20 January, 2017 | Bill and his guests Keith Olbermann, Heather McGhee, Tom Perez, and Jon Meacham answer viewer questions after the show. read more
Obamacare, at least in its original incarnation, is on its way out... attacks have focused mostly on sections of the Affordable Care Act that expanded access to health insurance.
At least as important, however, are the lesser-known parts of the law that have let Medicare use its financial clout to push for better, safer, and less expensive medical care.
Value-based care initiatives in the ACA include reducing payments for preventable hospitalizations, establishing mandatory reporting of physician quality, and payment arrangements that emphasize care coordination. Those kinds of initiatives have garnered widespread bipartisan support, albeit more vocally outside Washington.
Value-based purchasing saves lives and money... Most physician organizations now back value-based purchasing, understanding that accountability for quality and safety is the right path to controlling spending -- both morally and clinically. read more
An international group of leading doctors and academics say up to one-third of many medical procedures are now being done unnecessarily, causing physical, psychological and financial harm that could threaten the viability of healthcare systems.
A landmark report in The Lancet medical journal said more needed to be done to address inappropriate medicine, which includes deliberate over-servicing by doctors for their own financial gain.
Over-use of medicine, which paradoxically exists alongside under-use of evidence-based medicine, is driven by defensiveness among health professionals who fear being sued; gaps in knowledge; erroneous beliefs; and lack of meaningful consultation with patients to understand their individual aims and preferences, the researchers said...
The Lancet report said a fee-for-service payment system was likely fueling the over-use of medicine in some countries. read more
U.S. political journalist Matt Taibbi is very clear about the fact that he doesn't like Donald Trump.
Still, the Rolling Stone columnist says the president-elect got more than a few things right during an election campaign that brought to the forefront America's struggles with racism, class divide and economic stagnation.
One of Trump's gambles that really paid off, according to Taibbi, was painting a target on the back of the U.S. political media.
"The media and politicians had spent so much time with each other that they lost touch with regular people, and Trump capitalized on that. He made us in the media villains, representative of this out of touch, ivory tower political culture," he said.
"I think there's some fairness to it, as much as I dislike Donald Trump, he hit a note, several notes, in this campaign that were true, and that was one of them." read more
In a few short years, two things seem likely to happen. The country will look back fondly at the Obama years. And many of the people who voted for Trump will deny they ever did.
Wondering what the next year will look like? Look no further than eight years ago, when Republicans openly promised to block anything the incoming president tried to do. Now reverse the roles of the two parties.
Ironically, Trump's biggest problems over the next few years may not be with Democrats as much as with traditional Republican fiscal and military hawks, who have spent decades fighting two things that Trump seems indifferent to: budget-busting programs and the Russian bear.
Health care is shaping up as the first major migraine for Republicans. Trump has promised to "repeal and replace" Obamacare. Republicans are slathering over the repeal part but lack any collective sense of what to replace it with. read more