The Supreme Court spent a significant share of last week’s oral arguments on the Affordable Care Act debating the role of money in public health. Can the government rightly fine people for not buying health-care coverage? And what happens if such rebels face no penalty? Would we all, as a result, wind up less healthy? This line of thinking — the fine as a stick used to punish people who won’t get health care — isn’t the only potential contribution of money on public well being. Health researchers and behavioral economists are increasingly pondering the reverse: cash as carrot. ... Read More
Employer Health Costs Rise Faster Than Medicare
November 22, 2011 • By • Leave a Comment
Much of the attention on the rising cost of health care has focused on unsustainable public outlay for programs like Medicare. The federal government — using tax dollars — pays for millions of peoples’ coverage (and, eventually, will chip in for all of our care if we live long enough). The spiraling costs of doctor visits, medicine and surgery for so many people have contributed considerably to the country’s glum economic outlook. While businesses have been screaming about it, less focus has gone to the cost of employer-sponsored health care, and these rates per person have, in ... Read More
Holes in the Medical Safety Net
July 17, 2011 • By • Leave a Comment
Cynder Sinclair, chief executive officer of the Santa Barbara Neighborhood Clinics in Southern California, wants to keep her doors open for the poor and sick, but it’s getting harder by the day. On top of their normal caseloads, Sinclair’s four clinics are seeing 400 new patients per month, a record. No one is ever turned away, regardless of his or her ability to pay. Yet this month, state Gov. Jerry Brown signed a budget that cuts funding for Medicaid — a federally funded, state-administered program for the poor that goes by the name Medi-Cal in California — by $2 billion. The cuts ... Read More
Obesity — Not Aging — Balloons Health Care Costs
June 7, 2011 • By • Leave a Comment
"I guess I don't so much mind being old, as I mind being fat and old." — Peter Gabriel Our rising life expectancy has been nice for those who like being alive, but it seems a bummer for society as a whole. Even if Social Security doesn’t go bust as baby boomers slowly saunter into the sunset, their massive Medicare costs seem likely to crush the economy. Not surprisingly, further major gains in longevity, which researchers on aging have recently achieved with drugs in animals, is about the last thing deficit-obsessed policymakers want to see happen. Accordingly, less than 0.5 percent of ... Read More
Comparative Effectiveness Research Cornered by Foes
February 11, 2011 • By • Leave a Comment
That's how much the 2009 stimulus bill — the American Recovery and Reinvestment Act — devoted to this type of research, which aims to produce better information about the costs and benefits of alternative treatment options. It differs from clinical trials that compare new drugs to placebos and treatments to control groups. It instead compares multiple treatments, evaluating both effectiveness and cost. When done well, it can both improve treatment and save money. But that may not be enough. Although reliance on comparative effectiveness research seems eminently reasonable, opposition ... Read More
Taking Care of the Caregivers
November 15, 2010 • By • Leave a Comment
If you’re a “people-person” looking for a job in a field that’s growing not shrinking — and especially if you are an older “people-person” — you might consider the mushrooming field of at-home direct care. These are not the workers who provide care in nursing homes or hospitals, but those who go to the homes of the elderly, sick or disabled to help them eat, dress, bathe and a number of other tasks. By some estimates, seven of every 10 care workers for the elderly are direct care workers, and the opportunities are growing outside geriatrics: direct home care has been called ... Read More
Cost Savings From Health IT: Priceless
November 24, 2009 • By • Leave a Comment
Of all of the arguments at the heart of the U.S. health care debate this year, one stands out as particularly nonpartisan and uncontroversial: If we could just migrate everything doctors and hospitals do onto computers, the whole system would run more smoothly and, in turn, be cheaper. A RAND Corporation study estimated the savings from electronic medical records would be about $77 billion a year. The Center for American Progress added the federal government would save $196 billion over the next decade. The Obama administration has made the argument — probably because of its consensus ... Read More
Chest Pains in the USA
October 2, 2009 • By • Leave a Comment
I'm somewhat embarrassed to report a second fearful trip through an emergency room in four months — this time for chest pains — and that I emerged with an even cleaner bill of health than the first time. I'm beyond grateful to all the professionals who cared for me, and I'd recommend them for all your emergency needs in a heartbeat. If I were the health care industry, though, I'd also be embarrassed — about how much these efforts cost. As chronicled here previously, my first emergency room admission, in the dead of Minnesota winter last December, followed my collapse onto the carpet ... Read More
Health Care Charges Under the Knife
August 20, 2009 • By • Leave a Comment
If you paid sticker price on the last new car you bought, you might expect to pay about 15 percent more than you would with some negotiating. If you paid full price on a recent knee surgery, you could pay 500 percent more than market rate. And who knew you could even negotiate? Such is the nature of health care pricing where charges are determined by hidden costs and who's paying. Facing the brunt of reform efforts in Congress, health insurance companies pointed a collective finger at doctors recently with a survey by America's Health Insurance Plans, an industry trade group, which ... Read More
