Public Policy
Chastened and More Sober, Harry & Louise Return
08/21/08
A clever new ad sponsored by powerful DC-insider groups features a reformed Harry and Louise, this time hoping that Congress will make the changes that they opposed during the Clinton years. But reform is unlikely unless the nation's most powerful power-brokers - non-health care business - galvanize and mobilize to drive it.
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Knowledge Like Clear, Clean Water, Muir Gray on Health Care's Progress
04/07/08
Sir Muir Gray's vision of the challenges we now face in health care - he is Chief Knowledge Officer of Britain's National Health Service - merits attention by anyone seriously interested in the topic.
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On Corporate Health Care: An Exchange with Maggie Mahar
03/28/08
In a response to my article on the emergence of corporately-run worksite clinics, Maggie Mahar argues against for-profit health care, and I clarify my position.
Loving Our Children
03/14/08
New data clearly show that one in four American teens have at least one sexually transmitted disease. One in seven have more than one. A refusal to confront this news directly by changing the abstinence-only sex education policies of the last decade is tantamount to child abuse.
Cognitive Dissonance and HHS' Position on Medicare Physician Data
02/03/08
Just as it launches a new program aimed at allowing local organization access to physician profiling information, HHS has blocked access to that same information by a national consumer group.
PlumpyNut
01/30/08
Plumpy'Nut, a nutritional bar that can mean the difference between malnourishment and thriving in the world's poorest regions, is an example of the good we can do if we simply care to do it.
Families USA Health Action 2008: An Alternative Plan
01/29/08
Families USA is an impressive organization that has built a formidable platform over the year through its base, consumers. But to achieve the reforms it advocates for, it must leverage that platform with the one group that has enough strength and motive to bring meaningful reforms to fruition: large employers.
Families USA Health Action 2008: Don Berwick MD on Everything
01/28/08
Through patience, an ability to articulate need and solutions, and diplomacy, Dr. Berwick has facilitated tremendous quality advances in hospitals across the country. And that lends him enormous authority to urge the process on. At the Families USA meeting, he described his vision.
Families USA Health Action 2008: Tony Fauci MD on Global Health
01/28/08
Dr. Tony Fauci's work is inspiring because it is global health activism in the cause of peace, security and prosperity.
Families USA Health Action 2008: Tom Daschle on Reform
01/27/08
Former Senate Majority Leader Tom Daschle delivered a satisfyingly comprehensive and thoughtful reform proposal that made it clear he's aware of the deep challenges involved in actually getting change accomplished.
Families USA Health Action 2008: Nancy Pelosi's Address
01/24/08
Nancy Pelosi made a major health care reform speech at the Families USA Health Action 2008 Conference. If this is the most complete vision the Democrats have, then we're in trouble.
At Families USA Health Action 2008
01/23/08
The health care consumer advocacy organization Families USA invited several bloggers, including me, to attend their Health Action 2008 Conference in late January 2008. It was the chance to observe the health policy goings-on from the perspective of a very well-supported and well-intentioned group with great connections. I wrote several pieces there, though I doubt they appreciated my perspective.
Leveraging the Doctor As A Trusted Authority
01/09/08
Doctors have the stature and authority to create tremendous good through public policy. Why don't they use these assets?
On Practical Reforms
01/08/08
We know a great deal about what works and what doesn't in health care, and what structural reforms are critical to re-establish stability and sustainability to our health system. But most policy-based reforms are ideological instead.
Business As Usual: California's Health Reform Proposal
12/20/07
Like the other reform efforts we're seeing, California's is characterized by politics, back room dealmaking, and who will win the biggest purse. That's not a probable recipe for real change.
Policy- vs. Market-Based Reforms: RHIOs As A Case Study
12/20/07
RHIOs as Health Information Exchanges (HIEs) offered great promise in theory, but have been blocked by interest groups concerned that the exchange of data would hurt their competitiveness. But that role is now taking on much greater power through Health 2.0 ventures, which will make data available independent of the wishes of those who wish to keep information secret.
Why Consumers' Checkbook v HHS Is A Sideshow
10/20/07
The battles over transparency information will ultimately be swept away and remembered as anachronisms, as the overwhelming pressure for data that can drive decisions wins out.
We Are What We Eat: Where Is America's Leadership
10/18/07
The obesity epidemic has the power to crush America's future, but it's roots can be found in the lobbying efforts of agribusiness and the fast food, prepared food and junk food industries. Like the health care reform problem, we can't solve this unless we fix the way America's policies are developed.
What Obesity Really Costs
10/16/07
New data confirm what we already know: that the societal costs of the obesity epidemic are enormous. This is a problem that can only be solved by the nation's largest, most influential firms who do not profit from vectors that drive obesity.
Bogle on the Financial Sector's Threat to Democracy
10/02/07
John Bogle, founder of the Vanguard Group, has written a clear-eyed, worrisome description of how America's financial sector threatens our democratic foundations. Required reading.
Taking Obesity Seriously
09/15/07
America's obesity epidemic is setting America up to be an unproductive, uncompetitive country with enormous health care maintenance costs.
What About Health Plan Transparency
09/15/07
Shouldn't the performance of health plans be as transparent as they have demanded of providers?
Reform's Tougher Problem
08/29/07
Most reformers frame the problem in terms of universal coverage. But the much more difficult issue is cost and how to control waste in a policy landscape controlled by powerful special interests.
Benign Neglect and the Nursing Shortage
08/21/07
Despite all the noise about a nursing shortage, we turn away a tremendous number of qualified applicants for lack of nursing instructors. The real reason behind the shortage is our refusal to pay nursing instructors as much as they can make being nurses in the field.
Not Paying For Preventable Errors: A Big Step
08/20/07
On October 1, 2008, Medicare will change decades of policy and stop paying health systems for errors that were preventable. After Medicare took the lead, the major commercial health plans and many Medicaid plans followed, significantly raising the quality bar for hospitals and health systems.
Laszewski on Rove and Medicare D
08/17/07
When you look deeply into it, it becomes clear that Medicare D was the worst kind of public policy, a tremendously expensive and cynical scam perpetrated for the political and financial advantage of the Administration and the drug industry.
Mr. Bush's Health Care Reform Proposall
07/24/07
The Wall Street Journal ran an article on Mr. Bush's health care reform proposal. In terms of ameliorating the crisis, its functionally meaningless.
The Distribution of the Uninsured and the Total Population By Income Level, 2004
Source: US Dept. of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, Tabulations of the Current Population Survey
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The Distribution of the Uninsured and the Total Population By Income Level, 2004
Source: US Dept. of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, Tabulations of the Current Population Survey
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Should We Have Health Care Performance Transparency? By Whom? And How?
07/19/07
To heal health care, we need transparency. But it should be provided by neutral organizations that don't have conflicts of interest, and handled to assure doctors and everyone else involved in health care that the reporting will be fair and without prejudice.
To Fix Health Care, Fix America First
07/15/07
We can't fix health care because Congress and our legislatures are bought off by the health care industry, and there's no more powerful force that has influence over our lawmakers. If you don't believe it, look at the size of the 2006 lobbying contributions in the table below.
Those Crazy Californians: This Time Its Childhood Diabetes
07/13/07
California has taken a bold step in the fight against childhood diabetes. Even so, its hardly a match for the influence exerted by the fast food industry.
Crimes and Punishments: Zheng and Crawford
07/11/07
The difference in the way China is treating a public official who was caught taking illicit money and how we treated one of our own caught doing the same thing says everything you need to know about which direction we're headed.
Why Its Unlikely We'll Curb Obesity and Diabetes
07/09/07
Like the health care reform problem, we can't fix the obesity problem because Congress ensures that big contributors, the agribusiness and fast food sectors, can have their way with our kids. Its wishful thinking to believe that we can simply train a generation of children to be disciplined in the face of overwhelming advertising.
Mr. Orszag's Surprise
07/05/07
A report by Congressional Budget Office Director Peter Orszag provides a refreshing, non-partisan, data-driven perspective on the seriousness of the health care crisis.
Can Consumerism Save Health Care
02/27/06
As standalone coverage vehicles, there are lots of reasons to worry that HSAs and High Deductible Health Plans aren't good answers if you're low income or have a chronic disease.
