One of the big complaints about the recently enacted health care reform law is that it does little to control costs. There is some truth to that because the major focus is on increasing access to insurance. And yet there is reason for optimism on a couple of fronts:

  • First, with many of the access issues settled, stakeholders can focus directly on cost matters rather than cost-shifting and finger pointing
  • Second, health ...

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Writing in the New England Journal of Medicine three authors share their experience in running a head-to-head trial of Avastin (bevacizumab) versus Lucentis (ranibizumab) for wet age-related macular degeneration (AMD). They describe the barriers they faced and suggest that the barriers will need to be removed for comparative effectiveness research to succeed. They make good points and may well be correct in their policy recommendations. However the case of Avastin and ...

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The new health insurance reform law will generally require health plans to pay out at least 80 or 85 percent of premiums in medical expenses, depending on whether they are selling to individuals/small groups or to large groups. Intuitively it makes sense that purchasers would want the medical loss ratio to be as close to 100 percent as possible –- since the purchaser doesn’t derive utility a plan’s administrative expenses ...

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Cancer. The Big C. No one wants money to stand in the way of curing a patient. But real life is messier. Many new treatments for cancer are pricey yet provide only marginal gains over existing therapies in life expectancy and/or quality of life. Forty thousand dollars for a cure is not a real dilemma for policymakers -- the same spend for an extra six weeks of life is another story. In ...

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A major criticism leveled at the health reform law is that it doesn’t do enough to control costs. Yet experience with a similar breed of health reform in Massachusetts indicates that the cost control issue will come to the fore sooner rather than later. Recent stories have reinforced my conviction about this: Massachusetts health plans have sued the state and stopped issuing new policies to small businesses and individuals after the ...

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