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A New Theory of Health Insurance: Preventive Care and Health Care Reform

In all of the commentary about The Patient Protection and Affordable Health Care Act, little has been said about the dramatic change in the theory of health insurance that was embedded in the Act. While there are many changes to health insurance in the bill, most of them affirm the original foundations of health insurance in America: community rating, guaranteed …

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And Now for a Message about Public Health

With all the focus this past week on health care reform with a capital “H” (and a really boring official name, The Patient Protection and Affordable Care Act), a very important development relating to the public’s health could easily have been missed: a seminal ruling by New York federal court judge Robert Sweet. Judge Sweet’s March 29, 2010 ruling invalidates …

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Health Reform and its Aftermath: Time for a Civil and Truthful Dialog

Last week was a powerful and exciting week for anyone who cares about health care in this country.  Whether you agreed or disagreed with the specifics of this legislation, there was common agreement that the Patient Protection and Affordable Care Act of 2010 was momentous legislation. I do support the legislation, not because I think it is a perfect bill …

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Thank Anthem Blue Cross for Health Care Reform

When the history of the 2010 health reform bill is written, it should include a shout out to Anthem Blue Cross of California for all of its help. What a lot of changes in a short period of time! Remember the ancient history of January 19, 2010? That was the day that Scott Brown of Massachusetts was elected to fill …

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What to do about “Lemon Drops”

The White House is saying that we will have health reform enacted by next Sunday. While health reform is the term often used to describe the House and Senate passed bills, in fact a large part of what is called health reform is really focused on health insurance reform. And, a big piece of that reform is designed to deal …

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Health Reform and Access to Care

Today we are releasing a survey of Michigan citizens’ views[CHRTS CM SURVEY 2010] on access to health care. The findings from this survey paint a picture that differs from some conventional wisdom and adds a different dimension to the debate on health reform in Washington. In particular, the survey makes it clear that having health insurance is important but no …

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“The Summit” and Bringing it Home

Much has already been written about President Obama’s Health Reform Summit and what we learned or didn’t learn (see in particular blog posts at the Wall Street Journal and the New York Times). On the same evening as the Summit, I had an opportunity to participate on a health reform panel sponsored by the University of Michigan college Democrats with …

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The More Things Change

The fact that presidents have been trying to get some form of universal, government supported health insurance for almost 100 years now has been well publicized. What is less known is why — with the exception of the passage of Medicare and Medicaid in 1965 — almost all of their efforts have failed to produce substantive change. It’s instructive to …

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The Limits of Guidelines

Jerome Groopman published a provocative and thoughtful essay In the February 11, 2010 New York Review of Books  about the way one determines “quality health care.” Groopman’s focus is on clinical guidelines and just how prescriptive they can be. He makes a fundamental distinction between guidelines that can be applied in a standardized way (e.g., how to clean a catheter to …

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