Just Got Word

Just whose responsibility is it anyway to fix the medical system in the US?  Is it the AMA? The AHA?  How about hospital administrators in the aggregate?  What about policymakers; that is, when their work isn't being ignored or used as the reason for not supporting a purportedly necessary change (e.g., the Affordable Care Act). This comes to mind because a hospital client has a terrible problem in the ER; like at 175% capacity and the other charity hospitals in this urban setting have even higher ER capacity rates.  The thing is, this is an incredibly cosmopolitan city with lots to do.  There's nothing appealing about hanging out in the ER; that is, if you can even get inside.  So that's certainly not reason for the big crowds.  If you ask the Chief of ER what the solution to the chronic overcrowding is, he'd tell you that there is some kind of discharge problem "upstairs."  He thinks that a whole bunch of inpatients tieing up beds should be moved into rehab

One of the cornerstones of the fledgling Affordable Care Act is the “minimum coverage requirement,” where American individuals must demonstrate that they have current health coverage or pay a financial penalty for such irresponsible behavior.  The backlash for this impending arrangement has been considerable and illuminates the boundaries designed to establish and preserve government power as set forth in the Constitution.  For example, the reaction has led to: considerable lobbying in pursuit of exemptions for select groups (e.g., unions) and individuals lawsuits filed against: -                       the anti-constitutionality of the idea based on Congress overstepping its bounds in terms of Interstate Commerce Law, that is, whether the minimum coverage requirement is a constitutional exercise of Congress’ commerce power and -                       courts' ability to enjoin in the collection of tax under the Anti-Injunction Act (i.e., enjoining the imposition of the ACA p

Health care in the United States is too expensive since hospitals, physicians and pharmaceutical companies charge too much money for their services and goods.  For instance, a recent McKinsey study compared the U.S. to 13 other developed countries and found that in every other country, patients have more frequent hospitalizations, see physicians more often, and use more pharmaceuticals than we do.  But our costs are are much higher than theirs because our hospitals charge more, our specialists earn more, and our drugs cost more. Since Massachusetts, at last check, is still part of the United States, it should come as no surprise to anyone that Massachusetts is failing to deliver inexpensive/high quality care even though it is being held up by Democrats as an exemplar of sound government thinking in the face of untenable medical costs.  You can have transparent care, you can have ACOs, you can have forced enrollments or financial penalties (ne: "mandate"), but if the u

We have an interesting statistical phenomena underway where pro-Affordable Care Act (ne: Democrats/Liberals) politicos refuse to believe that those presently covered under private insurance will lose their coverage as a result of the Act, and where anti-Affordable Care Act (ne: Republicans/Conservatives) dogmatics are splashing the media with gaudy survey-driven statistics pointing at the impending private sector coverage loss.  So should we believe what our respective political parties are telling us and stick our collective heads in the sand when we hear any dissenting commentary?  What if we are among the independent voters and thinkers that are trying to make sense of both debates, where we don't have the luxury of going along with whatever party leadership is feeding us? The debate has caught fire in recent weeks, with controversial polls and consultants conflicting about whether employees will benefit or lose coverage by 2014.  For example, McKinsey & Company earlier