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Archive for June, 2009




Health Affairs Briefing: Delivering On Global Health


June 26th, 2009
by Chris Fleming

Getting “the right care to the right patient at the right time” is hard enough in highly developed countries like the United States. In low- and middle-income countries, the challenges are only magnified. Delivering on global health means dealing with a broad array of details that differ depending on the intervention and the location involved. […]

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The RUC’s Record: Backing Primary Care


June 24th, 2009
by Rebecca Patchin

Editor’s Note: Dr. Patchin wrote the blog post below in her official capacity as Chair of the Board of Trustees of the American Medical Association. Health Affairs recently published an interview with Kerry Weems, former acting administrator of the Centers for Medicare and Medicaid Services. In the interview, inaccurate statements were made about the role of […]

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Expanding Coverage for Low-income Americans: Medicaid Or Health Insurance Exchanges?


June 23rd, 2009
by Leighton Ku

While the most visible national health reform fight at the moment focuses on a public plan option for people covered through health insurance exchanges (or gateways), a quieter debate is brewing over whether coverage for low-income people should be achieved through Medicaid expansions or subsidies to purchase insurance through an exchange. For example, the Senate […]

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Pros And Cons Of A Public Insurance Plan


June 19th, 2009
by Jane Hiebert-White

Should Americans be able to enroll in a newly created, publicly administered health insurance option as the nation works to expand health coverage? That question is at the center of the current health reform debate. It is also the subject of the latest health policy brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF), which […]

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The Policy Lessons Of Health Care Cost Variations: A Roundtable With Bob Berenson, Elliott Fisher, Bob Galvin, And Gail Wilensky


June 18th, 2009
 
by John Iglehart and Chris Fleming

Editor’s Note: Below is the transcript of a Health Affairs Blog Roundtable on Atul Gawande’s New Yorker article on McAllen, Texas, and variations in health care costs. The roundtable used the article as a jumping-off point for a wide-ranging discussion on the policy implications of cost variations, delivery system reform, and other topics. Participants included Robert […]

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Geography And The Keys To Health Care Reform


June 17th, 2009
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Editor’s Note: In the post below, Amitabh Chandra responds to criticisms of the Dartmouth Atlas and offers his vision of the lessons of the Dartmouth findings on variations in health care costs and practice styles. Watch the Blog tomorrow for a roundtable discussion on Atul Gawande’s New Yorker article on McAllen Texas and the policy […]

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Beware The Siren Song Of New GME: Graduate Medical Education And Health Reform


June 15th, 2009
 
by Fitzhugh Mullan and Elizabeth Wiley

Federal support for graduate medical education (GME) training positions has been capped for more than a decade and it is no secret that the country’s teaching hospitals are restive. They want “more cap.” A number of bills have been introduced in the House and Senate proposing an increase in the Medicare funded GME cap by […]

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Nurse Shortage Eases Under Recession


June 12th, 2009
by Jane Hiebert-White

A new study published today in Health Affairs finds that the decade-long nurse shortage is easing, or even ending, partly as a result of the continuing recession. Study author Peter Buerhaus of the Vanderbilt University School of Nursing and colleagues found that older nurses are delaying retirement or returning to the workforce and part-time nurses […]

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Health Reform: Almost Here?


June 11th, 2009
by Jane Hiebert-White

“Dare we say it; reform is actually possible, perhaps more possible than at any time since 1964,” writes Health Wonk Review host and cofounder, Joe Paduda. He focuses today’s terrific health policy blog round-up on the prospect for reform and leads off  with Sen. Byron Dorgan (D-ND) on why reform is possible. Paduda then follows […]

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Hospital Costs And Quality: Ashish Jha’s View


June 11th, 2009
by Ashish Jha

Editor’s Note: Health Affairs has recently published two studies looking at the association between hospital costs and quality. The first, by Ashish Jha and coauthors, appeared in our May-June issue, and the second by Laura Yasaitis, Amitabh Chandra, and coauthors, was published online. Variations in spending and intensity of care, and the effects of these […]

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Hospital Costs And Quality: Amitabh Chandra’s View


June 11th, 2009
by

Editor’s Note: Health Affairs has recently published two studies looking at the association between hospital costs and quality. The first, by Ashish Jha and coauthors, appeared in our May-June issue, and the second by Laura Yasaitis, Amitabh Chandra, and coauthors, was published online. Variations in spending and intensity of care, and the effects of these […]

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Balancing Public Health And Freedom: The New CDC Director


June 9th, 2009
by Richard Carmona

The appointment of Dr. Thomas Frieden as the new director of the Centers for Disease Control and Prevention (CDC) is a triumph for public health and the American people. A passionate and well-informed professional, Frieden has been unusually successful as New York City’s Public Health Commissioner. In that role, with the strong backing of Mayor […]

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Public-Plan Option: Sustainable Growth Rate Formula On Steroids?


June 9th, 2009
by Robert Laszewski

Everyone in the health care debate seems to agree that the biggest problem is costs and that the best way to control costs is to get at the waste in the system. To raise the money needed to cover everyone and to make the system sustainable, goes the argument, we need to convert the upwards […]

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Nursing Workforce Solutions for 21st Century Health Care: How Do We Get There?


June 9th, 2009
by Chris Fleming

Join us for a discussion, moderated by Susan Dentzer of Health Affairs, examining the impact of the nursing workforce on health care delivery, access and quality. This event, on Friday June 12 from 9 a.m. to noon at the Union Station Columbus Club in Washington DC, also marks the publication of several papers in Health […]

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Health Policy Briefs: Medicare Reform And Beyond


June 8th, 2009
by Jane Hiebert-White

Health Affairs has launched a new series of Health Policy Briefs, with support from the Robert Wood Johnson Foundation. These free, online briefs aim to provide congressional staff and busy policy-watchers with quick, clear overviews of complex, front-burner issues in the health reform and policy debate. The first 2 briefs look at Medicare reform. The […]

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Dangerous Confusion On Medicare Cost Control


June 5th, 2009
by Joseph White

In a May 15 Health Affairs Blog post, Jeff Goldsmith argues against creating a new Medicare-like public health insurance plan to compete with private plans. As part of his argument, Goldsmith asserts that Medicare has done a worse job of controlling costs than private insurers have done. Goldsmith bases this assertion on a recent paper […]

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Following The Cost Conundrum: The Road To McAllen, TX, Through The Pages Of Health Affairs


June 4th, 2009
by Sarah Dine

Last week’s New Yorker article by Atul Gawande highlighted the phenomenally high variations in cost of medical care and services between regions in the United States, specifically focusing on McAllen, Texas. Gawande’s spotlight on McAllen was based on many studies of our health care system. For Gawande’s readers, we would like to point you to […]

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How’s It Going In Massachusetts?


June 3rd, 2009
by Jane Hiebert-White

Despite economic hard times, Massachusetts still shows gains in insurance coverage and access to care as a result of its 2006 state health reform. However, some of the early gains in reducing barriers to health care and improving affordability had eroded by the fall of 2008, according to Urban Institute researchers in a new study published last week on the […]

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52 Million Uninsured Americans By 2010


June 2nd, 2009
by Jane Hiebert-White

The number of uninsured Americans is projected to increase by at least 6.9 million by 2010 — meaning 19.2 percent of nonelderly Americans would be uninsured. This is an increase of 2.0 percentage points from 2007, say Todd Gilmer and Richard Kronick of the University of California, San Diego, in a paper published May 28 on the […]

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The Massachusetts Model: Massive Spending On Nonbenefit Costs


June 2nd, 2009
 
by Merton Bernstein and Nancy Altman

Plummeting coverage and soaring costs characterize the nation’s health insurance crisis. With much coverage for the nonelderly based on employment, job loss contributes to this misfortune. In response, Congress seems headed to emulate the 2006 Massachusetts “reform.” That’s an unpromising prescription because it seriously increases costs — just the opposite of what President Barack Obama […]

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