Farmers Become Health-Care Monitors

In yesterday’s Wall Street Journal (“In China…“), there is an interesting article about health care in rural China. The article gets at the heart of a number of health care issues: Physicians paid on a fee-for-service basis treat their patients more intensely compared to physicians paid on a salaried or capitation basis. In rural China,…

What is Comprehensive Care for Joint Replacement?

Bundled Payments for Care Improvement (BPCI)A helpful post from Steven A. Farmer, Meaghan George and Mark B. McClellan explains.  Comprehensive Care for Joint Replacement (CCJR) is a bundled payment structure for hip and knee replacements.  CMS notes that: 2013, there were more than 400,000 inpatient primary procedures in Medicare, costing more than $7 billion for hospitalization alone.…

The Unintended Consequences of P4P

Pay-for-performance (P4P) may be better at improving documentation of outcomes rather than actually improving outcomes.  Farmer, Black and Bonow give the following example: Beginning in the fourth quarter of 2008, [CMS] ceased to reimburse for costs due to selected preventable adverse events, including patient safety indicator 5 (PSI-5) (leaving a foreign object in the body…

Smoking Prevention in China

“All tobacco companies are state-owned, and the industry provides signifiant revenue; it also directly employs more than half a million people. From the government’s perspective, smoking is important to stability, both economic and social.  Some cigarettes are even subsidized–the cheapest brands cost as little as thirty cents a pack, because officials fear that farmers will…

How did the national debt get so big?

The book Cadillac Desert discusses the development of dams, aquaducts, and irrigation canals to slake the thirst of cities and farmers in the Western U.S..  While these projects did eventually deliver the water they promised, they did so at huge costs to taxpayers.  In the words of former congressmen Robert W. Edgar: “The old-boy network…