A new policy brief from Health Affairs and the Robert Wood Johnson Foundation explores a key aspect of landmark health reform legislation passed by the House of Representatives: the proposal for a government-run public health insurance plan. The brief lays out details of the plan, including who could enroll, who could receive subsidies to buy [...]

Both the new House health reform bill and the Senate Finance Committee bill, despite their best efforts, have to impose some taxes on some taxpayers; they cannot get all of a trillion dollars of subsidies for insurance out of Medicare.  But they differ on what and whom to tax: the House proposes to tax well-off [...]

Narrative Matters recently brought together 80 writers, journalists, and academics to celebrate the Tenth Anniversary of Narrative Matters.  There was much to celebrate: over 150 Narratives published in Health Affairs that covered a spectrum of human stories set in the increasingly institutionalized health care system.  We came to celebrate the power of stories and storytelling in the [...]

There has been much debate about whether the various health reform bills being debated in Congress contain enough measures to reform the health care delivery system and slow the rate of growth in health care spending. Speaking at the Sept. 9 briefing held to release Health Affairs’ Sept-Oct issue, a thematic volume titled “Bending The [...]

Early in President Barack Obama’s speech to Congress about health care reform, he mentioned health care costs as one of the causes of the problem of lack of insurance coverage. But most of the speech focused on what to do about health insurance costs, not health care costs. Changing the rules about how insurance companies operate [...]

Health reform proposals and an examination of what’s working to control health care costs dominated the most-read posts on Health Affairs Blog in August. Additional commenting is always welcome.

A Modest Proposal On Payment Reform
by Uwe Reinhardt
Low-Cost Health Quality Care In America
by John Iglehart
Obesity Spending Estimated at 147 Billion Annually
by Chris Fleming
Building A Health Marketplace That Works
by [...]

The Problem. The treatment of lower-income workers and families eligible for employer coverage is a difficult challenge for health reform. Many of these workers struggle to afford their rising contribution requirements. Recent survey findings indicate that 38 percent of workers eligible for employer coverage and with incomes under 200% of the federal poverty level (FPL) [...]

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 [...]

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 [...]

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 variations [...]

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 [...]

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 [...]

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 [...]

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 [...]

This week’s Health Wonk Review, the roving digest of the best of health policy blogging, features new posts on health reform, including the public plan option, health care costs, health IT, and more. This week’s host is Tinker Ready of Boston Health News.

There has been a great deal of debate over how much significance to attach to last week’s promise by health care industry leaders to “do our part” in achieving the Obama administration’s goal of cutting health care cost grown by 1.5 percentage points annually. President Barack Obama called the occasion “a historic day, a watershed [...]

One of the most controversial parts of the Obama health reform campaign platform was its pledge to create a new Medicare-like public health insurance offering that would “compete” with existing private insurance plans, and put pressure on them and on providers to hold down costs.
It would do this mainly by using Medicare-like pricing leverage to [...]

President Barack Obama’s budget, presented at a joint session of Congress on February 25, sets aside a reserve fund of $634 billion for financing health system reforms. President Obama explained his goal:  “Because of crushing health care costs and the fact that they drag down our economy, bankrupt our families, and represent the fastest-growing part [...]

There is widespread agreement that greater investment in information technology (IT) is critical to reforming U.S. health care. The use of such technologies as electronic health record systems, personal health records, e-prescribing, and computerized physician order entry holds the potential for vastly improving care at a reasonable cost. The recently enacted economic stimulus legislation included [...]

Wages for registered nurses (RNs) increased faster in California than elsewhere after California began implementing landmark legislation mandating minimum nurse-to-patient staffing ratios in acute care hospitals, according to a study published last week in Health Affairs (and free online through February 24).
In 1999, Gov. Gray Davis (D) signed legislation making California the first state in [...]