Posts

Health Insurance: The Fallacy of Choice

“I never advise people which health insurance to pick or whom to marry,” warned a seasoned managed care contract negotiator with whom I worked at the outset of my career.   For years I repeated this snarky sound bite thinking she was referring to both as highly personal decisions with serious consequences – until the day came in fall of 2009 when I was faced with the task of choosing one of five very different employer-sponsored health plans for my own family.   At that point I realized that what she really meant is that it is far easier to pick a spouse than a health plan (and I should mention this was two years into my second marriage). There are tens of millions of uninsured Americans who would love to have had the luxury of this problem, plus many millions more feeling constrained by limited options whether through their employer or individually purchased – so I’m not complaining about my abundance of choice.   Furthermore, I had a slew of highly atypical cre...

In the Aftermath of Trumpcare

Content warnings:   1) Health/care/insurance   2) Long 3) Mostly facts plus some opinions which are my own and not my employer’s. In the past 48 hours I have been visited, called and messaged by numerous friends, family and colleagues to discuss not only an autopsy of the Trumpcare debacle but also, encouragingly,   a desire to understand the complexity and   explore ideas on a way forward for our country.   One thing is for sure – improving the health of America will not happen through sound bites from anyone, even accurate ones.   Critical thinking and honest dialogue are our only hopes.   Furthermore, we all come at this complicated topic from the lens of our own life experience and values.    My own career context includes studying the science behind population health, the great privilege of providing hands-on care to all ages as a family physician (and teaching others), helping to steer and operate non-profit community health sy...