Since the recession hit hard a few years ago, health care expenditures have slowed dramatically. It now looks like, at least for medications, cost increases are making a comeback. For instance: Nexium, a heartburn drug, had a 7.8% price hike to a $262 average prescription in the first nine months of 2012. Enough to make…
States face a tough choice right now, of whether to expand their Medicaid roles with 90% of the costs being borne by the government. (Medicaid is a combined Federal/State program to pay for healthcare of low income individuals and families.) Why is taking money from the Feds a tough decision? For starters, it means supporting,…
You may have heard this week about a new study, led by my friend and colleague Pete Cram, which revealed astonishing variation in prices for hip replacement surgery. Staggering, actually—ranging from a bit over $10,000 to over $125,000. I have blogged a bit about hospital prices, and doctor fees, even a recent post on orthopedic…
Interesting take on the Bay of Pigs thinking in the Kennedy administration, as summarized in Jim Newton’s book on the Eisenhower Presidency: “The entire enterprise depended on an intelligence assumption that proved false, namely, that the Cuban people would greet the invasion force as liberators and turn against Castro.” Sounds eerily familiar to the Bush…
In September of 2011, Laugesen and colleagues looked at why health care in the US costs so much. Part of their analysis explored primary care physician fees. It showed that primary care docs in the US make a bit more, per office visit, than their colleagues in 5 other countries. But Americans are much less…
Andrews was easily the most anxious patient I took care of that month, a gray Michigan February (is there any other kind?) which I spent in the hospital caring for patients admitted to the general medical ward at the Ann Arbor Veterans Affairs Medical Center. (Andrews is a pseudonym, as are all the patients I blog about, unless…
“Revolutions are often fought over dichotomies—the king versus the people, the bourgeoisie versus the proletariat, and, of course, the autonomous patient versus the paternalistic doctor.” So observes Peter Ubel in the conclusion of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. Who decides? Doctor or patient? For decades, too…
NPR’s Planet Money published two excellent graphs this week, comparing health care spending in the US now versus the 70s and 90s. For example, here’s what they reveal about hospital versus non-hospital spending: In other words, hospitals have a shrinking proportion of the health care dollar, but not one that is shrinking very much. Despite…
In the New York Times on Friday, Roni Caryn Rabin writes a great article about the crazy price hikes that hospitals and medical clinics impose upon patients who come to them from “out of the network.” Examples include a more than $6,000 doctor visit, one for which Medicare would have paid less than $200. Examples…
I got an email recently from someone who read Critical Decisions, and who said it resonated with her in part because of work she does with a breast cancer hot line. “I’ve been volunteering as a Helpline worker for Living Beyond Breast Cancer. We get a lot of calls from women who seem to have…