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I am a physician with a longstanding interest in single-payer health care reform. I am a graduate of Harvard Medical School and I trained in both internal medicine and psychiatry. I am now an Assistant Professor of Medicine at the University of Hawaii John A. Burns School of Medicine, and also in private practice as a general adult psychiatrist. I have been a member of Physicians for a National Health Program since the 1980's. In 2008 I submitted a resolution to the Hawaii Medical Association endorsing single-payer, and to my amazement it was adopted (by a large margin) in March 2009. This led to running for office and I am now President-Elect of HMA. Over the past 3 years, I have been speaking on single-payer at every opportunity, including several Grand Rounds for physicians and several talks for the general public. I am a member of the One Payer States forum for single-payer advocates at the state level from around the country. On Sept. 1, 2011, I was appointed by Hawaii's Gov. Abercrombie to the Hawaii Health Authority, charged with designing and then running a universal health care system for Hawaii.
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Saturday, July 14, 2012Fee-For-Service is Not the Problem Washington policy makers talk about "the fee-for-service treadmill" as if it were the root cause of runaway US health care costs, but the evidence suggests other drivers are much more important, including fragmentation and administrative complexity, lack of access to effective care, and the de-profesionalization of doctors.
Monday, December 5, 2011Principles for Cost-Effective Sustainable Health Care Reform My previous op-eds identified wasted spending in US health care, and explained why competition in health care financing can't work, and how to achieve accountability without competition. These principles summarize what would work, based on the experience of other countries and a few progressive health care systems in the US.
Thursday, November 24, 2011Universal Publicly Funded Health Care: Establishing Accountability without Competition A previous article showed why competition among health plans can't work to improve health care. This article outlines how to establish accountability to effective delivery of quality health care without competition, while avoiding direct administration by a dysfunctional legislature, as with our current Medicare program.
Thursday, November 17, 2011Why Competition Among Health Plans Can't Help Us Insurance is a system for managing financial risk. When a high percentage of a population has known risk, as the case with health insurance when so many have pre-existing conditions and risk factors, then competition does not reward better plans, it rewards avoiding covering or paying for the sick, undermining the whole purpose of health insurance.
Wednesday, November 16, 2011U.S. Health Care Spending: Where Is the Waste? I have drawn on the experience of other countries, projections of US health care costs by The Lewin Group, the CBO, and CMS, and studies of regional variation in health spending to analyze the waste in US health care spending, and why universal health care would cost less while covering everyone.
