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America’s Health Care System is Broken: What Went Wrong and How We Can Fix It. Part 2: Health Insurance

Unlike most Western democracies, health insurance in the United States is provided by a haphazard mix of employer-based plans, Medicare for those over age 65 years or on social security disability or with chronic renal failure, Medicaid under varying state-dependent rules for some low-income recipients, and no insurance for tens of millions. Administrative costs, which […]

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America’s Health Care System Is Broken: What Went Wrong and How We Can Fix It. Introduction to the Series

Over the last half-century, medical science has dramatically improved throughout the world. Although costs have risen in all western countries as new technologies have been widely adopted, costs in the United States have risen much more than they have in any other country. Despite using fewer resources (eg, numbers of physicians and nurses, hospital beds) […]

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Physician Compensation Methodology Must Change!

  In our current health care environment, most professional services are paid on a fee-for-service basis. The payment is usually from a third-party administrator or an insurance company. Many only supply a partial payment, expecting the remainder to be billed to the patient. Although much in our lives have similar processes (ie fee for service), […]

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Diabetes Care for Patients Experiencing Homelessness: Beyond Metformin and Sulfonylureas

On any given night in the United States, an estimated 553,742 people are homeless. Applying a broader definition of homelessness that includes unstably housed people, an estimated 1.5% of Americans experience homelessness in a given year. Rates of diabetes are increasing among individuals experiencing homelessness. The social, psychological, and physical challenges of homelessness not only […]

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Medical Tourists: Incoming and Outgoing

Patients who travel to another country to seek health care are referred to as medical tourists. The term arose because many Americans seek less expensive elective surgical, dental, or cosmetic procedures while vacationing abroad.1 Of course, US hospitals and physicians have also long cared for medical tourists from other countries. Now, many medical tourists are going […]

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Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications

Little is known about national patterns of anticoagulant use among patients with atrial fibrillation after the availability of direct oral anticoagulants (DOACs) and the associated implications for healthcare spending. Methods The Medical Expenditure Panel Survey, a nationally representative survey, collects detailed information about prescription drug use, cost, and medical diagnoses. Using International Classification of Disease […]

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