News

Congratulations to Governor Snyder

Michigan Governor Rick Snyder deserves special notice and acknowledgement for the courage and focus he displayed in his decision not to sign on to the letter signed by all other Republican governors, asking for changes to the Medicaid program and advocating for the repeal of the Affordable Care Act. I am sure Governor Snyder disagrees with some provisions of the …

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What it will take: Case in point – Cancer Care

In the New England Journal of Medicine on May 26, 2011, Thomas Smith and Bruce Hillner describe a series of strategies to reduce the cost of spending on cancer care in the United States. The article is compelling, and highlights the reasons health care spending is so difficult to talk about—much less do something about: all five strategies involve changes to …

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Let’s just start over?

I get asked to speak about health reform on a fairly frequent basis. It is actually quite fun, because health reform is so topical and there is always something new going on. I also enjoy the subject because there is always a range of viewpoints in any given audience: from those who strongly advocate for a single payer system to …

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Health Care Reform and the Balancing Act

With the announcement of  Rep. Ryan’s proposal to convert Medicare into a voucher program and Medicaid into a block grant, contrasting visions of health care reform became very clear. The Ryan/Republican House approach embraces a market strategy and would effectively cap federal government payments for health care. A Medicare voucher program would leave seniors to purchase health insurance with government …

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Paternalism and Health: How Far Should We Go?

Mayor Bloomberg of New York made headlines when he decided to take on the soda industry (ok, I know, my New York roots are showing – pop for those of you from the Midwest!). Specifically, Mr. Bloomberg is seeking a federal waiver in the food stamp program (now called SNAP – supplemental nutrition assistance program) to ban the purchase of …

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A Broken Drug Development Process

For years, many in the health policy world have talked about the emphasis that pharmaceutical manufacturers were putting on “me too” drugs – drugs that are structurally similar to existing drugs with only subtle differences. And for a long time, I have been reading articles about the lack of new drugs in the drug development pipeline – especially blockbuster drugs …

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Truly Reducing Health Care Spending

The April 13 issue of the New England Journal of Medicine includes an important article on how comparative effectiveness research can pay for itself.  In it, the authors describe two procedures to treat osteoporotic vertebral fractures (compression fractures caused by osteoporosis): one in which cement is injected into the vertebral body to support the fractured bone; and one in which …

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What do we mean when we say “population health”?

Lately I’ve noticed a resurgence of the term “population health” in the health policy literature. It seems to me that the term is being used differently today than in the past, and I wonder how that might affect our ability to actually affect and improve population health. Like many who read this blog, I was trained in a school of …

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A Better Approach to Quality Improvement

In the April issue of the journal Health Affairs, my colleagues and I descibe the success of a broad collaborative effort that has been in place in Michigan to improve quality of health care. The focus of the April Health Affairs is what has happened since the seminal work by the Institute of Medicine – Crossing the Quality Chasm – was published. The Quality …

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His story should be history

I met a young man last week who lost his job in December of 2009, and despite his best efforts, still hasn’t found another. He told me he had excellent health benefits through his previous employer, but rarely needed to use them. He described himself as a typical young and healthy patient – going in for routine cleanings at the dentist’s …

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