Volume 93, Issue 4, 2015 (Op-Ed) Whether and to what extent the Affordable Care Act is meeting its goals continues to be debated, especially in this election season. Here’s my take on these questions. The ACA has (at least) 3 major goals: (1) expanding coverage (and “reforming” the individual insurance market), (2) slowing health care…

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Perspective Brett P. Giroir, M.D., and Gail R. Wilensky, Ph.D. N Engl J Med 2015; 373:1693-1695 October 29, 2015 DOI: 10.1056/NEJMp1511438 The Veterans Health Administration (VHA) is one of the largest health care delivery systems in the United States, with 9.1 million enrollees, 20,000 physicians, 1600 facilities, 288,000 employees, and a $59 billion budget. In…

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MEDICARE HAS SEEN A LOT OF CHANGES OVER THE PAST 50 YEARS, BUT WITH THE DELIVERY OF HEALTH CARE EVOLVING AND THE BABY- BOOMER POPULATION AGING, EVEN MORE CHANGES ARE TO COME. Recognizing Medicare’s 50th birthday is particularly poignant to me because I was the administrator running the program when it had its 25th birthday,…

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