Category: Public Health & Policy

The British are unafraid to talk about rationing. That’s something to admire.

I am a huge fan of Britain’s National Health Service (NHS), but probably not for the reasons many people might assume. It’s not because it’s “socialist” (a horribly inaccurate description), or that it’s nationalized, or anything like that. I’m a huge fan because somehow the people of Britain have developed the courage to talk about […]

Lessons from the meeting of different value-based concepts

Value remains one of the most widely invoked and variably interpreted concept in American health care delivery. Beyond patients, stakeholder groups across the health care ecosystem are undertaking value-based initiatives, including payers (e.g., value-based insurance design and payments), provider organizations (e.g., value-based care redesign), pharmaceutical companies and pharmacy benefits managers (e.g., value-based pricing and formularies), […]

How to pay for long-term care

The topic of paying for long-term care is an overlooked issue in health care. None of us want to think about living our final days in the nursing home, but statistically speaking, many of us will. How will you pay for it? What are the options? Long-term care in this country can be divided into […]

Market-based approaches solving the opioid epidemic

Mary first took oxycodone after a minor surgery and found she liked it. Returning to her surgeon a month later with vague ongoing pain, she received another prescription. Her primary care provider took over from there — until one day that physician checked a urine drug screen and a prescription monitoring program (PMP) report, only […]

Market-based approaches solving the opioid epidemic

Mary first took oxycodone after a minor surgery and found she liked it. Returning to her surgeon a month later with vague ongoing pain, she received another prescription. Her primary care provider took over from there — until one day that physician checked a urine drug screen and a prescription monitoring program (PMP) report, only […]

Medical bankruptcies happen less frequently than you think

Elizabeth Warren describes medical bills as “the leading cause of personal bankruptcy” in the United States. She bases that opinion in part on her own research, in which she and her collaborators surveyed people who had experienced personal bankruptcy, asked them whether they’d experienced health-related financial distress, and concluded that 60 percent of all bankruptcies in the U.S. […]

5 fears physicians face today

Like prep sports or prime-time television, medical meetings have seasons. In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of […]

Is there parity in mental health or are we still dealing with a paucity?

With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental […]

How health insurance contributes to our failing system

An excerpt from Prescription for Bankruptcy: A doctor’s perspective on America’s failing health care system and how we can fix it. Many years ago, while I was involved in developing the pre-hospital emergency medical care system in Massachusetts, I went with a group to meet with the then-president of Blue Cross Blue Shield of Massachusetts, John […]

Doctors as the gatekeepers of marijuana is a race to the bottom

This year Oklahoma voters made a clear choice to legalize medical marijuana, joining thirty other states that permit cannabis for medicinal use. Unsurprisingly, immediately in the vote’s aftermath, patients began asking me to “prescribe” medical marijuana licenses, as the new law stipulates users must have as a precondition for legal purchase. The new law does not, however, specify […]