What would it take to make the US health care system the best in the world? We already spend more money (by far) on health care than any other country, but our results are middling (see the figure below). Recent thoughts on what the US might do in order to translate our huge financial investment in health into better results, in the NEJM.
“The first challenge the U.S. health care system must confront is lack of access to health care…Affordable and comprehensive insurance coverage is fundamental. If people are uninsured, some delay seeking care, some of those end up with serious health problems, and some of them die.
The second challenge is the relative underinvestment in primary care in the United States as compared with other countries…In contrast to the United States, a higher percentage of these countries’ professional workforce is dedicated to primary care than to specialty care, and they enable delivery of a wider range of services at first contact…” Continue reading Health Policy Updates: August 19 2017
Physicians have not always been on the forefront of health care reform. In fact, we have often opposed it. A brief history and predictions for the near future, by James Surowiecki in the New Yorker.
“Doctors have typically framed their opposition to reform in terms of the need to protect the doctor-patient relationship from outside interference. That’s understandable and legitimate. But many doctors have also fought reform because it runs counter to their financial interests. As an A.M.A report once said, doctors ‘display a consistent preoccupation with their economic insecurity’; more bluntly, ‘They think about money a lot.'”
Continue reading Health Policy Updates: December 24 2016
Bill Clinton caused a still last week for using the word “crazy” to describe Obamacare. This was particularly questionable, argues Avik Roy, given the similarity of Hillary Clinton’s plan to Obama’s during the 2008 election season.
“If Hillary had won in 2008, and it had been her plan instead of Obama’s that became law in 2010, Hillarycare would be imposing exactly the same rate hikes as Obamacare has.”
Sarah Kliff sorted through Clinton’s remarks here.
Continue reading Health Policy Updates: October 8 2016
It was deja vu all over again, when a federal court judge laid down a ruling that (if it ultimately stands) would be a severe blow to the ACA/Obamacare.
What was the legal question this time? Apparently, the ACA cannot spend money to subsidize health insurance (all of the reduced-price insurance plans on the health care exchanges) without first having appropriated the money through Congress. Read more, from Sarah Kliff at Vox, here.
“This victory in Washington isn’t the final word on the lawsuit. But it does allow it to move forward, and means that the legal battle over Obamacare — one that has already included four Supreme Court cases — still isn’t over yet.”
Hillary Clinton made the health policy news this week for new statements regarding her ideas for new health care legislation. In contrast to Bernie Sanders’ “Medicare for All” single-payer type of plan, her new proposal for expanding health insurance coverage is being characterized as “Medicare for More.”
“The Medicare program covers Americans once they reach 65. Beneficiaries pay premiums to help cover the cost of their coverage, but the government pays the bulk of the bill. Mrs. Clinton’s suggestion was that perhaps younger Americans, ‘people 55 or 50 and up,’ could voluntarily pay to join the program.” Continue reading Health Policy Updates: May 14 2016
I have written about price variability in medical care in this space previously. New this week is a study in Health Affairs further demonstrating the huge differences in prices for medical procedures, depending on where you get them done. The related problem of the lack of price transparency to US consumers is included in my health care spending map.
Sarah Cliff talks about the study in Vox. Continue reading Health Policy Updates: May 1 2016