How the U.S. Health Care System Compares Internationally
- "The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror
. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity
." [full report
(pdf)] [more inside]
posted by kliuless
on Jun 17, 2014 -
About half of countries who attempt to build single-payer systems fail. That’s Hsiao’s estimate after working with about 10 governments in the past two decades. Whether he’s in Taiwan, Cyprus, or Vermont, the process is roughly the same: meet with legislators, draw up a plan, write legislation. Only half of those bills actually become law. The part where it collapses is, inevitably, when the country has to pay for it.
Ezra Klein's Vox Media looks at the financial and administrative mechanics
of Governor Peter Shumlin's quest to bring single-payer health care to Vermont. Bonus: 12 questions
posted by psoas
on Apr 9, 2014 -
Inside the Nightmare Launch of HealthCare.Gov
- "Unknown to a nation following the fiasco, McDonough's assignment from the President had boiled down to something more dire than how to fix the site. As the chief of staff remembers his mission, it was 'Can it be patched and improved to work, or does it need to be scrapped to start over? He wanted to know if this thing is salvageable.' Yes, on Oct. 17, the President was thinking of scrapping the whole thing and starting over." (previously
) [more inside]
posted by kliuless
on Mar 3, 2014 -
That lack of expertise explains why in building healthcare.gov, the government turned to industry contractors; in particular, to CGI Federal, a subsidiary of CGI Group, a Canadian company. To those uninitiated in the dark art of government contracting, it seems scandalous that CGI, a company most Americans had never heard of, a company that is not located in Silicon Valley (where President Obama has plenty of Internet superstar friends who could have formed a dazzling brain trust to implement his signature legislation) but rather in Montreal, could be chosen as the lead contractor for the administration’s most important initiative. While right-wing news outlets have focused on the possible relationship between Toni Townes-Whitley, senior vice president for civilian-agency programs at CGI Federal, and Michelle Obama, both of whom were 1985 Princeton graduates, CGI’s selection is probably more an example of a dysfunctional system than it is a scandal. “A lot of the companies in Silicon Valley don’t do business with the government at that level [the level required for federal contracting],” explains Soloway. “It is very burdensome, and the rules make it very unattractive.” Indeed, government contractors have to meet a whole host of requirements contained in a foot-thick book, including cost accounting and excessive auditing, to prove that they are not profiting too much off the American taxpayer. Hence, there tends to be a relatively small, specialized group of companies that compete for this work, even on such critical matters as healthcare.gov.
- Accounting for Obamacare
posted by beisny
on Dec 27, 2013 -
In real (or at least our preferred) life, we do have other, better things to do.
We have books to read, children to raise, friends to meet, loved ones to care for, amusements to enjoy, drinks to drink, walks to take, webs to surf, couches to lie on, games to play, movies to see, protests to make, movements to build, marches to march, and more. Most days, we don’t have time to do any of that. We’re working way too many hours for too little pay, and in the remaining few hours (minutes) we have, after the kids are asleep, the dishes are washed, and the laundry is done, we have to haggle with insurance companies about doctor’s bills, deal with school officials needing forms signed, and more.
posted by latkes
on Dec 18, 2013 -
The conventional wisdom about the origins of the Affordable Care Act is that it is a reformulated plan from the Clinton era, one that right-wingers like Newt Gingrich and the Heritage Foundation created. How true is it
? [more inside]
posted by MisantropicPainforest
on Dec 9, 2013 -
Happy Political Clusterf*ck Day (U.S.)
In one corner: the first federal government shutdown
, born of the House GOP/Tea Party faction's
crusade to delay, defund, and destroy Obamacare (and the Democratic Senate and President's resolve to not do that
have ping-ponged between the two houses, fighting over language to cancel healthcare reform (plus a few other items, such as the implementation of Mitt Romney's entire economic agenda
). National parks are closed
, contractors are hamstrung
, and 800,000 federal workers furloughed
until Speaker Boehner drops the "Hastert Rule"
and passes a bill the other branches can agree to.
In the other corner, heedless of the chaos
(though not without glitches
of its own): the official rollout of the Affordable Care Act and its state insurance exchanges
. The portal at Healthcare.gov
is your one-stop shop for browsing, comparing, and purchasing standardized, regulated insurance coverage
with premium rebates
, guaranteed coverage
, and expanded Medicaid for the poor (in some states)
. A crazy day, overall -- but peanuts compared to what might happen if the debt ceiling is breached in 16 days
. [more inside]
posted by Rhaomi
on Oct 1, 2013 -
More than half the population of small, rural Madras, Oregon (population: ~6059) and its surrounding community is served by one clinic: Madras Medical
. At the beginning of 2006, the clinic's doctors and nurses decided to ban pharmaceutical reps from visiting their practice. No more free lunches. No more free drug samples. No more gifts. And yet.... "It's made us better doctors." (Via) [more inside]
posted by zarq
on Aug 27, 2013 -
A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state’s health benefit exchange established by Obamacare.
The man is impressed. "This beats Obamacare I hope," he mutters to one of the workers.
“Do I burst his bubble?” wonders Reina Diaz-Dempsey, overseeing the operation. She doesn't. If he signs up, it's a win-win, whether he knows he's been ensnared by Obamacare or not.
posted by reenum
on Aug 26, 2013 -
The Oregon Health Insurance Experiment, an outgrowth of Oregon's 2008 lottery to allocate Medicaid slots to eligible residents, has released their second year of results
(Previous discussions on the lottery
and the experiment
). The gist of the results are that they found statisitically significant reductions in catastrophic health care expenditures, improvements in the incidences of depression, and increased use of health care services. They found minimal (and not statistically significant) improvements in the rates of physical health indicators (diabetes and hypertension) they tracked. Because of ethical concerns, there are no other randomized controlled tests on this scale that study the effects of Medicaid and few on the effects of health insurance in general (the only significant one being a RAND study released 30 years ago
). Because of the small amount of information available on the topic and the impending Medicaid expansion offered by Affordable Care Act, this study has drawn a lot of attention from political commentators. This will presumably be the last year these results will be published, as the state of Oregon was able to find extra money in 2010
in order cover the rest of its Medicaid-eligible population. [more inside]
posted by Weebot
on May 3, 2013 -
But it is already too late. CNN has been carefully orchestrating its transformation into a shockingly efficient news distribution company. They have been planning to saturate every screen in reach with this story as fast as possible, and the producer’s initial go-ahead pulled the trigger. On the air, Wolf Blitzer is sending the coverage to the Courthouse steps. And as planned the reporter is putting her phone down to go on the air, which cuts herself off from the only CNN employee with access to the opinion. We’re getting wildly differing assessments
: SCOTUSblog compiles first-hand accounts of the minutes between 10:06 and 10:15am on June 28, when CNN and FOX misreported and retracted that the mandate had been struck down.
posted by youarenothere
on Jul 8, 2012 -
Obamacare: One Less Reason to Get Married.
Erin Gloria Ryan of Jezebel writes: Insurance Marriages had become to the 21st century what shotgun weddings were to jokes about hillbillies. Back in 2004, the LA Times wrote about couples that married for insurance, couples who for varying reasons had not wanted to marry, but who had been driven to marriage by financial necessity. ABC News posted its own roundup of With This Policy, I Thee Wed-style couples in 2008, as did the New York Times. In 2008, 7% of couples who married reported doing so primarily for the insurance benefits. [more inside]
posted by Cash4Lead
on Jun 30, 2012 -
In less than an hour, the Supreme Court will hand down its final judgment in what has become one of the most crucial legal battles of our time: the constitutionality of President Obama's landmark health care reform law.
The product of a strict party line vote following a
of debate, disinformation
, and tense legislative wrangling, the Affordable Care Act
would (among other popular reforms
) require all Americans to buy insurance coverage by 2014, broadening the risk pool
for the benefit of those with pre-existing conditions.
The fate of this "individual mandate," bitterly opposed by Republicans despite its similarity to past plans touted by conservatives
(including presidential contender Mitt Romney
) is the central question facing the justices today
. If the conservative majority takes the dramatic step
of striking down the mandate, the law will be toothless, and in danger of wholesale reversal, rendering millions uninsured
, dealing a crippling blow to the president's re-election hopes, and possibly endangering the federal regulatory state
But despite the pessimism of bettors
, some believe
the Court will demur, wary of damaging
its already-fragile reputation
with another partisan 5-4 decision
. But those who know don't talk, and those who talk don't know
. Watch the SCOTUSblog liveblog
for updates, Q&A, and analysis as the truth finally comes out shortly after 10 a.m. EST.
posted by Rhaomi
on Jun 28, 2012 -
Deep vein thrombosis
is generally a topic that comes up with regards to airline seating and other periods of prolonged immobility (previously
). Anna Brown
was a homeless woman and constantly on the move, so doctors in the emergency room thought that her complaints of leg pain were just drug-seeking behavior. Unfortunately, drug seeking is a major problem
in ERs in the United States. [more inside]
posted by gracedissolved
on Mar 31, 2012 -
Yesterday, the Supreme court granted certiorari
to several of the challenges to the constitutionality of the Affordable Care Act. Here
's a great roundup of several news stories. I like the NPR
story for a quick summary of the issues. The Court will hear a total of 5.5 hours of oral argument, and a decision is expected by the end of the current term, in June.
posted by insectosaurus
on Nov 15, 2011 -