Congratulations to new Massachusetts Senator Scott Brown. We saw health care concerns drive the election of a Republican in the bluest of states.
Yet, most people want health care to be reformed…its not that we don’t want change…its that the current approach to ObamaCare looks to lock out change and lock in an insurance model that people can neither comprehend nor afford nor trust. As Albert Einstein once remarked, “Insanity is doing the same thing over and over again and expecting different results.”
So what is the right model for health reform? My humble suggestion is that our nation yearns for Health Assurance, not just Health Insurance. What does that mean?
continue reading »
Sustainable health reform requires a solid foundation…unfortunately the proposals we’re seeing out of Washington create a more elaborate house of cards, as we continue to create an elaborate health care ponzi scheme. The House that built Medicare has already saddled our country with Trillions in unfunded liabilities. The proposals we see look to continue to reward a medical-industrial complex that creates and manages diseases rather than focusing on optimizing the health of people.
So what are the criteria of a sustainable health system? continue reading »
When I was a kid, I hit my head a fair bit, including getting knocked out once at football practice. Initial care involved an evaluation, but scans weren’t the norm. Now that they’ve become increasingly common in the evaluation of head injuries in youth, have we gained much?
The Value of CT Scans in Youths Is Questioned in this study in the Lancet (article in NYTimes). continue reading »
I keep hearing about Comparative Effectiveness and how evidence needs to used in medical practice. Then I remember my days in the clinic/hospital, where complex patients presented in ways that didn’t fit textbook definitions and whose multitude of issues offered contradictory readings from the literature.
So how are we to move forward? I’m a strong believer that the best evidence needs to be used in clinical decision-making…the issue is in making this evidence usable in the field in a way that doctors can trust will be relevant to the person in front of them (as opposed to 300 carefully selected and studied patients in Finland).
So what will the new paradigm look like? My sense is the RCT will fade as consumer-focused care comes into play. If the best of science is directed to the patient sitting in front of a doctor, the goal will be to combine the information of others just like them (across multiple segments and disease phases) to predict both the natural course as well as the potential options for improvement (and their predicted results).
continue reading »
