We asked leading thinkers in California to address the issue of improving health care quality and access, by inviting them to begin a conversation around the following question:
The federal stimulus package includes $1.1 billion for comparative effectiveness research. What should the criteria be to determine if new medical treatments and technologies are worth the price?
Posts
Final Thoughts on Rethinking Our Approach to Spending
Dr. Claudia Chaufan makes some good points in her recent post about the excesses of U.S. health care finance. Like her, I can’t justify executive salaries at for-profit health plans in the tens or hundreds of millions. But the stratospheric total she cites – $1.75 billion in compensation in 2002 – still represented only about one-tenth of one percent of all national health spending that year…
My Rules For Creating a Competing Public Plan
There has been a lot of discussion about creating a public plan that would compete with the existing panoply of private options. I am not ideologically opposed to having a public alternative, but it must be done in a way that levels the playing field…
Are We Ready to Make the Public Good a Priority?
What makes me, you or any other individual happy is undoubtedly important. When we share resources, however, a broader perspective – thinking not only about private interests but public good – is important too…
Prevention Isn’t a Cure-All, But It’s a Great Place to Start
Medical or public health interventions in the form of primary prevention should, in theory, have the capacity to slow or reduce the rising prevalence of chronic disease, and simultaneously attenuate the downstream spending associated with it. Thus, if there is a ‘magic bullet’ for rising costs of health care immediately available, basic improvements in population health brought forth by existing treatments may be the best and most economical option…
Fewer Services Can Mean Better Care
To better manage resources and improve health outcomes, we will need to grow more comfortable saying “no” to ourselves and to others – through public and private coverage programs – when more services do not actually improve outcomes…
What Do We Owe Each Other?
As the health reform debate unfolds, the question before us is: what kind of a world do we want to live in – and what are we willing to give up in order to get there?
Reform Depends Upon Some Unpleasant Decisions
No matter how successful in the long term, a broader health reform agenda – changing the way care is paid for and delivered, and increasing our commitment to prevention and wellness – will still create short-term winners and losers with respect to cost, choice, and autonomy…
Medicare Needs to Learn to Say No
Even if you think administrative costs are too high, they still can’t explain the growth in health care spending. The percentage we spend on administration hasn’t changed in at least the last decade. So, while it may eat up some of our health care dollars, it doesn’t explain why the pie is getting bigger…
Getting to GDP+1
Slowing health expenditure growth requires, in the medium to long term, some slowdown in the rate of diffusion of new technology. That is a potentially scary prospect, raising the specter that slower health expenditure growth will deny us the health benefits that we might achieve if we let technology diffuse more rapidly…
Limiting Treatment to Those Who Need It
[T]he development of magnetic resonance imaging (MRI) has revolutionized our ability to diagnosis brain tumors and other serious musculoskeletal problems. But when patients with insurance clamor for an MRI every time they sprain their knee, that raises costs for all of us. It also is what makes insurance premiums unaffordable for many Americans…