The patient-centered model needs to replace the practice-centered model. The patient's health should be a higher priority than the doctor's rush to keep moving and fit as many people as possible into his schedule and his practice goals.

We have a tendency to rely on life-saving, last-minute efforts to turn around a person's health. These strategies are often unsuccessful and always extremely costly. They usually do not result in a lifetime improvement in health.

In a rational model of health care, the consumer must have the ability to distinguish bad products from good, and must have enough information and emotional distance to make purely rational choices about their or their loved ones' health care. There are a number of reasons this simply is not the case.

Without an emotional language our relationship with ourselves will be fraught with difficulty. And yet most of us have never learned to listen to ourselves and rarely even think about our emotional health as an absolute priority..... until something goes wrong.

If the D.C. Circuit decision in Halbig v. Burwell became the law of the land, it would threaten to place health insurance once again out of reach for the approximately 4.7 million families and individuals living in the 36 states where the federal government set up the Exchange.

Unfortunately, for most patients, patient-centered care is an anomaly. Hospitals are trying to change the culture to one of patient-centered care rapidly. Even so, hospitals often miss the mark.

Finding a place of compromise is commendable. But the budget accord earlier this month was silent on a critical issue that can wait no longer: reforming the state's Medicaid program.

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