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Other Points of View 
Eliminating a Viable Primary Care Workforce — A Primary Care Perspective(0)
When physicians or health policy experts propose that the United States move to a single-payer health care system, with all doctors on salary,1 I find it disheartening: I am hoping for a practical, ethical, financially sound solution that would correct (at least partially) the problems in our system and preserve its strengths. We need a [...]
Full StoryDead Souls — Comparing Dartmouth Atlas Benchmarks with CMS Outcomes Data
The premise, based on the Dartmouth Atlas of Health Care, that geographic variations in end-of-life Medicare spending can be used to identify wasted resources was popularized by Peter Orszag, director of the Office of Management and Budget, who has said that “30 percent of Medicare’s costs could be saved without negatively affecting health outcomes.”1 This [...]
Looking beyond the Market
For the most part, the market doesn’t work where health care is concerned. It has been particularly ineffective in constraining costs over the past half-century, with stakeholders (insurance companies, organized medicine, pharmaceutical companies, trial lawyers) propelling runaway spending. Yet as they shape reform legislation, politicians on both sides of the aisle merely want to make [...]
Cost Expansion versus Cost Control — Lessons from the Canadian System
The health care reform effort in the United States is driven by the desires for cost control and expanded coverage. However, as Daniel Callahan recently wrote, “cost controls that are likely to be politically acceptable will not be very effective, and what might be effective will not be acceptable.”1 Unlike cost savings, which are often [...]
More in this category
- Which Medicine, Which America?
- Health Care Reform and Clinical Culture
- The Tragedy of the Commons Revisited
- Primary Care Remuneration — A Simple Fix
- The Regressivity of Taxing Employer-Paid Health Insurance
- Values, Health Care Reform, and Universal Participation