Dear Doctor, "They're just kicking your Medicare fees further down the road."

When patients require specific therapies and an insurance company makes the frail or sickly patients jump thru hoops, denying or delaying care, it's time to move away from the insurance model.  

Average waiting times to get a non-emergent appointment with a specialist in the USA)

"Managed Care 101 in 2010" runs the gamut from how you measure and do something about value in health care, to cost-comparisons, to who you can and cannot trust, to the rights and obligations of patients and practitioners, and the purlicue--how to fight back.

It's schadenfreude: enjoyment obtained from the troubles of others.  That's where I find myself as I observe the surfeit of specialists juxtaposed to a dearth of primary care docs.