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Bartering for Care
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Naomi Freundlich,
The Century Foundation,
6/17/2009
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Growing up in suburban New Jersey, my father was a hematologist; most of his patients suffered from leukemia. In the 1960’s and early 70s, there were few effective treatment options for many of them and my father spent a lot of time running to the hospital in the middle of the night to provide blood transfusions for those who were in crisis; offering support and personal attention to each of them. Continue to blog here.
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Obama Divides and Conquers Physicians
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Naomi Freundlich,
The Century Foundation,
6/16/2009
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In President Obama’s speech to the American Medical Association today he stood strong on all the elements of health care reform that he’s championed since the election. And in front of a tepid audience that has yet to drink the Obama Kool-Aid, the President sought to divide and conquer the larger population of physicians—reaching out to those who reject the long-term fear tactics that raise the twin specters of “socialized medicine” and “rationed care.” Continue to blog here.
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Who Supports Health Care Reform, and Who Doesn't?
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Maggie Mahar,
The Century Foundation,
6/11/2009
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Amy Walter, editor-in-chief of The Hotline, is an excellent polllster. The numbers below show that the strongest supporters of healthcare reform tend to be Democrats who earn less than $100,000 and are under 65. This has been true from the beginning of the current debate on reform, though overall the number of people who support an overhaul grows. Continue to blog here.
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Finding “Common Ground” on Abortion is Not Likely
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Naomi Freundlich,
The Century Foundation,
6/2/2009
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With a single bullet, the killing of Dr. George Tiller, an abortion provider in Wichita, Kansas, made the process of finding “common ground” in the abortion debate much more difficult. As much as President Obama has been talking up conciliation, the rhetoric and ideology espoused by some abortion foes makes it almost impossible to work toward a national reconciliation on abortion and freedom of choice. Continue Reading on the Taking Note Blog.
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Truth Squadding Dick Morris' "The Death of American Health Care"
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Maggie Mahar,
The Century Foundation,
6/1/2009
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Dick Morris, the former political adviser to President Clinton who is now a ubiquitous gadfly commentator, denounced the White House for not being truthful about what health care reform will mean in a recent column posted on The Hill. Morris’ piece, titled “The Death of American Healthcare” seems worthy of analysis because he does such an able job of packing so much misinformation into a relatively small space:
Continue Reading.
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The Bottom Line: Health Care Reform
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Bernard Wasow,
The Century Foundation,
5/26/2009
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President Obama has been strong and calm and reassuring. Most voters like him and trust him. But he still must play the risky hand he was dealt, and in the end his success will be measured by his accomplishments, not his image. One central achievement will make or break his legacy: health care reform. Like FDR and LBJ, Obama is trying to use active government to improve the lives of average people. President Clinton, after his health care fiasco, was content to run a thrifty but sound fiscal policy and to trust his legacy to the peace and prosperity the country enjoyed when he was president. Continue Reading on the Taking Note Blog.
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Demystifying Death
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Maggie Mahar,
The Century Foundation,
5/22/2009
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Did you know that when there is "no hope of recovery" there are still things for the patient to hope for? Did you know that a "living will" is not a legal document in New York State or Massachusetts? Did you know that environmentalists have created nature preserves where you can be buried?
"What we are doing is basically land conservation," says Dr. Billy Campbell, who has created a preserve along Ramsey Creek in South Carolina. "By setting aside woods for natural burials, we protect it from development. At the same time, I think we put death in its rightful place, as part of the cycle of life.Continue Reading on the Taking Note Blog.
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Beyond Wikipedia
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Naomi Freundlich,
The Century Foundation,
5/22/2009
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No surprise, these days more and more doctors are searching online for medical information. What is surprising, however, is that in a recent study, nearly 50% of physicians indicated that they use Wikipedia—the open-access encyclopedia that allows anyone to edit articles—as their source for medical information.Continue Reading.
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Insurers Get Some Marketing Advice
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Maggie Mahar,
The Century Foundation,
5/18/2009
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As more and more employers back out of the health benefit business, more and more individual consumers are shopping for health insurance these days. Yet sales have remained relatively flat. The McKinsey Quarterly reports in its most recent issue. “What,” McKinsey asks, “is preventing health insurers from effectively addressing pent-up demand?” Continue Reading on the Taking Note Blog.
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The Health Care Industry's Promises on Spending
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Maggie Mahar,
The Century Foundation,
5/12/2009
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You’ve seen the headlines: “Health Care Industry Offers to Rein in Spending”; “Stakeholders to Obama: We’re Ready to Cut Costs.” What does this mean? I think it means that the industry—and in particular the insurance industry—is afraid, very afraid that the healthcare reform train is going to leave the station without them. They’re desperate to have “a seat at the table.” Continue Reading on the Taking Note Blog.
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Provider Backlash
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Naomi Freundlich,
The Century Foundation,
5/7/2009
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Fifteen years ago, insurers were trying to put a brake on healthcare costs by “managing care”—which often meant saying “no” to patients. Too often, insurers denied coverage for care that patients needed. Then came the backlash against managed care, and insurers relented. They began to say “yes” to more treatments, and passed the cost along to customers in the form of higher premiums, co-pays and deductibles. Continue Reading.
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Reinventing the Way We Train Doctors and Nurses
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Maggie Mahar,
The Century Foundation,
5/4/2009
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While in medical school, students are supposed to know the answers. They spend hours cramming, memorizing arcane language and hard-to-remember numbers so that if the question appears on a test—or worse still, if a resident decides to quiz them during rounds—they can answer it. Continue Reading.
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Experimenting with Medicare
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Maggie Mahar,
The Century Foundation,
4/24/2009
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This week, the Senate Finance Committee hosted the first of three roundtable discussions on health care reform. This session honed in on reimbursement and delivery reform; future roundtables will focus on expanding health coverage to all Americans (May 5) and financing health care reform (May 14). "Medicare is the big driver here,” declared Finance Chair Max Baucus (D-MT), and “How to scale it up” will be one of the key questions, he said, but “Medicare will be a big part of that solution.”Continue Reading.
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Mammography Screening: A Double-Edged Sword?
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Naomi Freundlich,
The Century Foundation,
4/22/2009
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I still remember the sound of her voice on the phone: scared, frustrated and looking for answers. That summer I was working as a patient representative at a New York City hospital when I got a call from a middle-aged woman who had undergone a routine mammogram two weeks earlier. She still hadn’t received the results. When the woman called the imaging center, she was told that the radiologist had not yet provided his report because he wanted to see films from her last mammogram in order to make a comparison. Continue Reading on the Taking Note Blog.
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The Fraying of Medicare
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Maggie Mahar,
The Century Foundation,
4/16/2009
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Many Americans assume that once they finally become eligible for Medicare, their worries about skyrocketing health care bills will be over. Unfortunately, that just isn’t the case. According to Fidelity Investments a 65-year-old couple retiring this year should assume they will need approximately $240,000 to cover medical expenses in retirement--- even though they have Medicare insurance coverage. Continue to blog here.
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Beyond Health Care
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Maggie Mahar,
The Century Foundation,
4/7/2009
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Robert Wood Johnson Foundation’s Commission to Build a Healthier America has just released a new report: Beyond Health Care. At a time when all eyes are trained on the debate over providing access to medical care for all Americans, the report looks beyond health care, to the health of the population. As it turns out our health—public health—has less to do with health insurance than one might think. |
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Is Max Baucus Ready to Cave On a Public-Sector Insurance Option? Tauzin Defends Baucus on Campaign Contributions Part 2
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The Century Foundation,
The Century Foundation,
4/2/2009
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This week, Ted Kennedy is back on Capitol Hill, and health care reformers are moved and relieved to see him, stalwartly carrying on, despite his illness. Ever since he collapsed at President Obama’s inaugural luncheon, Kennedy has not been able to spearhead the fight on healthcare reform in Congress as he might have wished, buttonholing colleagues in the halls of Congress on a daily basis. Instead Senate Finance Chairman Max Baucus has become the Democrat’s point-man on reform. And some liberal reformers fear that Baucus may be too quick to compromise with Republicans. Continue to blog here.
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Health, Education and the Welfare of the Nation
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Maggie Mahar,
The Century Foundation,
3/24/2009
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The correlation between education, poverty and health is so tight that I sometimes think we need to address the three simultaneously. Often this just isn’t feasible. But there are places in our society where the three problems come together in a way that invites a battle on all three fronts. Consider, for example, our nation’s poorest public schools. Continue Reading.
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The 111th Congress at Work
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Maggie Mahar,
The Century Foundation,
3/23/2009
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"http://www.healthbeatblog.org/2009/01/why-a-partisan-debate-over-healthcare-reform-is-inevitablepart-two.html" class="style9">
Nursing Homes, like deteriorating public schools, crumbling bridges and other pieces of our society’s essential infrastructure have been neglected for a long time. Now, HeatlhBeat reader Gregory Pawelski reports that this year, Congress is finally give nursing homes the attention they badly need. Continue to blog here.
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Why Obama Should Stand Firm on a Public-Sector Insurance Option Part I
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Maggie Mahar,
The Century Foundation,
3/19/2009
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Many Republicans in Congress are dead-set against including public sector health insurance--some call it “Medicare for All”-- as a choice under National Health Reform. The resistance is so strong that this could be the deal-breaker that prevents President Obama from gathering the Senate votes he needs to pass his plan for universal coverage this year. Nevertheless, if we want to provide sustainable, affordable, safe and effective healthcare for all, many say that the public sector option is essential. At the recent Healthcare Summit, President Obama put it this way: “The thinking on the public option has been that it gives consumers more choices and it helps keep the private sector honest, because there's some competition out there.”
Continue Reading.
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Why Obama Should Stand Firm on a Public-Sector Insurance Option Part II
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Maggie Mahar,
The Century Foundation,
3/19/2009
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Conservatives often argue that it just isn’t fair to force private health insurers to compete against a government plan because . . . Well, to be perfectly candid, they know that most for-profit insurers would lose. They don’t put it that way, of course. They argue that the government plan would enjoy “unfair advantages.” It wouldn’t’ have to pay profits to shareholders, for instance, and it wouldn’t have to pay seven-figure salaries to its secretaries. It also wouldn’t have lay out hundreds of millions to advertise –or to lobby Congress. Continue Reading.
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A New Team at the FDA -- Sharfstein's Critics
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Maggie Mahar,
The Century Foundation,
3/16/2009
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Over the week-end, when I heard that President Obama had selected Margaret Hamburg as FDA commissioner and Joshua Sharfstein as deputy commissioner, I began Googling “Sharfstein.” I already had read about Hamburg and I knew the former New York City health commissioner has earned very high marks. Continue reading.
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Health, Education and the Welfare of the Nation
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Maggie Mahar,
The Century Foundation,
3/13/2009
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We know that
health, education and poverty are linked. This is why, at one time,
the U.S had a Secretary of Health, Education and Welfare. Restoring
that cabinet post might go a long way toward inspiring discussion
about how to approach all three simultaneously. By viewing them as
separate problems, we “see” only one part of the
elephant. With that in mind, I have decided that, from time to time,
HealthBeat should look at ideas for educational reform.
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Broadcasting Misinformation: Planting Seeds of Fear
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Maggie Mahar,
The Century Foundation,
3/9/2009
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Inevitably, the debate over healthcare reform will inspire some to try to broadcast misinformation, sowing seeds of doubt, false hope or fear in the public mind. I will try my best to rebut some of the more flagrant attempts, on both sides of the issue. In the past, I have complained that progressive single-payer advocates sometimes exaggerate just how much could be saved if we eliminated private insurers’ administrative costs from the nation’s healthcare bill here (For an excellent, even-handed analysis of administrative costs for private sector insurers compared to public sector insurers, see this Urban Institute report). Continue Reading.
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Dr. Sanjay Gupta Withdraws
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Maggie Mahar,
The Century Foundation,
3/6/2009
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Regular readers may recall a blog where I questioned CNN chief medical correspondent Sanjay Gupta’s qualifications as a potential surgeon general. I had planned to write a part two to that blog, but as Gupta’s name began to disappear from the press, I decided I would be beating a dead horse. I suspected that either the administration was having second thoughts about the nomination, or that Gupta himself was concerned that his ties to drug-makers might lead to embarrassing questions during confirmation hearings.
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Health Care in the UK
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Maggie Mahar,
The Century Foundation,
3/3/2009
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Over at Managed Care Matters, Joe Paduda posted this letter from a “very good friend.” Does every patient in London get such good care? Probably not. But I have heard similar stores—and the UK does not have the best care abroad. (The NHS is still under-funded, though each year they’re putting more money into it.) France, Germany, Sweden, Denmark any Switzerland all boast better care.
Continue to blog here.
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The President’s Budget and the Challenge of Universal Coverage
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Maggie Mahar,
The Century Foundation,
2/27/2009
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President Obama’s budget demonstrates how difficult it will be to build a sustainable, effective, and safe health care program for all Americans. His ten-year $634-billion plan for funding health care reform depends on “asking the wealthy to pitch in a bit more” (budget director Peter Orszag’s happy phrase), wringing some of the waste out of Medicare and Medicaid (cuts that are needed, but that will not be popular ); and strong-arming drug makers to raise discounts on Medicare drugs from 15 percent to 21 percent. About half of the money will come from changes in government programs, half from tax increases. Continue Reading on the Taking Note Blog.
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Why Tom Daschle Had to Withdraw and Who Will Replace Him?
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Maggie Mahar,
The Century Foundation,
2/3/2009
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Howard Dean? Kansas Gov. Kathleen Sebelius? Former NIH director Harold Varmus (now at Memorial Sloan-Kettering Cancer Center)? Dr. Atul Gawande? Former Oregon Governor John Kitzhaber? John Podesta, founder and president of the Center for American Progress, formerly chief of staff to President Bill Clinton? These are a few of the names being floated in the mainstream press and the blogosphere as possible replacements for Tom Daschle as Secretary of Health and Human Services and/or healthcare czar.Continue Reading on the Health Beat Blog.
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The Amenities Race: Are Patients Irrational?
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Maggie Mahar,
The Century Foundation,
1/28/2009
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According to a new working paper by the National Bureau of Economic Research (NBER), as the nation’s hospitals battle for paying customers, they are engaged in a fierce “amenities race.”. What is troubling about the report is that it reveals that many patients seem to care more about rooms with views and pleasant service than just how many patients survive their hospital stays. Continue to blog here.
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Thoughts on President Obama's Inaugural Speech
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Maggie Mahar,
The Century Foundation,
1/22/2009
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When President Obama said “The time has come to put away childish things,” I couldn’t help but recall healthcare reformer Don Berwick, sounding discouraged last winter, as he said “Maybe this country just isn’t mature enough for health care reform.”Continue reading.
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Why a Partisan Debate over Healthcare Reform Is Inevitable—Part Two
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Maggie Mahar,
The Century Foundation,
1/19/2009
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When Tom Daschle testified on the Hill earlier this month he reassured many by saying that as Health and Human Services Secretary, he would be working for healthcare reform “guided by evidence and effectiveness, not by ideology.” Daschle, like Laszlewski, was suggesting that reform could and should be bi-partisan. But as I suggested in part 1 of this post, Daschle is only half-right. Medical evidence should guide our decisions about what to cover; but when it comes to questions of whom to cover—and how much coverage they should receive-- we are going to have to wrestle with “ideology."Continue reading.
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The Danger of For-Profit Hospices
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Niko Karvounis,
The Century Foundation,
1/16/2009
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Maggie recently wrote about a MedPAC decision aimed at stopping for-profit hospices from purposefully keeping patients under their care for extended periods of time in order bill Medicare for more days of service. Medicare’s concern that the hospices might be bilking the system raises a larger question: should we be worried that so many of today’s hospices are for-profit? Continue reading.
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The NIH: Past, Present, and Future
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Niko Karvounis,
The Century Foundation,
1/14/2009
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Like so many other federal agencies, the National Institutes of Health (NIH) has struggled under the Bush Administration, and today, it needs to be revitalized. Not long ago, I wrote about what we can expect for the FDA when president-elect Obama comes to office; now I’d like to turn the NIH. But to understand the agency’s future, one needs to recognize its recent past. Continue reading.
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The War Against Tobacco Slows
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Maggie Mahar,
Niko Karvounis,
The Century Foundation,
1/13/2009
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2007 marked the first time in 50 years that less than 20% of Americans smoked. This is the good news. The bad news is that, just as the battle against smoking has entered what may be its most critical, final phase, support for that battle has waned among policymakers—even though the problem is far from solved. Continue to blog here.
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A Very Open Letter from an Oncologist
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Maggie Mahar,
The Century Foundation,
1/10/2009
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During the holidays, I received the letter below from Dr. Peter Eisenberg, Medical Director at California Cancer Care, an oncology practice in Northern California. A member of The Century Foundation’s Working Group on Medicare Reform. Eisenberg is a very experienced, and successful oncologist, who has served on the board of the American Society of Clinical Oncology and the Association of Northern California Oncologists. Continue to blog here.
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Insurers Expand Primary Care: an Argument for Obama’s Plan
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Maggie Mahar,
The Century Foundation,
1/5/2009
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Imagine appointments with your primary care doctor that last 30 minutes—or longer. What if you could e-mail her when you need a prescription refill? If you have a two-minute question, she encourages you to call; she or a nurse practitioner will come to the phone. If they’re busy, they’ll return your call within a few hours. Continue to blog here.
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Can the Media Derail Health Care Reform?
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Niko Karvounis,
The Century Foundation,
1/5/2009
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By now you’ve probably heard the calls for speedy action on health care reform during the Obama Administration’s first hundred days. Some prominent observers even say that the President-elect should get the ball rolling during “his first days in office” The possibility of imminent health care reform is certainly exciting, but a word of caution: just because some of us might be ready for health care reform doesn’t mean that the media is ready to cover it properly. Continue to blog here.
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Four Health Care Media Myths That Didn’t Go Away in 2008
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Niko Karvounis,
The Century Foundation,
12/31/2008
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No matter how you slice it, health care is complicated—which means that the media has a vital role to play in helping the public navigate the ins and outs of the issue. Unfortunately, more often than not, reporters, commentators, and pundits don’t serve as trustworthy guides when it comes to health care. In fact, 2008 saw the media once again regurgitating myths that obscure the facts surrounding health care in the United States. Here are some of the most egregious offenders. Continue Reading on the Taking Note Blog.
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Health Care Reform--No “Magic Bullets"
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Maggie Mahar,
The Century Foundation,
12/31/2008
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Wishful thinking leads many well-meaning reformers to imagine that we can accomplish universal coverage in a single stroke. Writing in the December 31 edition of the New Republic, political scientist Jacob Hacker suggests that by declaring “healthcare for all” we can achieve universal coverage and , simultaneously, kick-start the economy. How do we do it? Continue Reading.
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Alzheimer’s Disease: The Basics
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Niko Karvounis,
The Century Foundation,
12/30/2008
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Earlier this month newspapers reported that Columbo—that is, actor Peter Falk—has Alzheimer’s Disease. Usually, when news breaks that a celebrity is suffering from a serious medical condition, there’s a flurry of coverage discussing the nature of the disease. Hopefully, the pattern will hold in Falk’s sad case—because Alzheimer’s is both a terrifying disease and a greater public health issue than most of us realize. Continue to blog here.
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Ezekiel Emanuel Appointed as Healthcare Advisor
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Maggie Mahar,
The Century Foundation,
12/19/2008
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This is from the Wall Street Journal’s Washington Wire: “Ezekiel J. Emanuel, a prominent bioethicist at the National Institutes of Health–and the brother of incoming White House Chief of Staff Rahm Emanuel–will serve as a senior counselor at the White House Office of Management and Budget on health policy, two Democratic officials said Thursday. Continue Reading.
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Retiree Health Benefits in the Recession
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Niko Karvounis,
The Century Foundation,
12/17/2008
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“Companies are concerned about how their balance sheets are going to look after two down quarters last year, the events of Sept. 11 and the big increases we've been seeing in health care costs,” the U.S. Chamber of Commerce’s Kate Sullivan told the New York Times in 2002. Reading the tea leaves, Sullivan pointed out that “employers are looking at any way they can to shave off some of those costs”—and that one of their biggest targets were company-sponsored health benefits for retired employees. Continue Reading on the Taking Note Blog.
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Irrational Exuberance over Electronic Medical Records?
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Maggie Mahar,
The Century Foundation,
12/17/2008
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When President-elect Obama outlined his economic stimulus package earlier this month, he emphasized the need to invest in the healthcare system’s infrastructure by pushing for electronic health records (EHR), nationwide: “We will make sure that every doctor’s office and hospital in this country is using cutting edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes, and help save billions of dollars each year.” Continue Reading.
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A Story of Pallative Care
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Maggie Mahar,
The Century Foundation,
12/15/2008
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The Dallas Morning News has done a wonderful series on end-of-life care. Thanks to
Annie for pointing it out. Here are excerpts from part one, written by Lee Hancock, describing an encounter at a Baylor University Medical School ICU unit between Ms. Patel, a palliative care team nurse, and Dr. Edward Taylor, a 36-year-old trauma surgeon. Continue to blog here.
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Making Use of Comparative Effectiveness Research
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Maggie Mahar,
Niko Karvounis,
The Century Foundation,
12/5/2008
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Last week the New York Times published a story about one of the biggest medical trials ever organized by the federal government, a study that showed that the newest, most expensive drugs used to treat high blood pressure (a.k.a. hypertension) work no better than inexpensive diuretics—water pills that flush excess fluid and salt from the body. Moreover, the research revealed that the pricier drugs increase the risk of heart failure and stroke. Continue Reading on the Taking Note Blog.
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The End of Pharma's Free Ride?
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Niko Karvounis,
The Century Foundation,
12/4/2008
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Yesterday Reuters reported that, in comments at a Financial Times conference in London, a top executive at Roche Pharmaceuticals condemned direct-to-consumer advertising as a disaster. “Direct-to-consumer promotion [of drugs] was the single worst decision for the industry," said William Burns, Roche’s head of pharmaceuticals, to conference attendees. "When industry says we're spending all the money on R&D but actually it's spending it on TV advertising to preserve margins, it doesn't get much credibility,” he continued. Continue Reading on the Taking Note Blog.
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The Good News on Heart Attacks, Strokes, and Breast Cancer
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Maggie Mahar,
The Century Foundation,
12/1/2008
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Assume that you are a 40-year-old man. What do you think the chances are that you will die of a heart attack or stroke in the next 10 years? (Please forgive the morbidity of the question; there is a purpose to this pop-quiz.) The answer: just 4 out of 10,000 according to Drs. Steve Woloshin and Lisa Schwartz, authors of Know Your Chances. Indeed, the chance that you will die in an accident before reaching your 50th birthday are 50 percent higher: 6 out of 10,000. Continue to blog here.
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Censorship, the Media and the Blogosphere
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Maggie Mahar,
The Century Foundation,
12/1/2008
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I recently attended a conference where bloggers and print journalists talked about the pros and cons of their respective professions. I noted that as a blogger, I am never censored. As a print journalist I was told, on more than one occasion; “Maggie, you can’t say that!” (even though I had evidence to back up my facts.) Usually, the editor was concerned that I would “scare the readers” or upset the publisher (and advertisers). Continue to blog here.
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One Simple Stimulus for Both the Economy and Health
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Hummy Song,
The Century Foundation,
11/26/2008
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When President-elect Barack Obama takes office, he will be preoccupied with a broad range of enormous and complex challenges, including a downward spiraling economy and two wars. But some problems that might seem lower on the priority list also present relatively manageable opportunities to make meaningful progress in ways that would greatly benefit the country. One such target for saving money and improving lives is dealing with tobacco—the nation’s number one cause of preventable death and one of its greatest contributors to high health care expenditures. Continue Reading on the Taking Note Blog.
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The Personal Side of Medicine
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Maggie Mahar,
The Century Foundation,
11/23/2008
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Below, a story and a poem from Pulse, a very special online magazine that uses stories and poems from patients and health care professionals to talk honestly about giving and receiving care. Continue to blog here.
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The Front Lines of Primary Care, Part 2
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Niko Karvounis,
The Century Foundation,
11/23/2008
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In my previous post, I discussed how the realities of primary care—the “hamster wheel” of 15-minute visits with sometimes-difficult patients suffering from complex, chronic conditions—can burn out idealistic primary care physicians (PCPs). Increasingly, disillusioned PCPs are leaving the field. A recent survey from the Physicians’ Foundation reports that one-half of PCPs would leave medicine if they thought they could do so. Continue to blog here.
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The Front Lines of Primary Care
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Niko Karvounis,
The Century Foundation,
11/20/2008
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In a recent post, Health Beat described the policy strategies that must be employed in order to address the primary care crisis in the United States. This post focuses on the human side of the primary care crunch by highlighting the personal experiences of doctors. Moving from the policy to the personal adds an all-important qualitative element to our understanding of just why American primary care is in such dire straits. Continue Reading on the Taking Note Blog.
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"Spread the Wealth" Controversy Hits Doctors
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Niko Karvounis,
Maggie Mahar,
The Century Foundation,
11/17/2008
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Last week Senator Max Baucus (D-MT) offered a “Call to Arms” for health care reform by way of a 98 page policy document. Because Baucus’ document was a sweeping, comprehensive look at America's health care problems, media coverage tended to focus on its grand principles rather than specific policy details. But when it comes to health care policy, it's all about the details, among which Baucus includes the following sticking point: a proposal to increase payments to primary care providers at the expense of compensation for specialists. Continue Reading on the Taking Note Blog.
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"Fat": What the Experts Know (Part 1)
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Maggie Mahar,
The Century Foundation,
11/17/2008
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The film opens with a fetching red-head puffing away on a treadmill. She’s perspiring, but she’s smiling gamely into the camera. “It’s not an average work-out, but I wasn’t an average weight,” she explains. “I have to do above and beyond what any of you guys would have to do. I have to try twice as hard, sometimes three times as hard—just to maintain this level of…chubbiness.”
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More Truths About Rising Health Prices
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Maggie Mahar,
The Century Foundation,
11/6/2008
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What is the biggest threat to the U.S. economy? According to Congressional Budget Office Director Peter Orszag, it is not credit famine, the long-term price of energy, competition from China, the loss of jobs overseas, or even a surfeit of Chrysler SUVs. It is, Orszag declared in October, “the nation’s looming fiscal gap — which is driven primarily by rising health care costs.” Continue Reading on the Taking Note Blog.
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Help, I've Fallen Into the Doughnut Hole and I Can't Get Up: The Problems with Medicare Part D
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Beverly Goldberg,
The Century Foundation,
10/28/2008
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Ever since the enactment of Medicare Part D, which pays private insurers to offer senior citizens plans to help cover the costs of their prescription drugs, bitter complaints about the program have been the norm. Most of the complaints have focused on the "doughnut hole," the coverage gap that occurs when someone spends more than the year's covered amount—$2,510 in 2008—on his or her medications. When that cap is reached, because an individual is on multiple medications or extremely expensive ones or both, the costs of medications must be paid for out—of—pocket until the person spends up to a level that is significantly higher than the covered amount—an additional $3,216 in 2008. At that point, the plan again begins to cover needed drugs under a catastrophic coverage provision. Continue Reading Here.
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Assigning Blame for Rising Medical Costs
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Maggie Mahar,
The Century Foundation,
10/24/2008
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The conventional wisdom about skyrocketing healthcare costs tends to blame someone: patients who demand too much care; doctors who practice defensive medicine because they fear being sued; aging boomers, and finally, everyone’s favorite, “the insurance companies.” Continue on the Taking Note Blog.
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What Makes the Mayo Clinic Different?
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Maggie Mahar,
The Century Foundation,
10/21/2008
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After working at the Mayo Clinic in Rochester, Minnesota for nine years, Dr. Marc Patterson decided to change his life. In 2001, he moved to New York City to take a job as chief of pediatric neurology at New York-Presbyterian Hospital (NYPH).
This year, Patterson returned to the Big House on the Prairie. "Sometimes I miss New York,” he acknowledges, “but working in a system that actually functions is worth it." Continue Reading on the Taking Note Blog.
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The Medicaid Challenge (Part 1)
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Niko Karvounis,
The Century Foundation,
10/9/2008
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In theory, Medicaid ensures that low-income families receive health care. But in practice, the program leaves much to be desired—and serves as a painful illustration that the existence of an insurance program isn’t enough to ensure access to necessary care.
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Is Healthcare a "Right" or a "Moral Obligation"?
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Maggie Mahar,
The Century Foundation,
10/6/2008
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I have to admit I often have found the language of healthcare “rights” off-putting. Yet the idea of healthcare as a “right” is usually pitted against the idea of healthcare as a “privilege.” Given that choice, I’ll circle “right” every time.
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Free Tuition for Medical Students?
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Maggie Mahar,
The Century Foundation,
9/10/2008
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Always a trailblazer, The Mayo Clinic’s Medical School has had a generous scholarship program for the past 20 years that enables about 60 percent of its students to attend school tuition-free. The 50 students who started at Mayo last summer each received $25,000 to use towards tuition of $29,200. Students also are eligible to receive an additional $2,000 to $5,000 a year based on need, said David Dahlen, director of student financial aid at Mayo, based in Rochester, Minn. Continue Reading on the Taking Note Blog.
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Americans Who Have Insurance —But Still No Access To Care
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Maggie Mahar,
The Century Foundation,
9/5/2008
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A friend who lives in Boston complained, not long ago, about not being able to find a physician. In Boston? “Come on,” I said. “This is like claiming you couldn’t find a liquor store.”
“They’re all oncologists and cardiologists,” he grumbled. “Last week I cut my hand badly enough that it needed stitches. I have good insurance. But I couldn’t get an appointment with my family doctor—or any of my friends’ doctors. I didn’t want to spend hours in the ER. So I wound up going to my sister’s house. She sewed it up at her kitchen table.” Continue Reading on the Taking Note Blog.
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Lessons from Massachusetts
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Niko Karvounis,
The Century Foundation,
8/26/2008
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The Massachusetts experiment in health care reform is all about expanding access. But it doesn’t try to control costs. This, in a nutshell, is why it’s running into trouble. The plan didn’t reform health care delivery, just coverage. Granted, in terms of bringing more people in under the tent, it’s been a success: Since the plan went into effect in 2006, 439,000 people have signed up for insurance—a number that represents more than two-thirds of the estimated 600,000 people uninsured in the state two years ago. Continue Reading on the Taking Note Blog.
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The Geriatrician Shortage
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Niko Karvounis,
The Century Foundation,
8/12/2008
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In a 2006 New York Times article, Dr. Amit Shah, a physician at Johns Hopkins, recalled how other doctors looked down on him during his residency because of his chosen field. "The most memorable discouragement came during his residency, from a pulmonologist," notes the Times. 'When I passed him in the hall, [the pulmonologist] would shake his head and mutter, 'waste of a mind,'" Shah said. Continue Reading on the Taking Note Blog.
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Health Care in Singapore
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Niko Karvounis,
The Century Foundation,
7/31/2008
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It’s always worth exploring how health care works in other countries, if for no other reason than that models in other countries give us the chance to see how some of the approaches discussed by American reformers might pan out. What do the experiences of Germany and Netherlands tell us about the possibility of a better mixed public-private system in the United States? How is China’s health care system a cautionary tale of market forces gone wild? Continue Reading on the Taking Note Blog.
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Reforming Medicare: Options, Tradeoffs, and Opportunities
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Jeanne Lambrew,
Henry J. Aaron,
Brookings Institution Press,
7/28/2008
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Everyone agrees on the need to reform Medicare but not on how to do it. Some argue the program is too comprehensive, others that it is not comprehensive enough. Some suggest it pays too much for health care, others, too little. Meanwhile, the financial stakes continue to mount. Medicare spending exceeded $400 billion in 2007, making it more expensive than the entire health systems of most other nations, as well as the largest national public program other than Social Security and national defense.
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Order the book here.
View related event.
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The Health Beat by Maggie Mahar Blog
 The Century Foundation fellow, Maggie Mahar discusses today's most pressing health care policy issues in The Health Beat by Maggie Mahar blog. Click here to view.
Getting More Value from Medicare
In “Getting More Value from Medicare,” The Century Foundation, fellow and HealthBeat Blog editor Maggie Mahar points out that past proposals for containing Medicare’s costs, such as putting a cap on physicians’ fees or requiring beneficiaries to pay more for their care, have not worked.
Money-Driven Medicine
 View, Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006), a book by The Century Foundation's Health Fellow, Maggie Mahar. |
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A Second Opinion
Dr. Arnold Relman,
PublicAffairs,
The Century Foundation,
4/23/2007
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Medicare Tomorrow
The Century Foundation Task Force on Medicare Reform, Century Foundation Press
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