January 24, 2016
The Manhattan Institute’s HEALTH CARE 2.0: USHERING IN MEDICINE’S DIGITAL REVOLUTION series delves into the details of how government policy stifles innovation in the delivery of health care. This paper, Part 1, surveys the key economic principles that drive innovative, dynamic sectors of the economy—and explains why American health care does not live up to those principles.
- Health care-market distortions have considerably worsened since Kenneth Arrow famously described them in 1963; but in other industries less dominated by misguided government intervention, similar distortions have gradually eroded, thanks to technology, especially the rise of the Internet.
- The tech world is full of stories of individuals who dropped out of college to design software and hardware that changed the world; but such innovation is far less common in health care—for reasons largely determined by public policy.
- Each current barrier to a more innovative, competitive, affordable health care system was created for a reason; but the cumulative weight of these policies has been to make U.S. health care less innovative, less patient-centered, and less affordable.
Source: HEALTH CARE 2.0, Part 1: How to Think About Market Forces in Health Care | Manhattan Institute
January 13, 2016
CON Regulations Have a Negative Effect on Nonhospital Providers
- The association of a CON regulation with nonhospital providers is substantial, ranging from −34 percent to −65 percent utilization for MRI, CT, and PET scans.
- Nonhospital providers in CON states experience significant decreases in the utilization of imaging services compared to hospital providers.
CON Regulations Have No Effect on Hospitals, Thus Increasing Their Market Share
- CON regulation has no measurable effect on hospitals’ utilization of imaging services. The volume of services provided in hospitals is not affected by CON regulation.
- This may explain why hospital providers have a stronger market presence in CON states than in non-CON states.
Consumers Are Driven to Seek Imaging Services in Non-CON States
- CON regulations are associated with 3.93 percent more MRI scans, 3.52 percent more CT scans, and 8.13 percent more PET scans occurring out of state.
- CON regulations may have a negative effect on consumers because patients living in CON states have to travel out of state more often than patients living in non-CON states. This propensity for traveling out of state to obtain medical services might be attributable to any of several factors: higher costs, a smaller selection of services, or restricted access to care.
CON laws act as barriers to entry for nonhospital providers and favor hospitals over other providers. In consequence, consumers of MRI, CT, and PET scanning services are driven to seek these services either out of state or in hospitals. More research is needed to determine whether additional costs and barriers in the healthcare industry restrict specific market providers and affect where procedures occur.
Source: Are Certificate-of-Need Laws Barriers to Entry? How They Affect Access to MRI, CT, and PET Scans | Mercatus
November 2, 2015
In the years since the passage of the Patient Protection and Affordable Care Act (PPACA, or, colloquially, Obamacare), most of the discussion about it has been political. But as the politics fade and the law’s many complex provisions take effect, a much more interesting question begins to emerge: How will the law affect the American health care regime in the coming years and decades?
This book brings together fourteen leading scholars from the fields of law, economics, medicine, and public health to answer that question. Taking discipline-specific views, they offer their analyses and predictions for the future of health care reform. By turns thought-provoking, counterintuitive, and even contradictory, the essays together cover the landscape of positions on the PPACA’s prospects. Some see efficiency growth and moderating prices; others fear a strangling bureaucracy and spiraling costs. The result is a deeply informed, richly substantive discussion that will trouble settled positions and lay the groundwork for analysis and assessment as the law’s effects begin to become clear.
Source: The Future of Healthcare Reform in the United States, Malani, Schill
March 3, 2015
What makes a top hospital? Four services that publish hospital ratings for consumers strongly disagree, according to a study in the journal Health Affairs.
No single hospital received high marks from all four services—U.S. News & World Report, Consumer Reports, the Leapfrog Group and Healthgrades—and only 10% of the 844 hospitals that were rated highly by one service received top marks from another, the study published Monday found.
The measures were so divergent that 27 hospitals were simultaneously rated among the nation’s best by one service and among the worst by another.
via What Are the Best Hospitals? Rankings Disagree – WSJ.
March 3, 2015
Dr. Macip presented the case on Saturday to a meeting of the American Academy of Hospice and Palliative Medicine. The presentation’s dispiriting title: “The 30-Day Mortality Rule in Surgery: Does This Number Prolong Unnecessary Suffering in Vulnerable Elderly Patients?”
Like Dr. Macip, a growing number of physicians and researchers have grown critical of 30-day mortality as a measure of surgical success. That seemingly innocuous metric, they argue, may actually undermine appropriate care, especially for older adults.
via A Surgery Standard Under Fire – NYTimes.com.
February 21, 2015
One of ObamaCare’s many unfortunate effects is its centralization of the nation’s health-care debate. Even Republicans now assume only Washington can fix America’s broken health-care system—look at the various federal-centric ObamaCare replacement plans that have been released in recent months. But state lawmakers can play an important role in improving health outcomes, lowering costs and increasing choices for patients.
Fortunately, elected officials in some states are showing promise in this regard. For example, legislators in South Carolina, Georgia, New Hampshire and Washington have recently introduced bills to weaken or repeal their states’ “certificate of need” laws, which increase health-care costs and empower bureaucrats and lobbyists rather than patients.
via Nancy Pfotenhauer and Nathan Nascimento: States Strike a Blow for Freedom in the ObamaCare Age – WSJ.
February 2, 2015
The U.S. government will begin releasing Medicare physician-payment records every year, cementing public access to how tens of billions of dollars are spent annually on everything from office visits to radiation therapy.
Last April, a year’s worth of the data was released for the first time in more than three decades after Wall Street Journal parent Dow Jones & Co. challenged a 1979 injunction that prohibited Medicare from disclosing its payments to doctors. It was unclear at the time if any more records would be released.
The data provided the first comprehensive look at a central part of the taxpayer-funded program for the elderly and disabled. It detailed payments to 880,000 individuals and organizations totaling more than $77 billion from the Medicare program in 2012, covering more than 5,000 different procedures.
via Medicare to Publish Physician-Payment Data Yearly – WSJ.