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MedPAC continues to ignore ACO overhead

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In a comment I posted on this blog last December, I noted that the Medicare Payment Advisory Commission (MedPAC) refuses to ask a very obvious question about the two Medicare ACO programs authorized by the Affordable Care Act: Do the administrative costs of running an ACO exceed the savings ACOs allegedly achieve for Medicare?

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Big data: The latest fad in health policy

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In case you blinked, big data is the newest new thing in establishment health policy.

We need an analysis of errors in health policy and why those errors go uncorrected long after they have been revealed. I would like to suggest that the IOM undertake this task. I suggest they entitle their report, “To Err is Human, and Health Policy is No Exception.”

Evidence-based medicine: A movement in crisis? By Trisha Greenhalgh, Jeremy Howick, and Neal Maskrey for the Evidence-Based Medicine Renaissance Group BMJ, June 13, 2014 It is more than 20 years since the evidence-based medicine working group announced a “new paradigm” for teaching and practicing clinical medicine. Tradition, anecdote, and theoretical reasoning from basic sciences would […]

P4P is failing in the UK

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Successes and failures of pay for performance in the United Kingdom By Martin Roland and Stephen Campbell The New England Journal of Medicine, May 15, 2014 In 2004, the United Kingdom introduced one of the world’s largest pay-for-performance programs, the Quality and Outcomes Framework. … The Quality and Outcomes Framework was originally designed in part […]

Another Green Flag for Single Payer

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Reflections on the VA Scandal KevinMD — Dr. Kevin Pho — the popular physician blogger, suggests that single-payer advocates reevaluate the single-payer idea in light of the scandal now unfolding within the Veterans Health Administration. He calls the scandal “a red flag for those who want a national single-payer system in the United States.” While […]

The critical shortcoming of Porter and Lee’s Value Transformation process is that it reforms our dysfunctional delivery system without first reforming our dysfunctional financing system. There are no examples of any delivery system succeeding in the absence of a functional financing system.

In a recent commentary at the JAMA Forum titled “The Innovation vs Consumer Protection Tug-of-War in Health Policy,” health economist Austin Frakt reflects on the possible sacrifice of innovation created by a single payer, universal health care plan.

By Harvey Fernbach, M.D. “I just enrolled in Medicare. It took me 5 minutes. Single payer anyone?” — John Podesta, Twitter, Nov. 14, 2013 The delays, glitches, complexity and time involved in enrolling in Obamacare is in sharp contrast to a America’s largest and premiere government financed and privately delivered health insurance program — Medicare. […]

The GOP, led by Republican Study Committee Chair Steve Scalise of Louisiana, introduced their alternative to Obamacare last week, HR 3121. Calling the GOP proposal a “health” plan is like calling their recent attempt to cut $40 billion in funding for food stamps a “nutrition” program. The GOP has already been obstructing one of the […]

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