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Archive for December, 2009




Jan. 5 Briefing on Long-Term Services and Supports


December 28th, 2009

The January 2010 edition of Health Affairs focuses on long-term services and supports and the challenges of ensuring affordable, high-quality care to people with disabilities, including many of the nation’s aged. The journal has invited key lawmakers and leading experts in aging and health policy to discuss the policies and new approaches needed to address […]

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Senate Approves Health Reform Bill; What’s Next?


December 24th, 2009

On the morning of Christmas Eve, the Senate voted 60-39 along partisan lines to pass the Senate health reform bill. Now legislators can head home for the recess break. However, the hard work of reconciliation between House and Senate versions of health reform bills remains. At Health Affairs Blog, we’ve invited analysts, economists, political scientists […]

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Will Health Reform Tactics Mean a Pyrrhic Victory?


December 24th, 2009

With the passage of health legislation in both the Senate and House, the presumption now is that reform will happen.  Still, let’s not forget that there is the daunting task of reconciling several significantly different provisions –for example,  on financing, a public plan, or abortion – while maintaining 60 votes in the Senate.  But for […]

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A Practical Solution For Rewarding Efficient Providers


December 23rd, 2009

We offer a practical solution to the issues that Jack Wennberg and Shannon Brownlee raised in their November 17th blog, “The Battle Over Rewarding Efficient Providers.”  We combine our experience in areas of law and patient care, respectively. American health care is in real peril of being swamped by surging costs.  President Barack Obama’s budget […]

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Would Reform Bills Control Costs? A Response To Atul Gawande


December 22nd, 2009

Atul Gawande, MD, is one of the best medical writers of our time. I subscribed to the New Yorker just so I could read him.  I reached eagerly for my Dec. 14, 2009 New Yorker when I heard he had an article there. I was deeply disappointed. What worries me is that his article will […]

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The Revised Senate Health Reform Bill: Cost Control And Other Aspects


December 21st, 2009

Editor’s Note: This is the second of two posts by Tim Jost analyzing the Senate health reform bill, as revised by the manager’s amendment offered on December 19. Jost’s first post focused on the health insurance reforms in the revised bill. One of the most common complaints about the health reform legislation pending in Congress […]

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Revised Health Reform Bill Moves Forward In Senate


December 19th, 2009

Editor’s Note: This is the first of two posts by Tim Jost analyzing the Senate health reform bill, as revised by the manager’s amendment offered on December 19. Jost’s second post focuses on efforts to control cost and many other aspects of the revised bill. The 384-page Senate Manager’s Amendment to the upper chamber’s health reform […]

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Health Care Costs And Imaging Technology Adoption


December 17th, 2009

Editor’s Note: In October, Health Affairs published two papers on factors driving imaging utilization. One paper, by Jacqueline Baras and Laurence Baker, analyzes the relationship between MRI supply and care for fee-for-service Medicare patients with low back pain. It finds that increases in MRI supply are related to higher use of both low back MRI and surgery. […]

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Health IT: What We Can Learn From Toys ‘R’ Us


December 16th, 2009

One of the more interesting recent health policy events took place at the Brookings Institution’s Engelberg Center for Health Care Reform. The December 2nd event did not focus on the reform bills in the House and Senate or the horse trading and sausage making that has gone into them.  The panels and discussion, titled “Using Data to […]

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Public Opinion And Health Reform: Looking At Hot-Button House-Senate Differences


December 15th, 2009

Editor’s Note: In addition to S. Ward Casscells, M.D. and Hiliary Critchley (photos and bios above), contributors to this post include Larry Kaiser, M.D of the University of Texas, John Zogby of Zogby International, Inc.; Grace Ren of Zogby International; and Stephanie Greer of the University of Texas. On November 7, 2009, the U.S. House of […]

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The Year’s Last Health Wonk Review


December 11th, 2009

Julie Ferguson at the Workers’ Comp Insider hosts the year’s last edition of the Health Wonk Review. Julie has done a great job of collecting the best in recent health policy blogging, include Tim J0st’s series of posts on the Senate health reform bill that appeared on the Health Affairs Blog. Happy holidays!

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Is More Care Better? The Evidence Suggests No


December 10th, 2009

Editor’s Note: In the post below, Jonathan Skinner and Shannon Brownlee examine the relationship between health care spending and utilization in hospitals, on the one hand, and patient outcomes on the other. In an earlier post, John Wennberg and Brownlee rebutted claims that spending and utilization variations among academic medical centers are due to differences in patient income, race, […]

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There Be Dragons: The Fiscal Risk Of Premium Subsidies In Health Reform


December 9th, 2009

Last week, the Congressional Budget Office weighed in on the biggest economic imponderable in the health care debate:  how private health insurance premiums will behave under health reform. Building on its December 2008 CBO health insurance market analysis,  CBO forecast largely benign effects from health reform’s private market reforms and subsidies on the vast majority […]

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Early Medicare Buy-In: A Public Option Compromise?


December 8th, 2009

Whether to include a new public health insurance option as part of health reform legislation has bedeviled Senate leaders trying to hold on to the 60 votes needed to ultimately pass a bill. The idea of allowing some individuals to voluntarily buy into Medicare before age 65 has emerged as a possible component of a compromise in […]

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An Interview With Thomas Russell


December 7th, 2009

Editor’s Note: Below is the transcript of a recent interview of Thomas Russell, who is stepping down on January 1 after ten years as executive director of the American College of Surgeons, by John Iglehart, Founding Editor of Health Affairs. In a wide-ranging and provocative interview, Russell endorses the creation of an independent Medicare commission to better allocate health care resources […]

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A Mother’s Search For H1N1 Vaccinations


December 4th, 2009

I became a mother obsessed.       It started in June, just days before my daughters, ages 12 and 10, were due to leave for summer camp. It waned a bit upon their return home, but returned full force with the start of the school year. My name is Rita, and I was obsessed with H1N1. I […]

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Do ‘Cadillac’ Plans Equal Cadillac Benefits?


December 3rd, 2009

Editor’s Note: For more on the controversy over taxing high-cost health plans, see a “Cadillacs Or Ambulances? The Senate Tax On ‘Excessive Benefits, a Health Affairs Blog post by Joseph White and Timothy Jost published today. The Senate Democratic health plan includes a provision, backed by the Obama administration, that would tax some “Cadillac” health plans to pay […]

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Cadillacs Or Ambulances? The Senate Tax On ‘Excessive’ Benefits


December 3rd, 2009

Editor’s Note: For more on the controversy over taxing high-cost health plans, see “Taxing Cadillac Health Plans May Produce Chevy Results,” a Health Affairs Web First article by Jon Gabel and coauthors published today. The Senate “Patient Protection and Affordable Care Act” draft legislation includes a steep excise tax on high-cost, so-called Cadillac insurance plans.  […]

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Patient Safety at Ten: Unmistakable Progress, Troubling Gaps


December 2nd, 2009

Ten years ago, the Institute of Medicine released To Err Is Human, a much-discussed report that launched the modern patient-safety movement.  Evaluating what has been accomplished in a Health Affairs Web First article published yesterday, Robert Wachter, author of two books on patient safety and editor of the federal government’s two leading safety Web sites, gives […]

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Orszag On Health Reform At Health Affairs Breakfast


December 2nd, 2009

At a Health Affairs reporters breakfast this morning, White House Office of Management and Budget Director Peter Orszag defended the ability of the health reform bill being debated in the Senate to “bend the cost curve” of health care costs. “The bill that is currently on the Senate floor contains more cost-containment and delivery system […]

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