The Affordable Care Act expanded Medicaid eligibility this year in those states which decided to follow its provisions. That means lots of people are now newly eligible for Medicaid. However, the number of people signing up for Medicaid in the states has been underwhelming. Which raises a question: how much can we expect enrollment numbers…
I was recently interviewed on NPR’s marketplace by Dan Gorenstein. He did a really nice story on the kind of bravery it takes for health care opinion leaders to put their ideas to the test of a randomized trial, when the world is already ready to pay them huge amounts of money to promote their…
People have criticized The Affordable Care Act for amounting to a large transfer of wealth, from wealthy Americans to those not as well off. But the real transfer of wealth has been from United States to other developed nations, whose healthcare costs we have subsidized for many years by paying so generously for many of…
As readers of this blog know, Medicare costs loom large in our nation’s future. If we do not find a way to control Medicare spending, it’s hard to imagine any way to remain a solvent nation. As we continue to explore ways of controlling these costs, it is important to remember that a great deal…
I recently reread a very informative New Yorker article by Ryan Lizza, called the Obama memos. I have assigned the article to my undergraduate health policy class, to help them understand the political climate surrounding the passage of The Affordable Care Act. And that climate was one of severe polarization, which cut against Obama’s naïve…
This week, my good friend Reshma Jagsi and I published an article in the New England Journal of Medicine, in which we explain why physicians are doing their job, as physicians, when they pay attention to healthcare costs. Here is a snippet from that article, and a link to find the full version. Health care costs…
A new study asks Orthopedic surgeons to guess the price of the devices they implant – “the amount your institution currently pays the vendor for the implant.” Despite a lenient grading system, in which the researchers counted as correct any guess within 20% of the actual price, surgeons estimated costs correctly only 1 in 5…
Last fall, an article in the New England Journal presented a powerful picture of just how much effort different pharmaceutical companies make to give poor people access to their products. Here is the picture from that article: The captains of industry are a competitive group of people, I am told. They like to see where…
The Affordable Care Act established several programs to promote the formation of Accountable Care Organizations. These ACOs are a relatively new way of organizing healthcare delivery, in which healthcare providers join together – perhaps across physician groups and hospitals – to care for a population of patients, and are then held accountable both for the…
If you live in the rural U.S., you probably face relatively limited access to the wonders of American healthcare. There won’t be as many physicians per capita offering you their services. This paucity of healthcare professionals will be especially stark for subspecialty care. There are not many ENT specialists opening up shops in rural…