Another Path to Reform

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It’s very hard to find a product or service that is both lousy and unaffordable. Such expensive duds are usually quickly replaced by cheaper and better competitors. Yet prior to the Affordable Care Act, healthcare was becoming more expensive every year while simultaneously becoming less convenient, less personal, and less satisfying. In 2009 I wrote a series of four posts explaining how the healthcare marketplace reached su...
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The Anatomy of a Shortage

“If you think health care is expensive now, wait until you see what it costs when it’s free.” – P.J. O’Rourke

I distinctly remember that in first grade I had an idea of breathtaking wisdom and profundity. Candy should be free. ...
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Rescuing Primary Care

For almost any category of product or service you can think of, a huge variety of price and quality is available. From clothes to food to transportation we can all think of lousy but inexpensive choices that we wouldn’t like and incredibly luxurious choices that we can’t afford. For almost all of us somewhere in the middle there are choices that are both pleasing and affordable. That doesn’t mean that my choice is the same as yours. You may not be happy with anything less than a BMW, while I’m t...
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A Pulmonologist Defends Benzonatate

Last month I posted about benzonatate, a cough suppressant also marketed under the brand Tessalon. (See the link below for the original post.) In that post I detailed an FDA warning about the serious potential side effects of benzonatate, especially in accidental overdoses in children. I also passed along the conclusion of the Medical Letter that safer cough suppressants were available. My colleague Dr. Roy Artal, a pulmonolo...
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More Match Day Misery

… or, If We Beg, Will You Go Into Primary Care? What if tomorrow 30% of the nation’s plumbers disappeared?  Perhaps they vanish due some fantastic science fiction experiment gone horribly wrong.  What would happen?  Would a national plumber group call for making plumbing a more attractive profession?  Would there be a cry for greater federal plumbing subsidies to draw more people from other fields into plumbing? No.  (Or at least, I hope not.)  In the short term, there would be a terrible shor...
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Torpedoing Primary Care

For the last few years the future of primary care has been looking bleak.  Fewer and fewer medical students are choosing primary care careers, just as baby-boomers retire and will need more care.  Primary care physicians meanwhile are retiring early or cutting back their practices at record numbers, worsening the coming shortage. The current issue of the Annals of Internal Medicine publishes a perspective article by Dr. David Norenberg that heaps on the gloom.  Describing himself as cl...
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Flip-Flop Hubbub

As summer approaches, researchers at Auburn University have performed a study demonstrating the dangers of that ubiquitous summer accessory, the flip-flop.  They recruited volunteers and recorded their gait in both sneakers and flip-flops.  In flip-flops the subjects took shorter steps and didn't raise their toes as far as they did in sneakers. This makes sense, if you think about it.  When we wear flip-flops we curl our toes down to keep the sandals from flying off our feet.  This keeps us fro...
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