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CHRT Blog

Primary Contact: Main Office Line: (734) 998-7555 or CHRT-info@umich.edu

Health Care Reform: Values and Beliefs vs Economics

Ever since Bill Clinton took a turn at health care reform, the issue has often been discussed as an economic one. Bill Clinton first framed the health reform issue in 1992 before he took office. He had famously kept as a center piece of his campaign the idea that “it’s the economy, stupid” and health care became part of that …

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Passions behind Health Care Reform – Illuminated by Tragedy

The terrible shootings in Arizona have been described, mourned and their causes much discussed.  There has been a particular debate about whether these crimes could possibly have been encouraged by some of the more heated political discourse that has occurred in this country over the past year or so. While it seems likely that when all is said and done, …

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Arizona and Bad Public Policy on Health Care

The Arizona Medicaid program has been much in the news lately for its decisions to deny Medicaid coverage for certain transplants. The state has variously argued several things about these decisions. First, that these are evidence based decisions; that is, that the transplants were denied because the research shows that they don’t actually work. But, when challenged by transplant surgeons …

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The 10% Rule

One of the big issues that prompted the passage of health reform last year was the 39 percent rate increase proposed by Anthem California for the individual market. That action both strengthened the will of the Democrats to enact health care reform and provided a clear cut talking point about the need for reform. As a result, one of the …

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The Affordable Care Act and the Courts

Much has been written this past week about the Virginia federal court decision about the constitutionality of the Affordable Care Act. While many have described the decision as politically motivated and delved into the politics of the various judges who have ruled or are about to rule on the Affordable Care Act, the more interesting question is: What is likely …

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A Case in Point: The Tangled Web of Misaligned Incentives and Health Care Costs in the U.S.

In 2007, the COURAGE trial (aka: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation –a mouthful!) results were reported in the New England Journal of Medicine. This study concluded that for those with stable coronary artery disease, the insertion of stents was no better than medication and lifestyle changes at preventing future heart attacks or strokes, nor did it extend life. There …

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Medicaid Expansion: Will it achieve its promise?

Many analyses of the impact of health reform focus on the large increase in expected Medicaid enrollment.  Indeed, our own analysis of potential Medicaid enrollment in Michigan showed as many as 452,000 people could be enrolled come 2014 (link to Cover Michigan) who are not enrolled today. Kaiser’s numbers were slightly higher, at 590,000 potentially new Medicaid enrollees, and more recent Census data suggest the …

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Catalyzing Practice Transformation Guided by the Patient Centered Medical Home Model

The Patient Centered Medical Home Model (PCMH) generates much discussion in health care circles. PCMH demonstration projects are widespread, accreditation organizations are developing and implementing certification programs for PCMH-based practices, and payers – including the federal government – are exploring new reimbursement policies to support medical home-based care. There is a sense of urgency about implementing medical home capabilities. Yet …

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The Cost of Prematurity

In 2006, there were 4.3 million children born in the United States. Approximately 55,000 of those children were born prematurely. Premature births have been increasing consistently since 1990 (though there appears to have been a slight drop in the rate of prematurity in 2007). In 1990, 10.6 percent of children were born prematurely; in 2006, that percentage had increased to …

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What’s happening in the UK? And, what’s it got to do with us?

In the midst of all the focus on election day in the U.S., there was a much overlooked article the same day on changes in the British health care system. The article is about what is called in Great Britain “NICE.” NICE is an acronym that stands for National Institute for Health and Clinical Excellence. NICE was established in 1999 …

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