As Congress prepares for an historic floor debate over health care reform, those of us who have worked in the trenches to measure and improve the quality of care are watching with a mix of anticipation and concern. Reform has the potential to significantly improve the transparency and, ultimately, the quality of our system of [...]

Editor’s Note: In addition to Arnold Milstein and Pranav Kothari (pictures and bios above), coauthors of this post include Rushika Fernandopulle MD, MPP, of Harvard Medical School and Renaissance Health in Boston, and Theresa Helle of the Boeing Company in Seattle. For more on health care delivery system innovations and reforms, see the Sept-Oct 2009 issue of Health Affairs, [...]

Two papers, released today by Health Affairs, provide a “reality check” about some of those living with chronic conditions who lack health insurance.
• Uninsured Adults With Chronic Conditions Or Disabilities: Gaps In Public Insurance Programs
By Steven D. Pizer, Austin B. Frakt, and Lisa I. Iezzoni
Who are the uninsured? Where do they live? To answer those [...]

Preventing and more effectively managing chronic illness are critical national health priorities. Patients with chronic disease currently account for three-quarters of overall health spending. Multiple morbidities are common: More than half of Medicare beneficiaries are treated for five or more chronic conditions yearly. Nine chronic ailments account for nearly 60% of the recent rise in [...]

As anyone who has been observing recent goings-on in the Senate Finance Committee knows, moving toward universal coverage is no easy matter. No sooner did Finance Chair Max Baucus (D-MT) release his long-awaited Chairman’s mark of health reform legislation than he was pushed to increase the subsidies available to low- and middle-income Americans to purchase [...]

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 [...]

Editor’s Note: The post below by Harold Luft is an abridged version of a longer White Paper. The full White Paper and additional information about Dr. Luft’s work are also available.
The Current Options Under Discussion
There is substantial debate among Democrats about whether a public-plan option is a critical component of health reform; Republicans seem unified in opposing the idea. The “public plan” proposals [...]

A rise in chronic disease, particularly among baby boomers and older adults, was a key driver of the fact that consumers spent about 40 percent more out of pocket for health care in 2005 than in 1996, researchers report in the January/February 2009 issue of Health Affairs, a thematic volume on chronic illness.
The study shows that the [...]

The contrast could hardly have been more sharp. In a week when The New England Journal of Medicine published a series of perspectives exhorting the United States to reinvent primary care before it collapses, speakers at the annual international symposium of The Commonwealth Fund emphasized how primary care physicians formed the critical core of health-care [...]

Back in November, Republican presidential candidate Mike Huckabee wrote a remarkably candid essay for a special election issue of the trade journal Modern Healthcare. Since then, the former Arkansas governor’s campaign has morphed from single-digit obscurity to mainstream prominence, and the candor on health care has mostly been scrubbed clean from his Web site. Nonetheless, [...]

By any measure, heart disease, once manifest by sudden death, has largely joined the ranks of chronic diseases in developed countries that can be managed by drugs and behavior, as several articles in the new January-February issue of Health Affairs devoted to Cardiovascular Disease & Society note. And of all diseases that have been [...]