Insurance Woes
A great cartoon from the Kaiser Health News website that pithily captures the “wonders” of the American health insurance system.

A great cartoon from the Kaiser Health News website that pithily captures the “wonders” of the American health insurance system.

I teach an undergraduate health policy class at Duke University. Recently, my students asked me whether states potentially hurt themselves by offering generous health care benefits when neighboring states don’t offer such benefits. Then I got home and pulled out a recent issue of Health Affairs, and read the results of a study suggesting that this…
David Asch and I recently published an article in Health Affairs on the challenge of getting healthcare practitioners to stop doing things they are accustomed to doing, even when the evidence that those things are harmful becomes overwhelming. Here is a teaser from that article, and a link to the full piece: As hard as…
A while ago, I wrote a post on how hard it can be for Medicaid recipients to get medical appointments, because so many physicians limit the number of Medicaid patients they see. They limit the number because Medicaid reimbursement is often, well, crappy! Here is a picture from a recent NEJM piece showing just how…
Healthcare reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients. This complexity…
Any sensible plan to reform the U.S. health care system must reform the way we pay physicians. Currently, we reward doctors for doing more “stuff” for their patients — for performing tests and procedures whether or not these interventions are necessary. Because of this strange reimbursement system, many primary care physicians receive more money performing…
In the New York Times on Thursday, October 17, Topher Spiro wrote an important op-ed expressing why we need to hold onto the medical device tax that helps pay for parts of the Affordable Care Act. Spiro backs up his argument by pointing out how profitable the device industry is. To his argument I would also add the fact…