Because the most glaring geographic variations in health care use have been observed in specialty and end-of-life care, policymakers have had trouble coming to terms with the work of John Wennberg and his Dartmouth colleagues. The questions the Dartmouth researchers raise about spending and quality are too disruptive, too threatening. Specialty and end-of-life care are […]

Editor’s Note: This is the last in a series of posts in response to Jon Gabel’s article “Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgical Centers?,” published March 18 on the Health Affairs Web site. Rep. Michael Burgess (R-TX) began the series, which also featured Jerry Cromwell.
The tension between commerce and professionalism is not new. Maimonides warned against allowing […]

Editor’s Note: This is the second in a series of posts in response to Jon Gabel’s article “Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgical Centers?,” published March 18 on the Health Affairs Web site. Rep. Michael Burgess (R-TX) began the series, which will also feature Chris Cassel.
Policymakers are increasingly concerned over incentives facing physicians to refer more lucrative, well-insured […]

Editor’s Note: Today, Rep. Michael Burgess (R-TX) kicks off a series of posts on Jon Gabel’s article “Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns To Ambulatory Surgical Centers?,” published March 18 on the Health Affairs Web site. The series will also feature posts from Jerry Cromwell and Chris Cassel.
To paraphrase the […]

Expanding coverage to the forty-seven million Americans who now lack health insurance could greatly improve care for people who already are protected, according to a new study in the September-October issue of Health Affairs. Economists Mark Pauly of Wharton and José Pagán of the University of Texas-Pan American found that insured adults who live in communities […]

I’ve worked in my small-town general practice in Scotland for ten years, combining clinical work there with a university post. In many ways my practice is pretty average. We have 5,700 patients, of all ages and from a mix of socioeconomic backgrounds. As in virtually all other British general practices, patient care is shared across […]

In an interview published online at Health Affairs [2-week free access], David Eddy, founder and medical director of Archimedes Inc. in Aspen, Colorado, discusses evidence-based medicine (EBM) with Sean Tunis, founder and director of the Center for Medical Technology Policy in San Francisco. Archimedes was founded to improve the quality and efficiency of health care […]

What happens when a government agency in charge of assessing the effectiveness of medical interventions crunches numbers and tells pharmaceutical companies their drugs are just too expensive? Sometimes, the government gets a better deal.
Twice last week, the much-feared National Institute for Health and Clinical Excellence (NICE) in England and Wales was a factor in drug […]

Orthodoxies rust easily. Even a benign truth — like the desirability of evidence-based medicine or health information technology — will decay if it is repeated too often or invested with an aura of magical infallibility. So the world needs Jerome Groopman.
An M.D. and Harvard professor who writes for the New Yorker, Groopman is creating a […]

In the wake of mounting drug safety problems, Congress is considering legislation that would strengthen the Food and Drug Administration’s regulatory authority to assure the safety of medications. Policymakers and the public are debating how to strike the right balance between drug safety oversight, the benefits of bringing new medications to market and ways to […]

The Washington Convention Center was abuzz as nearly 2,000 health industry and policy wonks gathered for the 4th annual World Health Care Congress. The standard policy topics of cost, quality, and coverage were up for debate, along with competition, effectiveness, transparency, and, of course, reform. For comprehensive blogging on the event, check out the official […]

Pay-for-performance (P4P) and public quality-reporting programs offer the potential to increase the quality of health care overall, but they threaten to actually decrease quality for minority and low-income patients in the process. In an article published April 10 on the Health Affairs Web site [free access through April 23], Larry Casalino of the University of […]

Two recent events in this winter’s panoply of D.C. health policy conferences stand out, largely because they invite us to think about a host of problems that beset our health care system in a new way; but also because they raise two nettlesome issues. One event was convened by Health Affairs to highlight a core […]

Disparities in access to quality health care remain prevalent in the U.S. health care system. So states the National Healthcare Disparities Report (NHDR) to Congress. The NHDR and its companion, the National Healthcare Quality Report (NHQR), both produced by the Agency for Healthcare Research and Quality (AHRQ), have served for years as critical gauges of […]

In his post, Jamie Robinson has raised the specter of an upside-down world of setting prices for biomedical innovations based on cost. Before we examine his serious admonition to focus on value in pricing new biotechnology drugs, let’s walk down the other trail: the argument that drugs should be pricy because they cost so darn […]