tim johnson

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Dr Tim’s ‘Truth About Obamacare': Lingering Unknowns, GOP Prospects

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

It’s the first Monday of the month, which means it’s time for some more “Truth About Obamacare” on the regular podcast hosted by Dr. Timothy Johnson, retired medical editor for ABC News and author of ”The Truth About Getting Sick in America.” He’s joined by his regular guests: John McDonough, a professor at the Harvard School of Public Health; Gail Wilensky, a health official under the first President Bush; and Larry Levitt, a senior vice president at the Kaiser Family Foundation.

First on the agenda: An update on the latest enrollment numbers — the December surge was expected to drop off, but January remained strong as well — and a bit on the continuing unknowns, including: Just how healthy or sick are the new enrollees?

John McDonough notes that much also remains unclear about the high numbers of recent Medicaid enrollees: How many were actually uninsured before?  And he discusses problems in several states that planned energetic Obamacare roll-outs but are stumbling over technical problems: Minnesota, Maryland and Massachusetts “are all having a very, very difficult time getting their Websites up, so that’s a real problem,” he says.

Also up for debate: the big news that three GOP senators are proposing a new conservative alternative to Obamacare, focused particularly on lowering costs. It’s called the “Patient Choice, Affordability, Responsibility and Empowerment” act, or Patient CARE. What are its political prospects?

Listen to the full podcast by clicking on the play button above.

Dr. Tim Johnson’s Obamacare Podcast: The ‘Unbelievable Bumble’

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

Dr. Timothy Johnson, retired Medical Editor for ABC News, in the WBUR studios. (Jesse Costa/WBUR)

As president, you know things are really getting bad when every humor outlet from The New Yorker’s Andy Borowitz (“Snowden Offers To Fix Healthcare.gov“) to The Onion (“New Improved Obamacare Program Released On 35 Floppy Disks“) is mocking your program’s failures.

President Obama himself expressed his frustration today over the widespread technical glitches besetting people trying to sign up for health insurance under Obamacare, saying that “nobody is madder than me,” NPR reports.

Here, in his latest podcast on health reform, Dr. Timothy Johnson, retired medical editor for ABC News, takes on what he calls “the very rocky start to the centerpiece of the Affordable Care Act: the insurance exchanges.” He and his guests discuss the technical SNAFUs that are marking the launch of the exchanges and dissect their causes. He begins with a New York Times article today that says federal health authorities simply did not have the expertise to do the job of setting up the technological infrastructure needed for Obamacare. He asks, “Question #1, are they right, these reporters? And question #2, can it be fixed?”

Listen to the podcast above to hear some answers (and to hear guest Dr. Gail Wilensky, a high health official under the first President Bush, refer to Obamacare’s technical failings as “an unbelievable bumble” — what a fun phrase, rolling so nicely off the tongue!) And here’s one useful tip: For those who have trouble on healthcare.gov, the Kaiser Family Foundation is offering a simple calculator of health insurance subsidies on its website, www.kff.org.

Readers, reactions? Please share below. And catch Dr. Johnson’s inaugural podcast here.

Dr. Tim’s Top Ten Health Reform Points


There’s something about Dr. Tim Johnson, the longtime ABC medical correspondent. You trust him. If he wrote you a prescription, you’d fill it. These days, he’s writing a prescription for the entire country, trying to cure the health care system of its spiraling costs. (He’s currently scheduled to appear Nov. 8 on WBUR’s “On Point.”)
As mentioned here, he has a new e-book out, “The Truth About Getting Sick in America.” He kindly consented to distill the whole thing down into its ten most essential points:

1) The US spends more than twice as much per person on health care as the average of all other industrialized countries ($7538 vs.$3060 in 2008) BUT we get no better outcomes AND we are the only industrialized country without universal insurance coverage.

2) For example, the five-year survival rates for 17 cancers are virtually the same in the US and Canada even though we spend almost twice as much per person ($7538 vs. $4079 in 2008).

3) And even within our own country, there are enormous differences in expenditures (adjusted for cost of living) with no difference in outcomes. For example, in Medicare spending in 2006: over $14,000 per person in Miami vs. under $6000 per person in Salem, OR.

4) One of the major factors encouraging this high spending without better outcomes is our “fee for service” payment system that basically says to doctors, hospitals, drug and device companies: the more you do or sell, the more you make. In other words our payment system incentivizes health care providers to do more whether or not it makes any difference in outcome.
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Fix Health Care In 77 Words Or 57 Pages

They don’t waste words.

In a letter to The New York Times, Dr. Arnold S. Relman, former chief of the New England Journal of Medicine, sums up his fixes for the health care system in a concise 77 (yes, I counted) words, including these:

To straighten out our dysfunctional malpractice system we need two separate systems: a no-fault insurance system to compensate plaintiffs and expert professional panels to determine misconduct by providers.

To control costs and improve care, we need to reform the organization and payment of medical practice along the lines suggested by recent proposals for “accountable care organizations,” and we need to replace fee-for-service with global payment (a fee per patient or medical episode). Multispecialty group practice should be the medical organization model of the future.

Not quite so brief, but still stunningly succinct, is a new manifesto just out from Dr. Timothy Johnson, longtime medical correspondent for ABC News. It is titled “The Truth About Getting Sick in America: The Real Problems with Health Care and What We Can Do,” and is just out as an e-book from Hyperion.

Always a great explainer, he packs it with fascinating facts (Median annal income for family practitioner: $176,000; median income for neurosurgeon: $609,000), frightening truths and dire predictions.

To wit: “Within five to ten years, health care costs will be so out of control that we — the public — will demand that the government bail us out. At that point, the easiest and quickest action will be to expand Medicare to cover everyone.”

And that, he suggests, may not be such a bad thing: “In my opinion, there is no way to get costs and quality under control without a strong role for federal government.”

Readers, here’s a mental challenge: How would you fix the health care system in 77 words or less? Write your scrip as a comment, and whoever gets the most “like”s by next Monday wins a nifty WBUR keepsake.