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As reformers attempt to fix our health care delivery system, they are dancing around what counts the most: the cost of health care. Pundits and “experts,” politicians and physician groups, devise convoluted schemes to expand insurance coverage while lowering premiums, without working to change our low-value health care delivery system. Our medical system squanders a trillion dollars a year by incentivizing wasteful spending for medicines, tests, and procedures that do not help patients. The unfortunate reality is that patients are not meaningful participants in their own health care decisions. That is because they are given misleading information about the efficacy and side effects of m
When I recently spoke to a group of seniors about the dangers and risks of hospitalization in the elderly, one of the audience participants was justifiably confused. She assumed that as her primary care doctor for many years that I would be involved in her hospital care. I had to tell her that was not the case. In fact, in our local hospital, Howard County General Hospital, not only are primary care doctors excluded from caring for their patients, but even more alarming to my patients and to those to whom I have been speaking about this issue, the hospital doctors are under no obligation to communicate at all with a patient’s primary care doctor, and generally they don’t. Recently Steve S
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