Articles

Much of what OMRUM reviews and analyzes is the total amount of money spent on healthcare in the United States but also who claims what percentage of each dollar. Based on our historical trend, the United States will spend, for the 1st time ever, over $5 trillion on...

1 of the most important arms of the government for public health is the HHS (Health and Human Services). It was created in 1953 and was known originally as HEW (Health, Education, and Welfare). Its motto is “Improving the health, safety, and well-being of America”....

As many readers know, the U.S. Congress recently passed and forwarded a large legislative bill to the president which he signed on July 4, 2025. The One Big Beautiful Bill Act is close to 1000 pages long and a relatively complex item of legislation. It has many parts...

1 of the fallacies from which this magazine would like to disabuse readers is that the free market system as it applies to the healthcare system is working well in holding down costs in the United States of America. This lack of control is, of course, a common theme...

OMRUM has presented a number of articles demonstrating conflicting policies and priorities for patients in our current system. These policies lead to chaotic and profligate behaviors by larger entities such as hospitals. One unusual set of behaviors will be discussed...

Most would agree that the father of medical imaging is Wilhelm Röntgen who in 1895 made 2 interesting discoveries. The 1st were x-rays themselves and the 2nd was their ability to discern anatomic features such as bones. X-rays occupy the part of the electromagnetic...

This article will be something of a departure from many of the above articles. Previous articles emphasized the unusually inefficient system we have and the enormous cost savings our system could achieve by reform. However, this magazine is called OMRUM (Optimal...

Years ago, Charles de Gaulle of France famously said "How can you govern a country which has 246 varieties of cheese?” In a similar fashion, one might ask how can we improve our current healthcare system when it is so heterogeneous, i.e. has so many different moving...

As noted often, the goal of OMRUM is to reduce the cost of healthcare while maintaining or (better yet) improving quality. However, any time one hears about reducing costs while improving quality, human experience urges caution if not overt doubt. After all, if...

In order to develop properly the idea of either outpatient or inpatient recidivism, some background is necessary. In this case, it involves who is responsible for the patient and who is responsible for patient care transitions. 1 of the most important concepts in a...

In finance, one hears the term “return on investment” frequently. A more colloquial expression might be “bang for the buck”. Another angle in the same discussion, especially when discussing the healthcare system, would be for a patient to reduce negative behavior and...

As reviewed in the previous piece (itself a summary of previous articles), the medical system in the United States has fallen far behind its first world neighbors in cost, coverage, and quality. Few of us are surprised by this information. In this article, I would...

We now begin the magazine’s second calendar year. We shall summarize what was reviewed in the early part of the magazine. The US spends $4.5 trillion/year on healthcare or $13,493/person(2022) each year, the highest cost per capita of any developed country in the...

The principal goal of this magazine is to promote cost reduction while maintaining or more ideally improving the quality of medical care. The discussion in the first year of OMRUM’s existence has largely focused on the “big strokes” of difficulties with medical care...

In the previous article, the term “siloed physician care” was introduced. Physicians who practice in this manner see their roles as narrow in their patients’ care. Often, they don’t see themselves as obligated to any greater purpose in a patient’s management. For any...

As an internist (a PCP for adults), one of my greatest challenges was finding a good specialist pool when referral was necessary. A specialist should be well-trained, judicious in use of resources, and at least reasonable in bedside manner. Interestingly enough, the...

Few issues affect society at so many levels as does the current controlled substance debacle and arguably the opioid crisis in particular. It disproportionately exists within poorer and less educated communities. It draws resources from law enforcement at the federal...

So, we will now resume development of how best to measure factors influencing the future cost of care for a patient. In Part I, the idea was brought up of measuring patient fitness as a good surrogate of future cost of care for the patient. A simple starting point for...

In order for the patient population to benefit best from any medical system and especially a universal healthcare system, the care team ministering to the patient must be, ideally, headed by a PCP (primary care physician). Specifically, I believe that every patient in...

An important question to ask at this point in what positive behaviors might a patient engage to stay healthier and reduce costs (as opposed to avoiding negative behaviors such as smoking, excess drinking, etc.) Allow me the following story after which I will develop...