Posts by Gail Wilensky, Ph.D.

Last year’s Affordable Care Act dealt primarily with the easy part of healthcare reform—reforming the health insurance market and expanding coverage. Both are important changes, but they are far from all that will be needed to address the problems facing the U.S. healthcare system. The legislation also directly included some limited delivery system reforms, such…

After three days of riveting hearings at the Supreme Court concerning various aspects of the Affordable Care Act, we are left waiting, probably until the last week in June, to see what, if any, portions of the act will be struck down by the There has been a lot of commentary on whether the Affordable…

Congress is again struggling with physician payment under Medicare. It has been slightly more than four years since I have written a column focused on physician payments and the challenge that the resource-based relative-value scale (RBRVS) and sustainable growth rate (SGR) present to the Congress. Once again, Congress has been holding hearings discussing the problems…

Now that the dust is settling on the recent Supreme Court decision regarding the constitutionality of the Affordable Care Act (ACA), it is important that hospitals and physicians recognize how much uncertainty still remains in their future and plan accordingly. The Supreme Court has resolved the constitutionality of the mandate (by declaring the penalty a…

In these most political of times, it should come as no surprise that the recent slowdown in healthcare spending has also become a political issue, with the Democrats linking it to the Affordable Care Act—most notably President Clinton at the Charlotte convention. To better understand the issue, we need to know how much healthcare spending…

India’s Supreme Court recently rejected a request from Novartis for a second patent for its cancer drug Gleevec. Forty other countries, including the United States, have provided protection for the patent. The patent is a secondary rather than a primary patent, and the court rejected it as not being a novel invention because Novartis had…

At most times, the IRS is one of America’s least loved institutions, but this past month has been a particularly bad period for the agency. First, it became clear that the IRS had been targeting groups that had “tea party” in their name or other identifications that indicated a conservative political tie for special scrutiny…

The roll-out of the health insurance marketplaces in October was not exactly the auspicious start for this important provision of the Affordable Care Act (ACA) that many had hoped for. In my September 2013 Eye on Washington column, I discussed the conventional wisdom regarding whether the federal and various state-run marketplaces, also called exchanges, would…

On Nov. 30, the Obama administration declared it had met its commitment that HealthCare.gov would work “for most people.” Although some have questioned whether “most” should mean “80 percent,” which is what the administration has decided it should mean, or something more, the more relevant question is, Where does the country stand now with implementation…

The last quarter of 2013 has one thing in common with the last quarters of every year over the past decade: It started with physicians facing significant reductions in unit fees in Medicare at the beginning of the following year—in this case, 24.4 percent. And like most other years, Congress intervened late in the year…