Ricky's Riffs:

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


On the Opioid and Gun Violence Epidemics: Rationales in Common

September 19th, 2018

We are currently in the midst of the most lethal drug epidemic in our country’s history. One of the shocking things about this crisis is that it has been going on for the past 20 years without showing any signs of letting up.  In 2016, overdoses involving opioids killed more than 42,000 people.  Of those deaths, 40% were from prescription opioids.   (Statistics are still being finalized for 2017.)

Several recent books describe the evolution of this epidemic, each from a slightly different perspective.*  I’ll focus on just one of them here.Read the rest of this entry »


A Rationale For A Single Payer Health Care System

August 27th, 2018

Real change is coming to our health insurance system.  This is inevitable for the simple reason that the system, as it stands, is not sustainable.  Premiums and deductibles keep rising, way beyond the rate of inflation. Drug prices also rise, as do hospital and medical device costs.

In 2010 President Obama pushed through his landmark legislation, the Affordable Care Act (ACA), which enabled millions of previously uninsured people to get health insurance for the first time. But the model was still rooted in the same private insurance system, and dominated by the usual players: Aetna, United Health Care, Cigna and the “Blues”. So there was little reason to expect the inflationary trends to slow down.Read the rest of this entry »


Book Review: “Irresistible: The Rise Of Addictive Technology And The Business Of Keeping Us Hooked” by Eric Alter

March 26th, 2018

With the recent revelations about the Russian trolling of the 2016 presidential election, during which both Facebook and Twitter were manipulated by a foreign power, we are witnessing the beginning of a national reckoning with social media.  A global network that was initially seen as a great gift to humankind is now being reconsidered.

Hailed as a great unifier, and a way to connect people—social media was the force behind the Arab Spring and other revolutionary movements—the broader implications of this network have come crashing down on us.  There has even been a good deal of hand wringing among some ex-Facebook executives, who have had second thoughts about what they have created.

Irresistible, the new book by Eric Alter, that describes the effects of social media on our children and the science behind those effects, sheds light on some of the reasons for this soul searching.Read the rest of this entry »


Book Review: “The Healing of America” by T.R. Reid

October 19th, 2017

Part of my frustration, as I watch the current health care debate, is realizing that most of those charged with reforming our economy simply do not understand the health care system. This holds true from the House of Representatives up to the Presidency.

The health care sector is one sixth of the US economy.  Those making decisions need to be educated about how this behemoth works. What are the cost drivers? Where are the inefficiencies? What are the relationships between interest groups—such as the pharmaceutical, medical device, hospital and insurance lobbies—and legislators in Washington, DC? Read the rest of this entry »


Book Review: “An American Sickness: How Healthcare Became Big Business And How You Can Take It Back” by Elisabeth Rosenthal

August 2nd, 2017

The Republican Congress has been doing its best to bring down the Affordable Care Act (Obamacare) and replace it with the cruel joke that would be known as “Trumpcare.” Despite the fact that only 17% of the public supports the Republican proposals, the GOP is still trying to burn the ACA to the ground.

It is in this environment that Dr. Elisabeth Rosenthal’s new book–An American Sickness–has arrived. The timing could not be better!Read the rest of this entry »


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 »


Pain and Suffering of the Digital Natives

October 25th, 2016

“Digital natives” are those young women and men who have been raised from childhood on computers. We see them everywhere:  Toddlers in strollers playing with iPhones, pre-teens on iPads in restaurants, strategically distracted to allow their parents to eat in peace; Junior High and High School kids doing schoolwork on laptops in the classroom or at home, sitting or lying in bed.

For the digital native, the computer is an extension of his or her body.  By the time they enter pre-school, many can navigate apps.  Ten-year olds can program software. Adolescents live their social lives on tiny screens.  Most of the digital native’s life runs through this digital medium.

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 »