Health ‘breakthrough’ anxieties

Nearly every day one reads about a revolutionary new pharmaceutical or medical procedure.  Years later, however, we often learn that this ‘breakthrough’ was only a marginal improvement, had serious side effects or simply did not work.  Ellen Goodman discusses in “Health ‘breakthrough’ anxieties” how a new breast cancer drug (raloxifene) seemed to offer a better…

HealthCare Direct LLC

“One of the quirks of the health care system is that health plans individually negotiate different prices with hospitals and doctors. The result is that two health plans can pay different prices for the same procedure at the same hospital. The contracts typically prevent a health plan from saying that it charges a certain amount…

Number of U.S. Deaths Drop 2% in 2004

After a large number of posts criticizing the American healthcare system on this very blog, it is now time to sing its praise. The San Diego Union Tribune reports today (“U.S. deaths dropped 2% during ’04, report finds“) that the number of deaths decreased by 50,000 between 2003 and 2004. This is surprising. Despite medical…

Nurse-Staffing Levels and the Quality of Care in Hospitals

Most people intuitively believe that having more nurses on staff at a hospital improves health outcomes. After reading Money Magazine‘s report that an average RN earns approximately $70,000 per year, relying on ‘intuition’ may not be the most appropriate manner to judge a nurse’s cost effectiveness. Do health outcomes really improve to justify this cost?…

Nata, Botswana

Nata, in Botswana, is a village of 5000 people located on the edge of the Makgadikgadi Pans. Unfortunately, HIV/AIDS is having a devastating effect on the people of this small village. Botswana has the second highest HIV infection rate in Africa. The current rate of infection is 37% nationally and Nata’s rate of infection is…

Medicaid and Immigration

DB’s Medical Rants cites an interesting New York Times article (“Medicaid Hurdle for Immigrants May Hurt Others“) regarding the administrative burden created by a new law requiring all Medicaid recipients to prove their citizenship in order to receive the public insurance.

Physician Assistant Timeline

Economists typically believe that there is too much regulation in the medical field. Due to problems of asymetric information in determining doctor quality, economists believe there is a role for certification and licensure, but these requirements are currently too strict. For instance, many routine procedures could be preformed by a Nonphysician Clinician (NPC) such as…

Using Physician Assistants: A Wise Tradeoff?

The use nonphysician clinicians (NPCs) in the provision of medical care has grown over the years. Although physicians still dominate the medical field, there were over 66,000 Physician Assistants in the United States in 2005. Before Physician Assistants (PAs) and Nurse Practitioners (NPs) were licensed, physicians were the only individuals permitted by law to perform…

Tax Credits, the Distribution of Subsidized Health Insurance Premiums, and the Uninsured

The popular press has been decrying the existence of large numbers of Americans without medical insurance. From Indiana to Wisconsin to California, politicians are looking for a means–such as government provided health insurance–to give more residents medical insurance. Economists, however, generally speak out against the provision of private goods by the government. An interesting solution…

PPS Economic Model

In an attempt to reduce costs, Medicare enacted a Prospective Payment System (PPS) in 1983. Medicare aimed to pay hospitals a fixed rate based on the Diagnosis Related Group (DRG) plus/minus an adjustment for location and local wage. Although this system gives hospitals the incentive to misclassify patients into high profit DRG, I will assume…