustainable clip, reigning in the costs of those patients is key to controlling health care spending. So who are those patients and what…
4 significant misconceptions about universal health care systems
Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress. I addressed the concept of single-payer health care, with Cuba’…
What can be done to improve our maternal death rate?
Why does the most expensive health care system on the planet do such a poor job protecting the lives of pregnant women? More important, what can be done about it? The United States continues to lead the world in health care spending yet it has the high…
What charity care patients get big hospital bills
When Ashley Pintos went to the emergency room of St. Joseph Medical Center in Tacoma, Wash., in 2016, with a sharp pain in her abdomen and no insurance, a representative demanded a $500 deposit before treating her. “She said, ‘Do you have $200?’ I said…
How the changing roles of hospitals are isolating physicians
Physicians nearing the end of their careers often mourn the loss of the hospital as it once was — the undisputed center of the health care universe. They remember a time when every community doctor rounded on patients in the morning, and every su…
The ideal health system lies between the two extremes
Admittedly, my views on funding health care have done a 180 since I left medical school. I grew up and went to university in the United Kingdom, which famously has one of the most heavily centralized socialized systems anywhere in the world. Born out o…
Why hospitals are getting into the housing business
One patient at Denver Health, the city’s largest safety-net hospital, occupied a bed for more than four years — a hospital record of 1,558 days. Another admitted for a hard-to-treat bacterial infection needed eight weeks of at-home IV antibiotics, but …
Why hospitals are getting into the housing business
One patient at Denver Health, the city’s largest safety-net hospital, occupied a bed for more than four years — a hospital record of 1,558 days. Another admitted for a hard-to-treat bacterial infection needed eight weeks of at-home IV antibiotics, but …
