Ricky's Riffs:

Random Thoughts on Travel, Education, Health, and the World in General


A Doctor Examines Trumpcare – Ricky’s recent Interview with Michael Finney

July 9th, 2017

Dr. Ricky Fishman talks about the current battle in Congress over Trumpcare, the unpopular bill being pushed by the Republican majority.  He describes the  effects of this bill on millions who may lose their health insurance and discusses where he sees health care going.  He believes that, in the end, we will have a single payer system.  However, the powers aligned against this movement are enormous.  Have a listen!


Public Option: Next Step Toward Universal Health Care

April 29th, 2017

The Republicans have failed to “repeal and replace” the Affordable Care Act (ACA).  They stated this would be their first order of business upon coming into power.  Although they will surely continue their efforts, it is unlikely that they will succeed.

It is now time to move forward with real health care reform.Read the rest of this entry »


How the ACA is “Blowing Up” the Health Care System and Why That is a Good Thing

April 4th, 2017

The American Health Care Act (AHCA) was written, presented, lobbied for and rejected within the first 60 days of Donald Trump’s presidency. For eight years, the Republicans had made “repeal and replace Obamacare” their rallying cry.  Yet even with control of both the executive and legislative branches of the Congress, Republicans were unable to pass what was to be their “signature” piece of legislation. It died a messy death in the House of Representatives.

The rushed and poorly thought out bill was defeated by the Democrats as well as by the Freedom Caucus, the ultra-conservative wing of the Republican Party.

The bill’s defeat was a victory for the Democratic party, but also for America. The Affordable Care Act (ACA)—an important step on the path towards universal health care coverage for all Americans—was, for the time being, preserved.Read the rest of this entry »


Obamacare and the Shifting of the American Mind

March 20th, 2017

The first order of business for Donald Trump and the Republican party was to “repeal and replace” the Affordable Care Act (ACA), commonly known as Obamacare.

Obamacare was the signature piece of legislation of President Obama’s eight years in office.  In terms of historical significance, it has been compared to Social Security and Medicare. It was a big leap–and a messy one.Read the rest of this entry »


Incrementalism vs. Revolution in Health Care, Part 2: Is Obamacare Crashing?

August 26th, 2016

The recent announcement that Aetna would be pulling out of a large number of the Affordable Care Act (ACA or Obamacare) exchanges, affirms a fundamental truth about health care and insurance in our country. Business and health care do not mix.

The ultimate goal of health care is to heal patients.  The goal of private industry, based upon shareholder mandate, is to generate profits.Read the rest of this entry »


Interview With Michael Finney–On the Direction of Health Care, 6/4/16

July 15th, 2016

Here is a radio interview I did with Michael Finney, KGO TV (Channel 7) consumer news reporter, on the direction I see health care moving in this country. We talked, among other things, about the differences, and similarities, between Bernie and Hillary on how we get to universal coverage. I explained to Michael how the changes in the health care system over the last several years have deeply impacted providers; about how most people have no idea about the reimbursement cuts most doctors have had to take; and more. So check it out and feel free to let me know your thoughts on this subject.

 


A World of Pain

June 30th, 2016

In our highly medicated society, Americans consume more mind and mood altering drugs—legal, illegal and prescribed–than any other people in the world.  Cocaine, heroin, marijuana, Xanax, Ambien, Atavan, alcohol and many more: a full spectrum of pain, anti-anxiety, anti-depressant and stimulating medications.

We all know people affected by the overuse of these substances. Some of us know people who have died from them.

But why are we in so much pain?  So depressed?  Why can’t we sleep? Or focus?Read the rest of this entry »


Revolution or Incrementalism: The Battle Over American Health Care

May 14th, 2016

As a health care provider, I have followed his year’s democratic presidential race with great interest. One major policy difference between Bernie Sanders and Hillary Clinton is that Bernie is pushing for a single payer model and Hillary wants to “build” on the Affordable Care Act that was passed under President Obama.

Here are a few of my thoughts on the subject.Read the rest of this entry »


Empathy, Patient Centered Care and Healing

September 30th, 2015

Carlos presented in the clinic, walking stiffly.  He wore a green asbestos suit and steel toed boots.  The distinctive chemical smell of the steel mill where he worked clung to him like a second skin.  Carlos is a welder. He wields a blow torch for most of his day.  Large pieces of steel hanging from gigantic chains and pulleys circle above and around him.  One by one, he maneuvers them into a position where he can begin the fiery work of melting them down and reshaping them.

There are open fires in the big, hangar-like space where Carlos works.  A toxic cloud hangs over the building, penetrating the clothing and skin of all who are exposed.  The ground shakes every 15 minutes or so from a machine in the next building as it pounds tons of molten steel into new forms.  After awhile, one doesn’t notice these little earthquakes.  They just blend in with the sounds of saws, trucks and the loud whistles that signal break time.

The work is tough but lucrative, especially for a recent arrival from Mexico.  A union job.  Seventeen dollars per hour, English not required.  But it takes a toll on the body.  One day, after three years on the job, Carlos bent over to pick up his blow torch and felt a sharp lower back pain that radiated into his right buttock.  It was enough to stop him from going on.  He reported the injury to his supervisor, who filled out a work injury report and sent Carlos to the clinic where I work to be examined and treated.  While Carlos was glad to get the medical attention, he was also thinking about missed time from work, lost pay and his family.  As there were rumors that another round of layoffs was coming, he was feeling very anxious.Read the rest of this entry »


Pathologizing the Female Body: Pregnancy, Modern Medicine and Integrative Care

April 30th, 2015

Pregnancy can be one of a woman’s most beautiful life experiences; an event many have dreamed of since girlhood. Hormones surge, creating a sense of euphoria (as well as occasional nausea). The awareness slowly arises of a real human being, her child, growing inside of her.Read the rest of this entry »