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LBJ and the Initial Cost of Medicare
When Johnson was pushing congress to establish the nation’s first real health care funding, many legislators, especially conservative southern Democrats, balked at the cost. Johnson was well aware that...
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Are People from Pennsylvania Sick?
In a 2011 JAMA article, Gil Welch and colleagues looked at how many chronic diseases Medicare enrollees had across different regions of the country. They came up with the following picture: This...
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Trial and Error in Reducing Medicare Readmissions
Thought I’d pass along a simple picture showing the results of Medicare efforts to reduce hospital readmissions. To their credit, the folks of Medicare are not sure what will work, so they have been...
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How Anti-Alcohol Regulations Promoted…Prostitution?!
John “Eagle-faced” Raines had a simple goal in mind: put a big hurt into the evil saloon industry that was threatening the moral fabric of late 19th century New York State. Low wage workers were...
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Medicare Versus Inflation: Who’s Winning Now?
There is one thing that politicians on both sides of the aisle agree upon: the biggest threat to the future fiscal solvency of the United States is Medicare, the program that pays medical expenses for...
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Will Obamacare Reduce the Crazy Variation in Hospital Prices?
If you have been paying attention to US healthcare policy debates lately, you know that hospitals have a price problem. Walk across the street from one hospital to a competitor hospital, and you could...
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Hospital Payments That Follow Patients Out of the Hospital
For most Medicare patients in United States right now, Medicare pays for hospital stays on the basis of what are called Diagnostic Related Groups or DRGs. You get diagnosed with pneumonia, and your...
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Variation in Medicare Costs Is Mainly Due to Post-Acute Care
Health policy wonks have been pointing for a while now to large variations in Medicare spending across different parts of the country. Live in Miami, and the government is probably going to spend a...
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An Unhealthily Frightening Fiscal Future
A recent article in the New York Times, projects increasing problems with federal budget deficits over the next several decades, problems caused in no small part by the likelihood of increased health...
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The Challenge of Predicting Future Medicare Expenses
As I pointed out in a recent post, experts have been debating what has caused the recent slowdown in medical spending in the United States. They are also try to figure out whether that slowdown will...
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How Truman’s Medicare Efforts Were Foiled by Red Baiting
In The Heart of Power, David Blumenthal and James Morone relate the 75 year history of presidential efforts (typically unsuccessful) to reform the U.S. healthcare system. I used to think major reform...
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A Surprising Early Supporter of Obamacare: Eisenhower?
On October 10, 1952, President Dwight Eisenhower gave a speech in Salt Lake City in which he reiterated his opposition to socialized medicine. In fact, he had long asserted that he would “use every...
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When It Came to Medicare Costs LBJ Concluded “What’s $400 Million Between...
Lyndon Johnson’s advisers were worried. They were drafting a Medicare proposal, a major component of Johnson’s war on poverty. But the cost of this program was turning out to be much larger than...
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Medicare and the Desegregation of American Hospitals
As anyone who has followed the Obamacare roller coaster over the past 4 years knows, passing legislation is only the first step in reforming a healthcare system. Since Obamacare came into law, we have...
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Why JFK Failed to Pass Medicare
In a late night phone call during a foreign policy crisis, Kennedy expressed disdain for domestic policy, showing the kind of attitude that doomed later efforts to reform the U.S. healthcare system:...
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The Biggest Government Health Care Spender Since LBJ Was…Ronald Reagan?
Many readers will recognize Ronald Reagan’s famous maxim that: “Government is not the solution to our problem; government is the problem.” Some will even recognize his vehement opposition to Lyndon...
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Is Medicare Being Too Generous To Rural Healthcare Providers?
If you live in the rural U.S., you probably face relatively limited access to the wonders of American healthcare. There won’t be as many physicians per capita offering you their services. This...
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Look How Much Medicare Spends after Patients Leave the Hospital
As readers of this blog know, Medicare costs loom large in our nation’s future. If we do not find a way to control Medicare spending, it’s hard to imagine any way to remain a solvent nation. As we...
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Are Bundled Payments the Future of US Healthcare?
I spoke recently with a reporter from the USA Today, who ended up writing a nice article on bundled payments in healthcare. I promise to return to this topic on future posts. But for now, let me whet...
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Inappropriate Medicare Incentives Lead to Unnecessary Subspecialty Procedures
Sometimes people flat out need cameras shoved down into their stomachs. A long history of reflux disease, for example, could prompt a gastroenterologist to perform an “upper endoscopy”—to run a thin...
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