By Evan Falchuk

To the right of these words you see three icons – one for a service called “digg,” one for Facebook, and one for another called “reddit.”  At the bottom of the post, you can see an icon for “buzz.”

If you don’t know, I wanted to give you a quick explanation of what those are there for and how they work.

DIGG AND REDDIT. Digg and reddit are similar services.  They are ways that people can tell other people that they found something interesting and worth reading.  To use them, all you need to do is set up an account on digg and reddit. Then you can browse around and find out what are the most popular, most controversial, or newest stories or blog posts that people around are talking about.

It takes about a minute to set up you account, and you’ll be very glad you did it.  I go to both sites all the time and find loads of interesting stuff.

Many media people use these services to source stories – I often find that something I see on TV or in a newspaper as “news” is something I read about through digg or reddit many days beforehand.  That’s cool.

I have those links on each of my blog posts so you can let other people know about anything I might write that is interesting.  The number on the digg icon tells you how many people have shared the post on digg.  The number on the reddit icon is a combination of how many people posted it and how many people liked or disliked it.  If you like it you can click the “up” arrow and if you thought it sucked, you can click the “down” arrow.

So PLEASE, if you like something I wrote, click on digg or reddit and let other people know.

BUZZ. This is sort of like Google’s version of digg, although it’s more like a combination of digg and twitter.  If you have a Buzz account, you’ll share whatever you click on with your network of followers.  It’s kind of an emerging network, but it’s Google, so I feel like I have to have it on the blog or someone will come to my house at night and make me put it on there.  Just kidding.  Sort of.

FACEBOOK. If you click there, it will open a new window, and it will automatically help you post what you’ve read here to your Facebook account.  Like the digg icon, the number there tells you how many people have shared the story on Facebook using that icon.  It doesn’t count if you just copy and paste the url, but I’m fine either way!

Thank you very much to all of my readers, it’s a thrill to me to have so many of you here every day.

Please help spread the word about my blog by clicking on those icons whenever you read something you like.

Thank you again!

By Evan Falchuk

EXCITEMENT, that’s what.

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By Evan Falchuk

The Jobbing Doctor, a primary care doctor in the UK, writes today about the British version of what Americans call “Pay for Performance,” or “P4P.”

He says something I’ve said many times before (like here, here, and here).  Which is this: incentives fail because they try to treat medicine as an assembly line process, when it’s not.

But what’s most interesting about his post is that it could have been written by a doctor from anyplace on the planet Earth.

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By Evan Falchuk

So the President gave a speech yesterday in which he said he would push, with Democrats in Congress, to pass a major health care bill through a process called “reconciliation.”

I don’t think most of us know what that is, exactly.  The meaning of it is simple, though: they can pass a bill with a simple majority vote.  They can eliminate a Republican filibuster in the Senate.  It’s been called the “nuclear” option, well, at least since Republican Trent Lott dubbed it that some years ago.

Some people are appalled that this could happen.  Should they be?

I don’t think so.

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By Evan Falchuk

The American Cancer Society says that men over 50 need to seriously consider whether they really ought to get screened for prostate cancer.  According to them, the risks of getting tested may outweigh the benefits of detecting the cancer, especially for younger men.  They say it’s a “complex issue,” but they understate how complicated it really is.

Like the recent controversy over breast cancer screening, the new recommendations add to the swirling morass of conflicting messages and priorities around health care in America.

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By Evan Falchuk

Warren Buffet is talking and reform opponents love what the unofficial Obama adviser has to say.  He says the President should scrap the whole thing and start over.

He says health care costs are a “tape worm” eating at American competitiveness.  His prescription: a “united effort,” a “national emergency” that will allow us, finally, to focus on “costs costs costs” above all else.

Buffet is a brilliant man, and he makes a very good point about how botched the sales job on reform has been.  But he’s missing something very important:

We have been focused on health care costs in America.  For decades.

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By Evan Falchuk

Today the Commonwealth Fund came out with a chart that it says is a “grim reminder” of what happens when health care doesn’t get reformed.

If only we had listened to Richard Nixon or Jimmy Carter.  We would have saved tens of trillions of dollars in health care spending.

Click to enlarge

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By Evan Falchuk

So the big, long health care summit in DC is over- here are my quick five quick reactions to it:

1.  It should have happened a long time ago, but it couldn’t have. It was a substantive conversation.  David Gergen said that, intellectually, “the Republicans had their best day in years” (he meant it as a compliment).  The bills that came out of Congress probably would have been a lot better if they had been discussed like this before they were drafted.  The trouble is, representatives on both sides weren’t at all up to speed on health care back then, so they couldn’t have had a conversation like this.  So we end up with bills first, smart talk later.  I think there’s a movie coming out about that kind of thing next week.

2. It was still riddled with silliness. Nancy Pelosi said the plans would create 400,000 jobs “almost immediately,” and would overall create millions of new jobs.  Meanwhile, John Boehner kept insisting that the plans were a “government takeover” of health care.  It wasn’t clear if Pelosi or Boehner were talking about the House bill, the Senate bill or the President’s new plan.  Actually, it wasn’t clear what they were talking about at all.  What always surprises me is the extent to which many politicians just say stuff that they can’t possibly believe to be true.  It’s one reason why a lot of people don’t want to trust them with important things that directly affect their lives…like health care.

3. You can’t put reform in a box and say you’re for it or against it. Well, I guess you could do it literally with the 2,000+ page bills, but I mean it figuratively.  They talked about a huge number of topics.  The uninsured, medical malpractice, rising health care costs, Medicare, Medicaid, comparative effectiveness, health insurance premiums, insurance mandates, state versus federal insurance regulation, interstate sales of insurance, pre-existing condition exclusions, uncompensated care, over-use of the ER, and on and on and on.  It’s the trouble with the so-called “comprehensive” plans- there’s no “system” to comprehensively reform.  So the bills aren’t “comprehensive,” they’re just long – a giant collection of stuff that will impact the health care system, some for the good some for the bad.

4.  It’s another cog in the anxiety machine. The fact that all of America’s top leaders, in the midst of a terrible economy and two wars, would meet for an entire day about health care sends a message that this is a hugely important issue.  And it is an important issue.  But the trouble with reform from the beginning has been that voters don’t understand what’s happening and are worried about it.  Today, as a friend suggested to me, was like porn for policy wonks.  But I think to regular people it just sounds like trouble.  Something big is happening which I don’t understand but which I know will affect me in ways I’m not going to like.  I’m sure representatives from vulnerable districts didn’t like it when the President said near the end that if the voters don’t like it they can vote in November.

5.  Republicans shouldn’t misread what’s happening. Republicans clearly have read the polls showing opposition to the reform plans.  But like in Massachusetts, rising support for Republicans isn’t because Americans are suddenly turning to their ideas.  I think voters just want this long, long, long health care saga to end.  As James Carville might have said, it’s the health care, stupid.

By Evan Falchuk

When Danny Williams, the Premier of Newfoundland and Labrador, mysteriously disappeared to the United States for heart surgery, it was a scandal in Canada.  Why, asked many Canadians, would a government official abandon the Canadian health care system in his own time of need?

The secrecy surrounding where he went and why only added to the sense that he knew the was doing something bad for his political health.

Now he’s talking, and he’s saying things that I suspect sound pretty radical for Canadians.  Politically, he’s almost forced to say it.  But I wonder if he really needed to be in the fix he is in.

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By Evan Falchuk

Barely a week after Massachusetts Governor Deval Patrick said he wants state controls on the price of health insurance, President Obama apparently wants to do the same at the federal level.  Both men must believe it’s good politics, because there are about 4,000 years of evidence that it’s not good policy.

But the trouble for reformers has never really been about policy.  It’s been about a fundamental misunderstanding of how people view health care and the very bad things that happen when you give people the impression you’re going to mess with what they have.

In this sense, the reform bills are like perpetual anxiety machines.  Contraptions that continually produce more public anxiety than they consume.

But why is this?

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