A Medicare reform that is long overdue: when Medicare Advantage enrollees return to traditional Medicare, they shouldn’t be penalized in the medigap market. Robin Hanson responds to Scott Alexander: core medicine is effective but it appears that extra medicine (delivered in high spending areas) is not. San Francisco opens a $1.7 million public toilet. (NYT) Why it is so hard to know if there is a relationship between red meat and mortality. States with freer economies attract more immigrants from other states and have higher growth rates ..read more

Stop overpaying hospitals by pursuing site-neutral payments in Medicare; increase efficiencies in Medicare Advantage payments as laid out in Paragon's proposal; let the enhanced ACA subsidies to health insurers expire after 2025; and Stop discriminating against traditional Medicaid enrollees (low-income kids, pregnant women, and people with disabilities) by lowering the federal subsidy rate for ACA able-bodied, working-age expansion enrollees to the rate paid for traditional enrollees ..read more

An argument on drug shortages: GPOs are not the problem. (Stat News) Biden executive orders have cost us more than $2 trillion, based on CBO estimates. CBO: the CMS funded models of care (designed to lower cost and improve quality) are increasing (not decreasing) federal health care spending. Study: subsidizing women’s work drives down birth rates. Laws on the books in half the states could make you responsible for paying for your parents nursing home care ..read more

Veterinary medicine is big business and private equity investors are taking notice. Medical spending on companion animals is up sharply and stands at nearly $40 billion annually. Private equity has poured more than $60 billion into veterinary investments since 2017. Investors are snapping up practices and raising prices. You may think you’re going to the same vet you’ve gone to for years. Then one day the prices are much higher, and you’re pressured to get more services than usual ..read more

FDA endorses the idea of a hospital at home – utilizing digital technology. Alex Tabarrok on the plusses and minuses of non-competes. The benefits of vaccines. Hypochondriacs don’t want to be cured. Not all of the NIH “cancer myths” are really myths. The uneasy case for banning Chinese pharmaceuticals ..read more

Does health care improve health? Scott Alexander contra Robin Hanson. Certificate of need (CON) laws still operate in 35 states. Why Medicare won’t pay for additional breast scans. Is the government hiding something about the “Havana Syndrome”? Why ACOs aren’t working. Cost of new regulations under Biden: $1.37 trillion ..read more

Nowadays nearly three-quarters of physicians are hospital employees or employed by investor-owned group practices. Many are bound by employment agreements that limit their ability to easily leave a job for a new one ..read more

Commonwealth Fund finds major differences in health care inputs and outcomes across racial and ethnic groups. It completely ignores the role of genes. Earth Day good news: Over the past 60 years, GDP is up nearly 800% but emissions are down 60% even though we are still using record amounts of fossil fuels. New Guinea Prime Minister to Joe Biden: “We are not cannibals.” Joe Biden promised to never cut Medicare and “to stop” anyone who tries. He just cut benefits for 33 million enrollees in Medicare advantage ..read more

The Wall Street Journal reported on communities hard hit by the opioid epidemic, hoping settlement funds would mitigate the damage done by drug addiction. The Opioid Master Settlement Agreement was patterned after the tobacco settlements, except federal officials tried to structure the funds in such a way to avoid the money from being siphoned off for purposes unrelated to drug treatment ..read more

Debt and more debt. How computer programs determine how much pain medication you are allowed to have. What happens when employees go out of network ..read more