Robert Samuelson in a September 29, 2011 Washington Post column asserts the country’s economic tribulations are primarily the results of a vicious health-care cost crisis. In the last 50 years, health care expenditures have risen from 2% to 26% of federal outlays and in the last 30 years from 6% to 19% of employers’ wages, resulting in rising taxes and shrinking personal disposable income. Future projections are even direr....MORE

Is $35,000 per year per month of life prolonged worth the taxpayers’ investment? Recently, the Centers for Medicare and Medicaid (CMS) decided “yes” to the delight of many men. Medicare will pay for the provision of the biologic, Provenge, which has been shown to prolong an average of three months the lives of men with metastatic prostate cancer.  (Such biologics cost approximately $100,000 per year.)....MORE.

In the next year the US Supreme Court likely will decide the limits of federal legislative and executive leaders to influence individual and local community behavior and activity directed at protecting and promoting health. The impact of its ruling will extend far beyond the constitutionality of the Affordable Care Act (Obamacare).

Until about 50 years ago, federal influence primarily involved environmental, research and public health hygiene/safety activities to protect the public’s health. Individuals and local communities were responsible for maintaining health and obtaining health care....MORE.

Recent studies in the Archives of Internal Medicine and PLoS Medicine report that the implementation of electronic health records (EHRs) and e-technologies fail to demonstrate significant improvements in outpatient healthcare quality or other benefits, such as cost savings. Such reports discourage physicians and the public from supporting major initiatives to expand such technologies. That is too bad.

As primary care physicians practicing in isolated Native American communities nearly fifty years ago, most of my peers and I became major proponents of such technologies. We believed they would be universally implemented within most of the US by the early 1980’s, once certain hardware and software limitations were resolved. We were mistaken. Why?  READ MORE.....

Dr. Donald Berwick, Administrator, Centers for Medicare and Medicaid (CMS) on September 3, 2010 quickly responded to an August 27, 2010 Op. Ed. article in the Washington Post by former health and human services secretary Michael Leavitt. Leavitt asserted the Affordable Care Act (Obamacare) portends serious negative consequences for Medicare’s future financial solvency and health care for seniors   MORE.

Many pundits opine Obamacare is a complex piece of legislation, difficult to understand and often vague regarding implementation/operational details. Not really. That is only the case if one assumes its primary goals are to contain health care costs, lower health insurance premiums and assure timely services for those in need.MORE.

I commend the courage of American Cancer Society’s Dr. Michael Thun.  He has challenged the validity and prudence of the findings and recommendation of his colleagues who serve on the esteemed President’s Cancer Panel, which recently issued a report on cancer and environmental toxins.

Widely being lauded by the media as a report that exposes “widespread”, “grossly underestimated”, and “serious threats” of “grievous harm” not adequately addressed by government agencies, most commentators support massive new spending initiatives. Praising the report’s legitimacy, Nicholas Kristof of the New York Times states, “It’s striking this report emerges not from the fringe, but from the mission control of the mainstream of scientific and medical thinking…”  Not according to Dr. Thun.....MORE

In the 1950s patients phoned my father’s office, a rural general practitioner, requesting medication refills. Most requests asked for the medication by some combination of size, color, shape and type, e.g., small, round, yellow pills; big, green, capsules.

 I wondered how my father knew the medication each requested given the vast array of medical conditions, the unique characteristics of each patient and the different mix and severity of ailments from which each suffered.  I naively assumed there was just one medication - distinguishable by size, shape, color and type – that had been found most effective for treating each condition depending upon its severity. One day he told me my assumption was dead wrong and that he used many different medications to treat the same condition based upon their effectiveness and side effects within each patient. Sometimes he provided a physiological reason for the difference but often he responded the decision was based upon a subjective assessment, i.e., either he and/or the patient had determined it worked better or had fewer side effects....MORE