In areas of the country hardest hit by COVID-19, clinicians are already being forced to make tragic rationing decisions: about who to admit to the hospital, who to transfer to the ICU and who to place on scarce ventilators. These decisions feel out of character with our national identity. We normally think of ourselves as…
Keeping with my recent theme on US healthcare prices, from the people at Vox media, here’s an illustration of how expensive it is to get an MRI in the United States versus other countries: And the cost of a day in the hospital: Sigh…
Here is the opening of an article I recently published in JAMA, available now online, in which I raise concerns about misguided congressional efforts to promote the use of high-value healthcare services, without doing anything to reduce the use of low value ones. Health care systems around the world are under pressure to restrain health…
All else equal, it would be wonderful if hospitals had an incentive to provide high quality care. It does not seem fair to pay the same amount of money to a hospital that does a great job of caring for its pneumonia patients and one that does a lousy job. For the most part, however,…
She came to the urgent care center with a sprained ankle. The primary care provider gave her excellent care, expertly applying evidence-based evaluation guidelines to her situation, and, thereby, avoiding unnecessary x-rays. By all measures, the provider’s care was excellent, but the interaction still ended up reducing his salary. You see, that patient’s only medical…
I remember one time having a conversation with Daniel Kahneman, one of the founders of behavioral economics, about the topic of happiness and emotional adaptation, in the context of chronic disability. We were discussing emotional impact of experiencing a limb amputation. Kahneman pointed out that it is the loss of the limb that is really…