CMS just announced that U.S. healthcare spending increased 4.6% in 2019 to $3.8 trillion, which accounted for 17.7% of the GDP. In contrast, the general inflation rate in 2019 was approximately 1.8%.  Of course, this was all before coronavirus hit. Before we get to 2020, these numbers say in a very...
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The Texas Lieutenant Governor, Dan Patrick, was recently lambasted by much of the press for his comments in an interview he did on the Fox network. He said that he is 69 years old and he was willing to take the chance that he could be infected from the COVID-19 virus...
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Two more state-level experiments to support primary care have failed. Before I go over the findings, let me first say that I appreciate that some states are willing to think big and take risks by trying new approaches. Change is hard. One of the real strengths of America has been its...
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It is actually refreshing when people are honest, especially when they lift up the curtain to reveal what is really going on behind it. In a recent interview, a former manager at Lilly, confesses about the process by which Lilly set prices. For example, a product called Xigris was priced largely...
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Some people think that the solution to better-supported primary care is in DPC/salaried physician payment models. I don’t think it is the best answer. I realize money is not the only motivator explaining why people perform work. Meaningful work matters too. But meaningful work that is not respected and paid for...
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I’ve written before about the unrealized dreams of Obamacare, unrealized because they were poorly designed. One example is the mostly disappointing results of Accountable Care Organizations, which were created in Obamacare. Another is how hospital-physician group mergers drive up the costs in areas where these mega-systems dominate the local market (Harvard Pilgrim...
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I have had several dealings with the benefits managers/HR managers of large corporations and other large organizations over my career. I have one over-arching conclusion about what motivates these people: they will never be a source of disruptive innovation in healthcare. I find them to be passive people. They are fundamentally...
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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...
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I can’t make up this stuff. I am on several listservs that publish medical news items. I understand that there are probably several staffers that contribute to the daily blasts, not knowing what the others are doing. But I assume there is still some sort of editor that makes sure the...
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First, a history lesson. Back in the mid 2000 oughts, the AAFP launched a wholly owned subsidiary called TransforMed. It was originally started to help practices implement the “new model of care” from the Future of Family Medicine Report. Soon after it was launched, the joint principles of the patient-centered medical...
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