We recently convened an expert roundtable to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable. This got us thinking - while the process by which ineffective practices or technologies are abandoned is neither simple nor automatic, even the language used to describe it is not clear. Here we review and clarify the terminology.
Should a patient’s level of cognitive function be considered when allocating scarce organs for transplantation? In a recent perspective in the New England Journal of Medicine (NEJM), Scott Halpern and David Goldberg weigh in on the highly charged debate.
Health care and immigration, two hot button issues for the incoming Administration, come together in a new paper in The Milbank Quarterly on Spanish-speaking immigrants’ access to safety net providers.
Is cancer “special” in terms of the public view and the value placed on potential treatment and cures? The multidisciplinary Penn Precision Cancer Medicine Consortium discussed whether cancer is treated differently from other diseases, and then considered the more normative question of whether it should be treated differently.
The eye-popping price tags on some new cancer drugs pose two fundamental questions: are the drugs worth their cost, and if they are, how can we afford them? The Penn Precision Cancer Medicine Consortium considered cost trends and drivers in the second of its conference calls leading up to an in-person conference in May.
December 8, 2016 [This blog originally appeared on the PolicyLab at Children’s Hospital of Philadelphia blog. View the original blog post here]
Nearly half the patients I see are covered by Medicaid or the Children’s Health Insurance Program (CHIP), both of which have comprehensive sets of benefits and are historically thought of as safety nets for the unemployed. However, you might be surprised to learn that the fastest growing users of these public health insurance programs for their children are employed and unable to afford or receive health insurance for their children through their employer health plans.
In a recent paper, Mark Pauly and Vivek Nimgaonkar take a 20-year look at the relationship between growth in the share of the workforce in medical care and changes in the unemployment rate, and offsetting effects on jobs in other sectors such as education or public services. They find that when economy-wide unemployment is high, growth in medical employment reduces the unemployment rate significantly, without crowding out jobs in other services or government. When the share of medical jobs grow, so does the rest of the services sector. When the unemployment rate is low, however, growth in medical sector jobs does not reduce unemployment. It draws jobs away from other industries, but does not draw disproportionately from education or public services.
The election of Donald Trump has ushered in an uncertain future for the Affordable Care Act (ACA), from modification to total repeal. While many policy experts are concerned about people losing the coverage they gained through the ACA, other aspects of the ACA are also under threat: specifically, provisions that address the social determinants of health.