Family physician, author, blogger, speaker, physician leader.

Tag Archive for health care reform

Healthcare Future in 2030 – Think Car Insurance. Doctors Will Work for Walmart and CVS.

With health care reform and the creation of a retail marketplace to buy health insurance via exchanges, the future of healthcare delivery has become cost shifting from employers to employees. What will health care look like in 15 to 20 years? Think car insurance and retirement planning. In a future post, I will cover how health care will look like retirement planning. This new reality will impact both patients and doctors in a very different way. Auto Insurance – Don’t Use It! People will trade low premiums for higher deductibles. In auto insurance, people avoid filing claims for fear of increasing future premiums and access alternative services like windshield repair and body shops to get the job done without using insurance. This will also occur with high deductible health insurance as now it will be essentially catastrophic health insurance and not comprehensive health insurance. This is a perceptive championed by […] Read More »

Would Doctors and Patients Pick a Better Health Care System If They Saw It?

we believe Integrated will triumph Fragmented every time – Steve Jobs, Apple CEO Two articles recently got my attention. The first was an interview by Dr. Robert Pearl, CEO of the Permanente Medical Group with my favorite author and thinker Malcolm Gladwell. On Pearl’s on Forbes blog, he answered Gladwell’s request to tell people what is was like to be a doctor. The second was a NPR article  “When Facts Are Scarce, ER Doctor Turns Detective To Decide On Care” by Dr. Leana Wen, patient advocate and author of the book When Doctors Don’t Listen. Both articles reminded me how doctors and patients have different realities simply by where they practice. As a practicing primary care doctor in an integrated health care system, which is partnered with a physician led medical group, these stories were quite foreign to me. These stories were once my reality in residency but no longer […] Read More »

Why Doctors Should Read Malcolm Gladwell’s David and Goliath. Can a David Fix Health Care?

October 1st was a special day. The Affordable Care Act (ACA) also commonly known as Obamacare continued to march forward with the opening of the insurance exchanges. The federal government shut down because Republicans and Democrats disagreed around Obamacare funding. Most importantly, October 1st was when I could finally read Malcolm Gladwell’s new book David and Goliath. Gladwall ponders why do underdogs succeed when we least expect them to? Is it possible that advantages a Goliath has can be a disadvantage? When might a disadvantage for an underdog appear to be an advantage? As I put his observations together, I wondered are there any learnings for doctors and the health care system? Absolutely. A David typically does not have the resources or power to make a difference as viewed by conventional terms. Gladwell uses stories like the US civil rights movement, successful individuals with a dyslexia, and his excellent New […] Read More »

The problem with health insurance exchanges. The risk for patients. Pension plan to 401k analogy.

With the implementation of health insurance exchanges in October 2013 and the beginning of the Affordable Care Act (ACA), also known as Obamacare, there is tremendous risk for the American public to be worse off. Certainly the millions of Americans who currently are uninsured because their employers do not offer insurance coverage and those with pre-existing conditions unable to purchase affordable individual coverage, will benefit. It is those with employer based insurance coverage who may lose. They just don’t know it yet. Employers have found it difficult to absorb the rising health insurance premiums and costs, which have increased faster than inflation. They have tried many ways to slow health care spending including requiring employees to have more “financial skin in the game” to encourage them to make “smarter” choices about their health care. They’ve done this with higher deductibles and co-pays and requiring employees to pay a larger percentage […] Read More »

Future of Health Care Crystal Ball Via Rock Health – Inspiring Stories. Much Potential. More Questions.

If you want to see the future of health care, the can’t miss conference of the year is the Health Innovation Summit hosted by Rock Health in San Francisco. As a practicing primary care doctor, I had the opportunity to view health care through the lenses of a technology entrepreneur. I thought the conference was even better than the one I attended last year. Absent was the provocative rhetoric by 2012 keynote speaker Vinod Khosla who noted that “technology will replace 80 percent of doctors”. What continued to remain was the curiosity, confidence, enthusiasm, and optimism that health care and medical care could be even better and the willingness of entrepreneurs to fix a problem and build a business around it. Themes I found particularly interesting included the following: Make health care smarter by creating platforms, whether software or hardware, like wearables, to collect patient data and to analyze data, […] Read More »