Clearing the way for transparency in health care

In August, during a stop in Minnesota, President Bush “went public” about transparency—urging that better information be made available to the public about the costs and quality of health care. In August, during a stop in Minnesota, President Bush “went public” about transparency—urging that better information be made available to the public about the costs…

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The challenge of Medicare physician spending

The dilemma for Medicare is to devise a physician payment strategy that promotes the delivery of the appropriate volume and mix of services, provides good access to physician services for seniors, and moderates or controls physician spending. With the new emphasis in Medicare and elsewhere in health care on rewarding “good performers”—that is, those who…

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Pay for performance and physicians—an open question

Pay for performance as a payment strategy in health care has continued to gain substantial momentum over this past year. Pay for performance as a payment strategy in health care has continued to gain substantial momentum over this past year. The recent push toward pay for performance has been spurred on by the rapid rates…

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Changing the tax code for health insurance

In his State of the Union address, President Bush proposed major changes in the tax treatment of health insurance coverage. These changes, which are included in the president’s FY08 budget, would eliminate the current employee tax exclusion for employer-sponsored health insurance and replace it with a new deduction for all individuals who purchase health insurance.…

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The growing interest in a comparative clinical effectiveness center

Information will be a critical component in U.S. healthcare reform, no matter what direction it ultimately takes. As candidates for the 2008 election are again demonstrating, there is little consensus about how to approach healthcare reform. Different proposals abound, and it is far too early to see which, if any, will dominate the political landscape.…

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The SCHIP debate raises fundamental questions

Reauthorization of the State Children’s Health Insurance Program (SCHIP) is one of the “must-do” pieces of legislation during the current congressional cycle. SCHIP has had a known expiration date of Sept. 30, 2007, since its enactment in 1997. As of mid- September, the choices moving forward include either the Senate or the House bills passed…

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The future of military health care

During 2007, I had the privilege of serving as the co-chair of a congressionally mandated task force on the future of military health care. The task force was established by the FY07 National Defense Authorization Act and directed to make recommendations to Congress about a broad range of measures, including those needed to sustain the…

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Medicare continues to struggle with physician payment

The challenge of Medicare physician spending continues to be a thorny issue. A year and a half ago, I wrote a column about the subject. The challenge then—and now—is to develop a strategy for reimbursing physicians that promotes the delivery of the appropriate mix and volume of services, provides good access, and moderates physician spending.…

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On fiscal wake-up tours and toothless tigers

In what seems to have become an annual exercise in fiscal futility, the Medicare trustees dutifully released their annual report in late March indicating impending fiscal disaster for Medicare. And once again, the report was met with scarcely a ripple in the press and hardly more than a yawn from the public. Oh, to be…

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Campaign 2008 healthcare reform revisited

As we enter the final phase of the election cycle, discussions of healthcare reform are again claiming a significant place in the campaigns of the two leading presidential candidates. A year ago, it seemed health care would hold a central role in the political discussion. It had been reported as the No. 2 issue for…

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