Brad Wright, PhD
Brad Wright is a health policy professor.
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Latest articles
Health policy
In many communities around the country, hospitals are one of -- if not the -- largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that.…
In many communities around the country, hospitals are one of — if not the — largest employers. Consequently, there are undoubtedly economic issues that would befall an area if its hospital were to close. But this post isn’t about that. It’s about the health care consequences, and by extension, the health consequences that might arise in a community when a hospital closes its doors.
The logic is fairly straightforward: If a …
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If your hospital closes, does patient care suffer?
Conditions and diseases
We all know them. We see them on TV. We read about them in the paper. And, with the explosion of social media, you hear about it from people you know. If you have a Facebook account with a sizable…
We all know them. We see them on TV. We read about them in the paper. And, with the explosion of social media, you hear about it from people you know. If you have a Facebook account with a sizable enough network of friends, you’ve probably seen at least one negative comment about vaccines. On one end of the spectrum, there are the seemingly innocent people who claim that they …
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We have the power to prevent disease. But we’re not using it.
Health policy
While there are plenty of valid reasons to be skeptical about the Affordable Care Act, regardless of where you fall on the political spectrum, it’s hard to argue that imposing an individual mandate to purchase insurance won’t result in more…
While there are plenty of valid reasons to be skeptical about the Affordable Care Act, regardless of where you fall on the political spectrum, it’s hard to argue that imposing an individual mandate to purchase insurance won’t result in more people obtaining coverage. According to the results of a recent survey conducted by the Centers for Disease Control and Prevention (CDC), that’s precisely what’s happened.
Based on results of the National …
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The uninsured rate has fallen, but it may soon rise
Health policy
As of September 2, CVS -- the ubiquitous pharmacy/convenience store -- has stopped selling tobacco products, including both cigarettes and smokeless tobacco. This is a bold move from the retailer, which is also planning to rebrand itself as “CVS Health”…
As of September 2, CVS — the ubiquitous pharmacy/convenience store — has stopped selling tobacco products, including both cigarettes and smokeless tobacco. This is a bold move from the retailer, which is also planning to rebrand itself as “CVS Health” to emphasize its place in the health care delivery chain. I personally applaud the decision, because there are simply no benefits to tobacco use in any form.
And it’s also …
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CVS removes tobacco products: Did they go far enough?
Health policy
Luxury goods are items that people purchase in disproportionately greater amounts as their income increases. That’s how economists think of them anyway. But for the average American, a luxury good means something else. We tend to think of luxury goods…
Luxury goods are items that people purchase in disproportionately greater amounts as their income increases. That’s how economists think of them anyway. But for the average American, a luxury good means something else. We tend to think of luxury goods being things like designer clothing, luxury cars, and high-end restaurants. Our minds fill with images of Gucci, Burberry, and Luis Vuitton, or Mercedes-Benz, Porsche, and Ferrari.
One thing is clear to …
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Is higher cost health care perceived as being higher quality?
Health policy
Most people, regardless of their political leaning, can agree that the market for health care in the United States isn’t really working well. Take one step further, though, and disagreement rapidly ensues. On the left, the common understanding is that…
Most people, regardless of their political leaning, can agree that the market for health care in the United States isn’t really working well. Take one step further, though, and disagreement rapidly ensues.
On the left, the common understanding is that a market failure has occurred, and that the proper thing to do is have government intervene to correct that failure — usually by expanding public insurance programs, subsidizing private insurance, and …
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Can transparency in health care happen in the United States?
Health policy
A primary criticism of the Affordable Care Act is that it creates incentives for employers to hire fewer full-time employees. One of the House’s attempts to repeal the ACA even referenced it as the “job-killing healthcare law.” It’s true that…
A primary criticism of the Affordable Care Act is that it creates incentives for employers to hire fewer full-time employees. One of the House’s attempts to repeal the ACA even referenced it as the “job-killing healthcare law.” It’s true that there are some provisions in the ACA that employers may exploit in order to minimize the cost of doing business.
At the same time, it’s also true that the ACA protects …
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Does Obamacare really kill jobs?
Health policy
The Affordable Care Act was enacted all the way back in 2010. But, even before then, critics were asserting that this new law would more or less destroy the American economy, insert Uncle Sam squarely between patients and providers, and…
The Affordable Care Act was enacted all the way back in 2010. But, even before then, critics were asserting that this new law would more or less destroy the American economy, insert Uncle Sam squarely between patients and providers, and initiate the end of freedom as it ushered in socialized medicine. That was nearly 4 years — and 40 repeal attempts — ago, and yet, the sky remains intact above …
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The Affordable Care Act is here and the sky has not fallen
Health policy
In recent months, news reports focused on the number of new enrollees as a key test of the law. Although the troubled performance of the Healthcare.gov website during October and November delayed enrollment for hundreds of thousands of potential subscribers,…
In recent months, news reports focused on the number of new enrollees as a key test of the law. Although the troubled performance of the Healthcare.gov website during October and November delayed enrollment for hundreds of thousands of potential subscribers, Obama administration officials and congressional Democrats hailed a surge in enrollment at the end of the year as proof that the law would fulfill its promise of providing affordable coverage to
…
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How should we define the success of the Affordable Care Act?
Health policy
The president, by his own admission, did “fumble the ball” on the rollout of the major elements of health reform implementation. Not only is Healthcare.gov not functioning as it should, but people in the individual market are having their health…
The president, by his own admission, did “fumble the ball” on the rollout of the major elements of health reform implementation. Not only is Healthcare.gov not functioning as it should, but people in the individual market are having their health insurance coverage cancelled–despite repeated assurances that if they liked their current coverage, they could keep it.
While that is absolutely a problem, it needs to be put into perspective. For …
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You can now keep your plan: What does this mean for you?
Health policy
For employers, the Affordable Care Act takes two distinct approaches. First, for small employers (those with 50 or fewer full-time employees), the ACA does not penalize, but rather incentives the purchase of insurance with subsidies available through the Small Business…
For employers, the Affordable Care Act takes two distinct approaches.
First, for small employers (those with 50 or fewer full-time employees), the ACA does not penalize, but rather incentives the purchase of insurance with subsidies available through the Small Business Health Options Program (SHOP). Second, for large employers (those with 51 or more full-time employees), the ACA does very little. Recognizing that the overwhelming majority of these large employers already offer …
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Obamacare’s effect on small business: An unintended consequence?
Health policy
In coming years the US could see growing shortages in the availability of primary care physicians (PCPs). With the number of individuals seeking care increasing and the current medical system continuing to incentivize physicians to specialize, the number of available…
In coming years the US could see growing shortages in the availability of primary care physicians (PCPs). With the number of individuals seeking care increasing and the current medical system continuing to incentivize physicians to specialize, the number of available PCPs will decline proportional to the population. To fill that gap, Ezra Klein and others have asserted that expanded scope of practice will allow nurse practitioners (NPs) …
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The NP vs MD debate is missing the bigger picture
Health policy
In the US, many health care woes are blamed on the federal or state government. Whether there is too little oversight and lack of transparency or too much interference and regulation, it seems that policy and politics often end up…
In the US, many health care woes are blamed on the federal or state government. Whether there is too little oversight and lack of transparency or too much interference and regulation, it seems that policy and politics often end up getting blamed for health care system troubles. But what happens when one lives in a country with no functioning …
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What health care in the United States can learn from Nepal
Health policy
Unplanned readmissions to the hospital have been the focus of much attention in recent years for obvious reasons. First, they are relatively easy to measure using administrative claims data. Second, like all inpatient hospitalizations, they cost a lot of money–and…
Unplanned readmissions to the hospital have been the focus of much attention in recent years for obvious reasons. First, they are relatively easy to measure using administrative claims data. Second, like all inpatient hospitalizations, they cost a lot of money–and are therefore a target for reducing spending. Third, they are a proxy for quality of care, as at least some portion of them are likely avoidable if the hospital does …
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Is the hospital readmission rate a measure of quality?
Health policy
For all intents and purposes, the Affordable Care Act (ACA), the president’s signature piece of legislation, will provide more health care coverage to poor and underserved populations. Persistently disadvantaged communities have much further to go than those with insurance, and…
For all intents and purposes, the Affordable Care Act (ACA), the president’s signature piece of legislation, will provide more health care coverage to poor and underserved populations. Persistently disadvantaged communities have much further to go than those with insurance, and new means of accessing and paying for care will benefit them disproportionately. Nevertheless, with more than 20 percent of the nation’s black population uninsured, more than 30 percent of Hispanics …
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Will health reform address the racial disparity of the uninsured?
Health policy
Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This…
Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This is not exactly what the article said, but most journalists aren’t scientists, so we should cut them a bit of …
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The Oregon Medicaid study: What does it tell us?
Health policy
I recently wrote about some of the unintended, but positive, consequences that could result from employers dropping employer-sponsored health insurance (ESI). Following that post, many weighed in about various other consequences of such behavior from employers and what that means…
I recently wrote about some of the unintended, but positive, consequences that could result from employers dropping employer-sponsored health insurance (ESI). Following that post, many weighed in about various other consequences of such behavior from employers and what that means for health care coverage for millions of families in the US. One issue in particular caught my attention; not only because of the touching stories associated with …
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A creative way to meet our health needs: Direct practices
Health policy
We all know about Medicare, the federal government health insurance program for Americans who are over the age of 65 and/or disabled. We know that as we have begun to live longer, the Medicare population has ballooned and the costs…
We all know about Medicare, the federal government health insurance program for Americans who are over the age of 65 and/or disabled. We know that as we have begun to live longer, the Medicare population has ballooned and the costs of the program are, by most estimates, “unsustainable.”
We also know that Medicare, despite being a government program, is beloved by America’s seniors. If it was an unpopular program, Congress would …
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Medicare Advantage works well when you are healthy
Health policy
From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and…
From 1974 to 1982, a group of researchers conducted the RAND Health Insurance Experiment. In lay terms, what they did was assign people to different levels of insurance coverage, with a particular focus on the amount of co-payments, co-insurance, and deductibles that people had to pay, and then they observed their use of the health care system. As you might expect, those who had to pay more out of their …
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Expanding Medicaid and cost sharing: A recipe for disaster?
Health policy
The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much…
The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much more of the health care reform law due to objections regarding the contraception mandate. Despite the bills legal successes in the past, there are (at publication) more than …
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The Affordable Care Act still has hurdles before full implementation
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