Category: Policy

Should there be mandatory state enforced nurse-to-patient ratios?

On November 6th voters in Massachusetts are facing a very important health care-related question. In addition to voting for political parties in the midterms, they also face three ballot questions. The first of these is whether there should be mandator…

Health care is expensive. It’s time to treat the cause.

We do not rely on the benevolence of the butcher, the brewer, or the baker to feed ourselves — Adam Smith observed in the “Wealth of Nations” (1776) — but on their regard for their own interest. The desire to pursue a profitable living also holds true …

The British are unafraid to talk about rationing. That’s something to admire.

I am a huge fan of Britain’s National Health Service (NHS), but probably not for the reasons many people might assume. It’s not because it’s “socialist” (a horribly inaccurate description), or that it’s nationalized, or anything like that. I’m a huge fan because somehow the people of Britain have developed the courage to talk about […]

Lessons from the meeting of different value-based concepts

Value remains one of the most widely invoked and variably interpreted concept in American health care delivery. Beyond patients, stakeholder groups across the health care ecosystem are undertaking value-based initiatives, including payers (e.g., value-based insurance design and payments), provider organizations (e.g., value-based care redesign), pharmaceutical companies and pharmacy benefits managers (e.g., value-based pricing and formularies), […]

How to pay for long-term care

The topic of paying for long-term care is an overlooked issue in health care. None of us want to think about living our final days in the nursing home, but statistically speaking, many of us will. How will you pay for it? What are the options? Long-term care in this country can be divided into […]

Medical bankruptcies happen less frequently than you think

Elizabeth Warren describes medical bills as “the leading cause of personal bankruptcy” in the United States. She bases that opinion in part on her own research, in which she and her collaborators surveyed people who had experienced personal bankruptcy, asked them whether they’d experienced health-related financial distress, and concluded that 60 percent of all bankruptcies in the U.S. […]

5 fears physicians face today

Like prep sports or prime-time television, medical meetings have seasons. In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of […]

How health insurance contributes to our failing system

An excerpt from Prescription for Bankruptcy: A doctor’s perspective on America’s failing health care system and how we can fix it. Many years ago, while I was involved in developing the pre-hospital emergency medical care system in Massachusetts, I went with a group to meet with the then-president of Blue Cross Blue Shield of Massachusetts, John […]

Considering the recent setbacks of evidence-based medicine

For my students in 2018, it’s difficult to imagine an era when there was no such thing as evidence-based medicine (EBM). When I started medical school in 1997, though, the term had only been in use for six years, having been introduced by Dr. Gordon Guyatt at McMaster University (though EBM’s intellectual origins can be traced […]

Considering the recent setbacks of evidence-based medicine

For my students in 2018, it’s difficult to imagine an era when there was no such thing as evidence-based medicine (EBM). When I started medical school in 1997, though, the term had only been in use for six years, having been introduced by Dr. Gordon Guyatt at McMaster University (though EBM’s intellectual origins can be traced […]