Can single payer systems work?

Much of the discussions of the pros and cons of single payer systems are ideological.  Single payer advocates will say they are fair, potentially can leverage economies of scale, and more equitable.  Single payer opponents will argue that they are inefficient, and restrict choice. An interesting paper from Tomoki Fuji (2018), shows that the answer…

Healthcare Economist on President Trump’s plan to lower Medicare drug prices

A recent report from Assistant Secretary for Planning and Evaluation (ASPE) found that for about 30 physician administered drugs, prices are 8 times as high as those charged in other developed countries. To address the high prices, President Trump unveiled a three-part plan to reduce drug prices.  Under the “international pricing index” proposal, U.S. drug…

Patient care under uncertainty: Or why I learned to stop loving clinical practice guidelines

The National Cancer Institute defines personalized medicine as “uses information about a person’s genes, proteins, and environment to prevent, diagnose, and treat disease”. In practice, however, patient treatment is rarely personalized by individual since evidence to support complete personalization is rarely available. Personalization in practice more often means care that varies with some individual characteristics.…

The importance of competition in ACA marketplaces

Competition matters for markets…even health care markets. A paper by Van Parys (2018) relies on a database of plan premium and market characteristics among states with federally-facilitated health insurance exchange Marketplaces.  In this analysis, she finds that: In 2018, Marketplace premiums were 50 percent ($180) higher, on average, in rating areas with monopolist insurers, compared…