Healthcare Topic: Health Reform

Wednesday, October 10, 2008
Although there is considerable attention paid to addressing cost growth and investing in public health and prevention, the most noteworthy aspect of Presidential candidate Barack Obama’s health care plan is its focus on attempting to make insurance affordable for all Americans
Tuesday, February 2, 2009
“Decent care” offers a new approach to health care that seeks to acknowledge and apply universal human values of decency. Just as the concept of “decent work” sought to name and redefine the conditions of work in the industrial age, decent care seeks no less than to redefine and describe values that are essential to primary health worldwide.
Friday, April 4, 2009
As unemployment rises to its highest level in 24 years, one expected consequence is an increase in the number of Americans who may forgo needed health care because they lost their health insurance along with their job.
Tuesday, April 4, 2009
I believe today we face one of the most important decisions in our Nation’s history—how to address the insolvency of our health care system that threatens to decimate our country’s budget, stability, and overall wellbeing.
Thursday, May 5, 2009
While there is certainly no magic bullet, constructing a system that keeps in mind the needs of families and children will prove crucial to the integrity of the system as a whole. Improvement will certainly require simultaneous efforts on a number of fronts, but building a system around the needs of our children will create health care that embodies our values, delivers effectively, and eventually lowers cost.
Tuesday, June 6, 2009
Broad reform of the U.S. health care system could save $3 trillion by 2020, expand coverage to 99 percent of Americans, and save 100,000 lives annually...If that is the prize on offer, why is health care reform so difficult and what is standing in the way of President Obama and Congress succeeding?
Tuesday, July 7, 2009
If any major health care legislation is passed in the United States in 2009, it will almost certainly involve some form of an insurance exchange. This post focuses on why policymakers are eager to create an exchange and the detrimental impact of risk selection on true competition in an insurance exchange.
Wednesday, August 8, 2009
To be successful, healthcare reform must pay for extending coverage to the uninsured while credibly controlling future costs. Current proposals include a mandate for employers, a public insurance option, and tax increases on high-income households.
Monday, August 8, 2009
Some believe that too much competition has been the catalyst for rising health care costs and inefficiency in the American health care market. I disagree. I believe that the U.S. insurance market actually suffers from too little competition.
Monday, September 9, 2009
As if just talking about dying weren’t hard enough for most of us, now comes the disinformation campaign about end-of-life care discussions waged by opponents of health care reform.
Wednesday, September 9, 2009
Sen. Max Baucus’s America’s Healthy Future Act of 2009 has received a tepid reception from Democrats and Republicans alike. That’s precisely because Sen. Baucus’s bill embodies compromise, mutual conciliation, and moderation. While pragmatism and expediency are laudable goals, they are apt to produce uninspiring results, and that’s what we’ve gotten in the Healthy Future Act.
Tuesday, November 11, 2009
Health care reform offers significant opportunities not only to improve the quality of end-of-life care, but to apply the principles of good end-of-life care to improving our health care system.
Monday, February 2, 2010
In the U.S., private-sector insurers hold a powerful monopoly in insurance markets, and this hinders progress. Conversely, in the U.K., it has historically been the government-run hospitals’ monopoly power that was hampering improvements.
Wednesday, February 2, 2010
As the nation ages, health care must evolve to focus around three critical factors: adopting person- and family-centered engagement with older adults who have complex care needs, improving the health of the older population as a whole, and improving cost efficiency.
Tuesday, March 3, 2010
Health care reform is testing the United State’s capacity to address big issues and has highlighted glaring flaws in the legislative process. What’s clear by now is that it’s tough to boil health care policy down into concise talking points and it’s nearly impossible to sell sensible reforms politically.
Tuesday, April 4, 2010
On March 23, President Obama signed the Affordable Health Care for America Act. This legislation will go down as one of the most significant pieces of social policy legislation that Congress has ever passed. Sure, the legislation isn’t perfect—no law ever is—but it expands coverage to 32 million Americans
Tuesday, April 4, 2010
Our country recently took an historic and long overdue step toward health system reform. While the new law is not perfect and more still needs to be done, this sweeping reform package will greatly benefit America’s patients and their physicians.
Tuesday, April 4, 2010
Health care reform is now the law of the land, and the rollout has begun. If the law stands without major revision, only time will tell how it ultimately affects health care costs, coverage, and quality. Like everyone else, I have my own thoughts, but opinion and forecast must give way to reality.
Tuesday, May 5, 2010
Lost amid the yearlong debate over health reform and the heated talk of death panels and socialism were some major changes to the way in which the United States funds public health, prevention, and wellness programs as a result of the passage of health reform legislation.
Tuesday, May 5, 2010
A little-known provision of the health reform law has the potential to transform long-term care services and delivery. The Community Living Assistance Services and Supports Act establishes the nation’s first voluntary insurance program to purchase long-term care services and supports from the community.
Tuesday, June 6, 2010
In Britain, because the NHS is funded by taxation, everyone in the country is required to pay for the cost of medical care. However, the amount each person in Britain pays into the NHS is not proportional to what they take out in the form of services, medications, and care.
Tuesday, June 6, 2010
Certainly now that health reform has been signed into law, most of us are looking toward the future, focusing on the daunting task of implementing this major piece of legislation—perhaps the most significant and wide-reaching piece of social legislation to pass in the last several decades.
Tuesday, June 6, 2010

Now that the Patient Protection and Affordable Care Act has been signed into law, the key question is whether it will lead to improved quality and better value in health care. While many people feel that this is an issue best left to the federal and state governments, many analysts feel that the reforms needed to improve quality and value cannot be done by governments alone but that real, lasting reform needs to occur at the community level.

Tuesday, July 7, 2010
In the four years since a significant package of health care reforms was enacted in the Netherlands, the Dutch have emerged with a health system that’s innovative, dynamic, and widely viewed by many health policy experts as a blueprint for a high functioning 21st century health care system.
Tuesday, August 8, 2010
Unlike in the U.S., where it’s exceedingly difficult to pass health care legislation, sweeping health care reforms are commonplace in Britain. Because of their parliamentary, winner-takes-all political system, when each new government arrives in power, they almost always introduce broad changes to the National Health Service.
Tuesday, August 8, 2010
Given that the United States has the highest health care costs in the world relative to the size of our economy, it would be hard to argue against the utility of examining where and how our health care dollars are being spent. Finding ways to decrease the cost and burden of health care benefits both patients and the economy.
Tuesday, August 8, 2010
When administration officials tout the cost savings potential of the Patient Protection and Affordable Care Act in a lead New England Journal of Medicine article ( Aug. 12, 2010), one has to wonder if the statute adequately addresses the core drivers of poor health and excessive health care costs in a way which is understandable and actionable by patients and their doctors.
Tuesday, September 9, 2010
Terminal illness is one of the most difficult issues in medicine and health policy. Terminal illness forces us to address end of life care, death, quality of life, and the limits of modern medicine. Terminal illness is also hugely expensive.
Thursday, September 9, 2010
Medicaid currently pays for half of all long-term care in the United States at a cost of more than $100 billion a year to taxpayers. As a result, state and federal budgets are collapsing under the weight of these skyrocketing expenditures
Tuesday, September 9, 2010
Innovation requires several things. Certainly, it needs new discovery, but in business it also implies market adoption. In most U.S. industries, this happens through pressure from one (or both) of the following dimensions: 1) improved quality or utility of a product and 2) the price of the product.
Tuesday, September 9, 2010
In the midst of health reform, there continues to be uncertainty amongst legislators, the general public, and the health care community about how health reform legislation will affect the actual delivery of health care. One category of health care providers that is expected to face some of the biggest challenges related to health reform is the safety net health clinics.
Tuesday, October 10, 2010
In 2011, health insurance premiums in the United States are going to rise. In all likelihood, the price increase that consumers are going to see isn’t going to be trivial.
Tuesday, October 10, 2010
Prior to the passage of health reform legislation, the U.S. health care system was already anticipating a shortage of primary care physicians as older physicians retired and fewer medical students appeared ready to take their place. Now, with the potential influx of millions of newly insured patients in 2014 when the full effects of health reform take effect, this potential shortage has become more urgent than ever.
Tuesday, November 11, 2010
Health care providers all over the United States are converting from paper-based health record systems to electronic health records (EHRs). But the transition from paper to electronic records does not come without challenges.
Monday, December 12, 2010
Ultimately, the central lesson emerging from Europe at the moment is that within hospital and insurance markets, it often takes more regulation and a more active state in order to create meaningful competition and productive incentives.
Tuesday, January 1, 2011
The Republicans pledged to “repeal and replace” health reform, but some political observers are now concerned that the result could be little more than “repeal and confuse.”
Monday, January 1, 2011
Data from the National Health Statistics Group at the Centers for Medicare and Medicaid Services shows that health spending accounted for 17.6 percent of the gross domestic product in 2009—up a full percentage point from 2008. There was a time when a 10 percent share was viewed as apocalyptic.
Thursday, January 1, 2011
January 1st each year millions of us resolve to improve our health—to eat less, exercise more, quit smoking, and so on. Seems simple enough. Sounds like basic willpower. But if staying healthy was that easy—we’d all keep our resolutions.
Tuesday, February 2, 2011
As Washington lawmakers face renewed pressure to remedy the country’s trillion-dollar budget deficit, fractured public opinion on where to make critical cuts—in health care and other major entitlement programs—could complicate political strategies in the run up to the 2012 presidential election
Tuesday, February 2, 2011
To start a real dialogue that leads to real reform, here’s the small business position: The past was awful, the present lies somewhere between no-better and much-worse, and the future can be bright if sensible replace follows blessed repeal.
Thursday, February 2, 2011
The Obama administration often touts the health-law provision that over the next decade will close the unpopular “doughnut hole”—a gap in Medicare prescription drug coverage. But officials rarely cite another provision, one that might cause sticker shock among some seniors.
Tuesday, February 2, 2011
These days, the most hotly contested element of the health care reform law is the mandate that requires every American to purchase insurance coverage come 2014. The mandate is a lightning rod for criticism and many have expressed hope that the Supreme Court will deem it unconstitutional
Thursday, March 3, 2011
National health reform legislation gave birth to accountable care organizations, which were touted as a model to promote quality and reduce costs of health care delivery, but are they “HMOs on steroids”?
Thursday, March 3, 2011
Imagine that you decided to run an Accountable Car-Care Organization. The government announces that you would no longer be paid on repairs alone, but for keeping cars on the road and out of the garage.
Tuesday, March 3, 2011
Prevention is one of those things that everyone can agree on, the health policy world’s equivalent of apple pie (minus the fat and sodium). Except that nowadays, health care is so politicized that no one can agree on anything.
Thursday, March 3, 2011
With the nation about to renew its emphasis on wellness and prevention with the delivery of the National Prevention Strategy, it is fair to wonder if the long-established approaches to prevention and health promotion can truly upend their own paradigm and achieve the strategy’s goal of “… Moving the nation from a focus on illness and disease to one based on wellness and prevention.”
Thursday, March 3, 2011
Almost all agree that the rising rate of obesity in the U.S. has spiraled to an alarming rate and that we must take steps to re-introduce healthier lifestyles. What is up for debate is how we get there amidst contrasting schools of thought. At days’ end, the truth is that no one simple answer exists.
Thursday, April 4, 2011
PCMH models are new, diverse, dynamic, and evolving. We need to understand them, work with them, and design them from blueprints that meet patients’ needs.
Tuesday, May 5, 2011
Beginning in 2014, the Patient Protection and Affordable Care Act (PPACA) hands the Secretary of the U.S. Department of Health and Human Services a joystick – the Essential Health Benefits package – with the potential to rocket small-business health insurance premiums skyward.
Tuesday, May 5, 2011
As of this writing, since taking control of the House in January, Republicans have tried to repeal the ACA, strike out large portions of the law, defund it, and weaken some of the regulations of health reform. Some were willing to shut down the government over health reform.
Tuesday, May 5, 2011
For the first time, consumers shopping for a health policy will be able to get a good idea of how much of the costs different plans will cover for three medical conditions: maternity care, treatment for diabetes and breast cancer.
Wednesday, June 6, 2011
The Patient Protection and Affordable Care Act of 2010 created the Prevention and Public Health Fund to prevent illness and promote the health of all Americans. The Prevention and Public Health Fund (the Fund) will provide $15 billion over the first 10 years and $2 billion each year after to national, state, and community efforts to promote health and wellness. These efforts will help prevent disease, manage conditions before they become epidemics, and decrease burgeoning health care costs.
Wednesday, June 6, 2011
For most seniors, the “right place” is what they consider to be their homes and communities. Before passage of the Patient Protection and Affordable Care Act (ACA), the limited set of federal and state options for community-based care hampered the extent to which this vision could be realized.
Tuesday, June 6, 2011
The 2010 health care law, the Patient Protection and Affordable Care Act (PPACA), hits small business with a barrage of inequities. Among the most egregious is the health insurance tax (HIT) launched by the law’s Section 9010.
Thursday, June 6, 2011
Addressing three dilemmas: Who defines value and how? How can value be measured? Can a value-based system also respect choice?
Monday, June 6, 2011
Do you want more evidence that health care reform can be a hugely difficult process? If so, then take a look at the political and policy tumult over the British government’s health care reforms to the English National Health Service.
Tuesday, June 6, 2011
Starting next March, all insurers and employers will have to make it easier for consumers faced with the ordeal of picking a health plan. Under the 2010 health law, they’ll have to provide health policy information that the average enrollee can understand and use to compare with other plans.
Monday, July 7, 2011
Treating skinned knees and stomachaches is part of the drill at any school nurse’s office or school-based health center. But for many kids, health-care providers at these sites do much more than treat everyday aches and pains: They give checkups and vaccinations, make sure kids take their insulin shots and antidepressants on time, and teach them how to manage chronic conditions such as asthma.
Thursday, August 8, 2011
The cornerstone of a more effective and efficient system of care is to engage people in making decisions about their life and health in a way that upholds their dignity, independence, and right to self determination. Unfortunately, when it comes to serving older Americans who face advanced illness, this concept is contrary to the way most health care is actually delivered.
Tuesday, August 8, 2011
Small-business owners are deeply concerned that the 2010 health care law (PPACA) will prolong what has been described as America’s “jobless recovery.”
Monday, August 8, 2011

In this era of government gridlock and the 15-minute doctor’s appointment, a growing number of consumers are no longer waiting for the political establishment to solve the nation’s health care crisis. Instead, they are banding together to fix problems themselves.

Using the latest technology and a lot of moxie, all sorts of innovative organizations have popped up, delivering the same essential message: patients who actively participate in their own care can improve their health – and help others, too.

Tuesday, August 8, 2011
The U.S. debt ceiling debate was a master class in political dysfunction. However, in the midst of the political infighting and false debates about the merits of raising revenue versus slashing spending, one firm fiscal fact remained: unless the U.S. can slow the rate of growth in health care spending, we’re going to keep having these paralyzing debt debates time and time again.
Wednesday, August 8, 2011
In our current economic climate, community health centers continue to absorb rising numbers of uninsured patients, providing high-quality and affordable care while generating billions in savings to the health care system.
Tuesday, September 9, 2011
He finally said it. “Obama cares,” President Barack Obama told a town hall over the summer, turning the Republican “Obamacare” phrase on its head. I was wondering what took him so long
Tuesday, October 10, 2011
The 2010 health care law will conjure up a strange brew of inequities as it comes to a boil in 2014. The mechanistic, one-size-fits-all health insurance subsidies, for example, will generate serious questions about the law’s fairness.
Tuesday, October 10, 2011
Nearly every developed country is under substantial pressure to slow the growth in health care spending. However, as we have seen, while virtually every country has pledged to spend less, few have been successful.
Tuesday, November 11, 2011
The Obama Administration abandoned the Community Living Services and Supports (CLASS) Act last month. This public long-term care insurance program was slated to be the country’s first attempt at dealing with an aging Boomer population that is in denial about what it costs to grow old in America.
Wednesday, November 11, 2011
If there’s one thing everyone in Washington can agree on it’s that prevention is good. And that’s about as far as the agreement goes. As for the rest of it – who is responsible for prevention, how to define prevention, what is the government’s role in prevention, how much to spend on prevention and when to spend it – is not so clear, and wrapped up in the bitter politics (and difficult economics) of the day.
Tuesday, November 11, 2011
Let’s not capitalize on or mourn the loss of CLASS for too long. We have work to do – and we do not have the luxury of time before forging ahead.
Thursday, December 12, 2011
There is surprisingly little consensus – and not even much being written – about what growth rate would be “sustainable”? Defining sustainable growth and establishing a credible target is one of our top research priorities.
Tuesday, December 12, 2011
Assuming the 2010 health care law survives through 2014, one of the big questions is the future of small-group insurance plans – those in which the employer chooses and administers a plan or plans for employees. The health insurance exchanges built into the Patient Protection and Affordable Care Act (PPACA) create mechanisms for small-group survival, but also powerful incentives for their dissolution.
Thursday, January 1, 2012
Once most doctors saw how grading could help them improve, they were won over. Electronic medical records are good for the patient, the doctor and the bottom line. But they're not the silver bullet that will slay all the nation's health care problems.
Friday, January 1, 2012

Kudos to Robert Samuelson  (Op-Ed, January 16, 2012, The Washington Post) for bringing attention to health care spending in the U.S., and to the more subtle but potentially more important issue of the relationship between health spending and the economy—one that typically goes unrecognized as commentators equate health care with medical need.

Thursday, February 2, 2012

The Patient Protection and Affordable Care Act (PPACA) has a thousand pages of moving parts, and the relatively few that have rolled out are shedding sprockets across the landscape. This is deeply worrying, given that the stability of the nation’s health care system depends on the successful construction and launch of a vast fleet of new institutions before New Year’s Day, 2014.

Number-one selling point

Monday, March 3, 2012

Center for Sustainable Health Spending colleagues George Miller, Ph.D. and Paul Hughes-Cromwick have the following thoughts.

Thursday, March 3, 2012

By Stuart Taylor, Jr. for Kaiser Health News

How big is the constitutional challenge to the Obama health care law, which the Supreme Court will hear on March 26-28?

For starters, it's big enough for the justices to schedule six hours of arguments—more time than given to any case since 1966. After all, the Affordable Care Act is arguably the most consequential domestic legislation since the creation of Medicare in 1965.

Tuesday, April 4, 2012

For small business, the 2010 health reform law means higher costs, more red-tape and fewer choices. Some provisions are already in effect (e.g., coverage expansions, drug tax, FSA limits). Others start in 2013 (e.g., medical device tax, increased “Medicare” taxes on business owners’ wages, a new “Medicare” tax on owners’ investments).

Tuesday, April 4, 2012

By Julie Appleby, Kaiser Health News

Nine prominent physician groups today released lists of 45 common tests and treatments they say are often unnecessary and may even harm patients.

Thursday, June 6, 2012

This is my fourth blog on the topic of sustainable health spending (others are here: 1, 2, 3).  I have argued that under the Patient Protection and Affordable Care Act (ACA), long-run sustainability in health spending is largely determined by the federal government’s ability to meet its Medi

Tuesday, June 6, 2012

The long process of health care reform will begin the day after the U.S. Supreme Court rules in the case of NFIB v Sebelius. No matter how the Court rules, we will still face the big problems that predated The Patient Protection and Affordable Care Act (PPACA) – high and rising costs, gaps in coverage, uneven quality and heavy red-tape burdens for individuals, providers and businesses.

Thursday, June 6, 2012

Warm summer days and evenings draw many people outside to enjoy the weather and the extended daylight. As families take advantage of the pleasant conditions to take walks on local trails, ride bicycles on pathways and streets, and play in parks, it’s important to remember that these leisurely activities are facilitated by the presence of active transportation supports in our communities: safe and attractive sidewalks, bicycle paths, multi-use paths, parks and other recreational areas.

Friday, July 7, 2012
If states turn their backs on Medicaid expansion they leave a lot of federal money on the table. They also leave behind many vulnerable, low income constituents—our friends, families and neighbors—who could receive coverage through Medicaid without purchasing private health insurance (to which they may not have affordable, available options).
Tuesday, July 7, 2012
It is now time to focus on its robust and effective implementation so that we can all benefit from a care delivery system that puts people, families, and their care needs first.