Reference Pricing

What percentage of your prescription drug costs should your insurance company cover?  You may say “100%, of course!”  However, if health insurance cover all pharmaceutical costs this will drive up premiums.   One solution to this problem is reference pricing.  If generics are available for $10 and name brand drugs are available for $100, the…

Shortage! Shortage!…Shortage???

In the news, you often hear that there are shortages of nurses and physicians.  We need more nurses and physicians, right?  According to an editorial by Laurence Baker in Health Services Review, we should be a little skeptical of calls for more and more healthcare providers.  If supplier-induced demand is a problem, more providers will…

APGAR Score

P4P.  Evidence-based medicine.  Insurers and policymakers want to be sure that patient insurance premiums are being used towards high quality medical care. One example of quality evaluation in practice is the Apgar Score.  In 1952, Dr. Virginia Apgar developed this metric to evaluate the health of newborns.  Newborns receive a 0, 1, or 2 score on 5…

Quotation of the day

It’s a truism that people are complicated, multifaceted, contradictory, surprising, but it takes the advent of war or other momentous events to be able to see it.  It is the most fascinating and the most dreadful of spectacles…the most dreadful because it’s so real; you can never pride yourself on truly knowing the sea unless…

Getting Naked

The physician-patient interaction can be a strange one.  Patients leave their most important possession–themselves–in the hand of strangers.  Typically conservative women will bare their naked bodies to physicians.   Although rare, the possibility exists for the physician to take advantage of this situation.   In the U.S. “4 percent of the disciplinary order that state medical…

Why do we die?

What factors predict how long we live?  What are the best ways to forestall death? The determinants of premature death are 40% behavoiral, 30% genetic, but only 10% medical care.  It is important to remember that medical care and health are far from synonomous.

The birth of the N.H.S.

Why did the British decide to have the government pay for health care?  Are they socialists by nature?  Were they just ahead of their time?  Did some lobbyist win the favor of government? Actually, it was done out of practicality.  World War II shifted the provision of health care from the private to the public…