For new readers, the editors and the majority of contributors to The Medical Care Blog recently authored and signed onto a special consensus statement about climate change, labeling it the “greatest threat” to global public health. As part of the plan to publish that statement, we also declared that the drivers and health risks of climate change would be a central topic of our blog for 2024. We have published calls for clinicians to act as activists for social change, in a post titled “Don’t ‘Stay in Your Lane’”. We also reviewed and summarized the American Public Health Association’s long hi ..read more

I am a health economist, trained to make sense of messy data. I generally work amidst a sea of numbers. But I’ve found that seeking out stories in health services research–those of doctors and patients–can help me anchor what’s truly important in research. These stories may also help researchers communicate the value of their work to others. For the past seven years, I’ve worked on several of Medicare’s primary care models. First, I worked on the Comprehensive Primary Care Plus Initiative (CPC+) and more recently on the Primary Care First and Making Care Primary models. These models all seek t ..read more

Patient-provider racial/ethnic concordance (i.e., physician and patient identify as the same race/ethnicity) has emerged as one key suggestion for mitigating healthcare disparities. Past research has underlined its benefits, including improved infant mortality and more appropriate prescription regimens. However, the sum of the evidence remains unclear and many facets of the patient-provider relationship have yet to be examined. From historical and practical perspectives, shared decision-making and doctors communicating treatment options are critical in improving healthcare trust and experience ..read more

Competition between hospitals in a given market should provide incentives to ensure quality while also lowering costs. Over the past two decades, hospital markets have increasingly consolidated. This consolidation reduces competition and increases the comparative leverage that hospitals and associated health systems have. While there are some theoretical advantages of increased consolidation such as potential for economies of scale, prior research has shown that consolidation has been associated with higher costs, in addition to worse quality. In response, regulatory agencies at both the state ..read more

If the US healthcare industry were its own country, it would be in the top 10% of all countries in greenhouse gas emissions. Welcome to the February, 2024 edition of the Healthy Intersections Podcast! This month, we sit down with David Introcaso, PhD, to discuss the healthcare industry’s carbon footprint. Dr. Introcaso is the host and producer of the Healthcare Policy Podcast as well as an experienced researcher. He talks us through understanding the scope of the problem and makes excellent points about the role of policies in addressing the climate crisis. Why not require healthcare organizat ..read more

In January, the Medical Care Blog’s editors published a consensus statement on climate policy and health. This statement was co-signed by many of our authors, editors, and editorial board members of the Medical Care journal. As we look ahead to our focus theme for 2024, we want to begin with a look backward as well. The American Public Health Association (APHA) has a legacy of adopting position statements that acknowledge and propose responses to environmental health hazards, including the changing climate. APHA has a long history of member-driven scientific policies to address environmental ..read more

Medicare for All is Not Happening… 10 years from now will we have Medicare Advantage for All? Grandmother and granddaughter in the same health plan? Others have written that the US should achieve universal health insurance coverage, better health outcomes, and lower costs via comprehensive programs such as “Medicare for All”, as proposed by Senator Bernie Sanders. More recently, Amy Finkelstein and Liran Einav suggested a much more limited universal, national “basic” plan [pdf] in their book “We’ve Got You Covered“. Their proposal couples a public plan with a robust market for supplemental pro ..read more

From The Medical Care Blog: A special consensus statement on climate change and public health In 2021, more than 250 of the world’s leading medical and public health journals released a joint statement about climate change and public health. Published simultaneously, editorial boards of the journals declared climate change to be the “greatest threat” to global health. They called on global leaders to make 2021 the year that the “world finally changed course”. Figure: C02 Emissions 1980-2022 Source: Global Carbon Budget 2022. The editors and numerous authors of The Medical Care Blog (see sign ..read more

The United States Preventive Services Task Force has recommended lung cancer screening for at-risk groups since 2013, and updated again in 2021. This is a simple procedure involving a low dose of radiation used to take a CT image of the chest. If utilized by most eligible Americans, screening could reduce lung cancer mortality by up to 20%. We’re talking about potentially tens of thousands of lives saved per year.  Lung Cancer Screening: Free and Underutilized Furthermore, the Affordable Care Act has mandated that health insurance companies cover screening for current and former smokers i ..read more

California just took a significant step toward single payer health care. On Oct 7, Governor Gavin Newsom signed Senate Bill 770 (Unified Health Care Financing) into law. Introduced by Senator Scott Wiener (D-San Francisco), the law directs the Secretary of the California Health and Human Services Agency to research, develop and pursue a waiver framework for unified health care financing in the state. That is wonky language. So let me explain. For California to deliver single payer health care, it not only needs its own funding to cover uninsured state residents. It also needs to redirect exis ..read more