In the real world, the choices aren’t made clear in the employee benefits office. In the real world, the cheap health plan and the expensive health plan both promise you ‘medically necessary’ care and you don’t really know what that means. So you sign up for this care and you think, ‘Aha! This one’s cheaper than the other. And it’s promising medically necessary care. You don’t really know that one car is a Lexus and one car is a Chevy. These two plans are being presented to you as Lexuses. And so you say, ‘I’ll buy it.’ But in fact, in terms of the care it makes available, it’s cheap because it’s a Chevy, not a Lexus.

— Physician and health policy expert Gregg Bloche explains how it’s really, really confusing to pick health insurance plans….and why picking the wrong plan may mean the denial of treatment.

The principles of the oath, says Dr. Gregg Bloche, are under an “unprecedented threat.” In The Hippocratic Myth, Bloche details how doctors are under constant pressure to compromise or ration their care in order to please lawmakers, lawyers and insurance companies.

In the current health care system, you’re not paid to keep people healthy. If you’re a complex patient with a range of problems, it doesn’t fit into the world [of primary care visits.] You needs a project manager — a whole team to take you under their wing and see you through this course of illness. What [Brenner’s] creating is the system as it should be.

— Atul Gawande, talking about Dr. Jeff Brenner, who is working to lower health care costs in Camden, New Jersey by targeting the chronically ill.

Atul Gawande joins Twitter. (Gawande on Fresh Air last July talking about hospice and end-of-life care decisions.)