Tag Archives: Atul Guwande

Health Policy Updates: March 11 2017

The big health policy news this week was the revelation of the new GOP “repeal and replace”/Trumpcare plan, which has been named the American Health Care Act or AHCA.

Vox.com’s Sarah Kliff explains how some of the biggest proposed changes would work:

“In 2020, enrollment in the Medicaid expansion will “freeze” and states with no longer be able to sign new enrollees up for the program. Legislators expect that enrollment would slowly decline, as enrollees’ incomes change and they shift off the program…

On the surface, the tax credits for the oldest Americans seem the most generous. People in their 60s, for example, get twice as much help as those in their 20s….But under the Republican plan, insurers would be allowed to charge the oldest Americans five times as much as the youngest Americans. Their financial help would not scale nearly as much as their premiums would.”

I liked this “high yield” layout from the NYTimes of what the GOP plan will keep, change, or get rid of from Obamacare.

Conservative health policy expert Avik Roy weighed in on the plan in Forbes:

“Leading House Republicans have included a number of transformative and consequential reforms in their American Health Care Act, the full text of which was published Monday evening. But those reforms are overshadowed by the bill’s stubborn desire to make health insurance unaffordable for millions of Americans, and trap millions more in poverty.”

Continue reading Health Policy Updates: March 11 2017

Health Policy Updates: August 14 2016

A large part of the ACA/Obamacare was to expand Medicaid; many (though not all) states elected to do so. New data out this week in JAMA Internal Medicine suggests that patients are benefiting. Compared to states that did not expand Medicaid, previously uninsured patients who have now gained access to Medicaid coverage do better on many metrics, including better access to outpatient care, increased diabetes screening, and reduced non-compliance due to cost.

The Oregon Medicaid experiment from a few years ago left Medicaid skeptics with some reason to be agnostic as to whether Medicaid actually improves people’s health. These data lessen the foundation for such skepticism, and should  thus should help move the conversation forward. Continue reading Health Policy Updates: August 14 2016

Health Policy Updates: December 19 2015

The Washington Post’s Wonkblog reports on a new study out of UNC-Chapel Hill, finding that significant out-of-pocket prescription drug costs still exist for seniors on Medicare. Even once the “donut hole” closes, prohibitive coverage gaps for seniors will still exist.

“What the researchers found is that closing the coverage gap will save money – about $2,500 at current cancer drug prices. But that still means around $4,000 to $10,000 out-of-pocket spending for patients, which may be unattainable for people on a fixed income. And that assumes that drug prices stay stable and do not increase, as they’ve been doing for many cancer drugs.” Continue reading Health Policy Updates: December 19 2015

Health Policy Updates: December 5 2015

One of the parts of the ACA/Obamacare law was the creation of insurance companies known as “coops.” These consumer-run organizations were intended to increase competition and offer lower-cost insurance options to patients. However, many of the coops have been folding in recent months, for a variety of reasons, and now less than half of the 23 original coops are still standing.

“Several co-ops said they wouldn’t be able to enroll new customers in 2016 after the Centers for Medicare and Medicaid Services (CMS) announced that certain reimbursement rates would be only 12.6 percent of what had been expected. Eighteen co-ops were denied money they were expecting, according to Martin Hickey, CEO of New Mexico Health Connections and chairman of the National Alliance of State Health CO-OPs.” Continue reading Health Policy Updates: December 5 2015

Health Policy Updates: May 9 2015

First, an FYI this week: I will be giving Medicine Grand Rounds coming up pretty soon, on the morning of Friday the 22nd. I will be focusing mainly on Health Services research, but will also plan on touching on a variety of health policy topics. I hope some of you can make it!


If you read one thing this week, read Atul Guwande’s essay “Overkill.” It is an eloquent (of course) and comprehensive look at all of the factors contributing to unnecessary, low-value health care in the USA.
Our ever more sensitive technologies turn up more and more abnormalities—cancers, clogged arteries, damaged-looking knees and backs—that aren’t actually causing problems and never will. And then we doctors try to fix them, even though the result is often more harm than good.”