In the debate about health reform, many issues are getting an inordinate amount of attention, but one is not getting the detailed consideration it deserves. How it is finally resolved is likely to be one of the key factors of the ultimate plan’s success or failure. That issue is the design of the health insurance [...]

The “public plan” is today’s ultimate Rorschach test; different observers may see very different perspectives.  Particularly when the advocates leave loose ends, their opponents weave those untied threads as they will.  Nobody’s on firm ground so no concrete debate is possible.  Lots of smoke, hardly any light. 
It seems that there are some simpler clarifying questions [...]

Medical spending on conditions associated with obesity has doubled in the past decade and is estimated to have reached an annual rate of $147 billion in 2008, say researchers in a new study published July 27 on the Health Affairs Web site. The study was presented at the U.S. Centers for Disease Control and Prevention’s “Weight of [...]

As President Barack Obama and his allies press their case for health care reform, the president exhorts that his vision will slow the growth of medical expenditures, expand coverage to millions, and improve the quality of care.  In the trenches, where millions of medical interventions occur daily, physicians and hospital managers who do the heavy lifting describe a [...]

At an 11:00 AM press conference on Monday, July 27, Eric Finkelstein of RTI International will discuss the findings from a new study on medical spending on obesity that will be published this morning on the Health Affairs Web site. Finkelstein will be joined by Thomas Frieden, Director of the Centers for Disease Control and Prevention, and Bill [...]

Editor’s Note: In the post below, Uwe Reinhardt proposes to move from the present, price-discriminatory system of private-sector pricing of health services toward an all-payer system that could serve as a transition to an eventual system based on bundled payments per episode of illness for acute care, or capitation for chronic care.
In a response to Reinhardt’s [...]

Editor’s Note: In a separate post, Uwe Reinhardt proposes to move from the present, price-discriminatory system of private-sector pricing of health services toward an all-payer system that could serve as a transition to an eventual system based on bundled payments per episode of illness for acute care, or capitation for chronic care.
In his response below [...]

Editor’s Note: The Centers for Medicare and Medicaid Services has been deprived of needed resources and authority by Congresses and Presidents of both parties, former CMS acting director Kerry Weems said in a recent Health Affairs interview with the journal’s founding editor, John Iglehart. To follow up on this interview, the Health Affairs Blog convened [...]

Editor’s Note: The Centers for Medicare and Medicaid Services has been deprived of needed resources and authority by Congresses and Presidents of both parties, former CMS acting director Kerry Weems said in a recent Health Affairs interview with the journal’s founding editor, John Iglehart. To follow up on this interview, the Health Affairs Blog convened [...]

Global health issues, especially those affecting the world’s poor, rarely gain anywhere near the attention that the U.S. public and policymakers give to domestic concerns.  However, in one small corner of the current health reform discussion, there is a golden opportunity not only to reduce U.S. health care costs but also to improve the health [...]

Eliminating polio everywhere will require global cooperation on several fronts, including lowering the cost for poor countries to vaccinate with inactivated polio vaccine (IPV), says a leading global health researcher in the July/August Health Affairs thematic issue on global health.
Eradicating the wild polioviruses was supposed to have been achieved by 2000, but the effort to [...]

For those of us who have made Medicaid the focus of our work, it never ceases to amaze us as we watch the great health care debate unfold how frequently we find ourselves saying, “Medicaid can do that.” Or, even more often, “Medicaid is doing that.”
These are heady times for big concepts for transforming health [...]

Editor’s Note: In a recent Health Affairs essay titled “What ‘Patient-Centered’ Should Mean: Confessions Of An Extremist,” Don Berwick surveyed the debate in the health policy community over how the principle of “patient-centeredness” should be defined and implemented. He argued for “a radical transfer of power and a bolder meaning of ‘patient-centered care,’ whether in [...]

It is often observed wryly that Americans have more interest in the well-being of their automobiles and pets than their own health. The challenges of activating patients to manage diet, lifestyle, and chronic conditions are well documented, and the accompanying costs of chronic illness are even more thoroughly characterized. The threats these pose to health [...]