ObamaCare Update or Fear and Loathing: The Affordable Care Act

JOHN SHUFELDT, MD, JD, MBA, FACEP In the conclusion of my October 2012 column on ObamaCare I wrote that no matter the outcome (of the presidential election) our future will not be boring. Fourteen months later, it has not been boring and we are just around the corner from imposing the individual mandate (aka tax penalty) on those who don’t have minimal insurance coverage. However, before we cross the starting line let’s review a bit …

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Reforming Healthcare Starts With Reforming Patient Expectations

Back in 2008, while the Obama administration was first evaluating healthcare reform, Peter Orszag, then the director of the Congressional Budget Office, estimated that 5% of the nation’s gross domestic product, or $700 billion per year, goes to medical tests and procedures that have no proven positive impact on outcomes. Unaccounted for in this estimate are the billions more spent managing the often lifelong complications inherited from inappropriate tests and unproven procedures. MRIs that identify …

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Healthcare’s Title Bout: Free Market Economics KOs Reform

At the risk of oversimplifying, the healthcare “crisis” – and subsequent attempts to “reform” it – really boils down to a coverage crisis and a cost crisis. The two, of course, are inextricably linked. Ans every attempt to solve one seems to exacerbate the other. Our healthcare delivery system has essentially failed to manage cost and manage coverage simultaneously. The teeter-totter is perpetually imbalanced. The problem with reform efforts to date is complex. However, the …

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