Is a test that costs $800,000 to add one year of life worthwhile? In one survey, most physicians said yes-evidence that controlling costs will require overcoming very powerful, and irrational, psychological forces. Imagine for a moment that you are in charge of the U.S. health care system, and must decide whether to pay for a…
Would you rather experience a bad situation forever or for just six months? Any sane person would choose the temporary situation. And yet, according to a study I published this week, if you chose the temporary situation, you’d be more likely to suffer over the next six months-so focused on the hope that your situation…
If I told you that neighborhoods cause people to develop diabetes, would you believe me? And would that make you more or less willing to see your tax dollars spent researching ways to treat and prevent diabetes? That is essentially the question my colleagues and I posed to a wide swath of Americans, and a…
One of the greatest joys of practicing medicine is for me to understand where my patients are coming from, so I can best help them through their medical journey. I was reminded of this fact recently, when talking with a patient who had just come back to my primary care clinic after visiting the liver…
In an effort to be the first president since Lyndon Johnson to succeed in reforming our nation’s health care system, President Obama is exhibiting honorable flexibility. Taxing health care benefits for employees? He was against it when running for office, but he is considering it now that the federal budget deficit is growing so rapidly….
Did you know that Adolf Hitler had three testicles? You didn’t? Well, you are right. That is just an urban legend — one that I have just created. In fact, if anyone tells you that Hitler had three testicles, they are either misinformed or they are lying. Why am I mentioning Hitler’s three testicles to…
Republicans criticizing health care reform efforts are beginning to sound as principled as Groucho Marx, who once quipped: “Those are my principles, and if you don’t like them, . . . well I have others.” On the one hand Republicans complain that health care reform will cost too much money. On the other hand, they…
Any sensible plan to reform the U.S. health care system must reform the way we pay physicians. Currently, we reward doctors for doing more “stuff” for their patients — for performing tests and procedures whether or not these interventions are necessary. Because of this strange reimbursement system, many primary care physicians receive more money performing…
No sooner had the Obama administration committed a billion dollars to comparative effectiveness research than the critics began laying out their concerns: such research is a prelude to rationing, they said; it threatens to thwart doctors’ and patients’ abilities to make their own decisions. It will transfer too much power to government bureaucrats and treat…
American presidents have been trying to reform our health care system since at least the Nixon era, but with only limited success. Past reform efforts have failed for many reasons. For starters, the U.S. health care system is complex, with the medical industry making up almost 1/6 of our economy. But perhaps the biggest obstacle…