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Americans Who Have Insurance —But Still No Access To Care
Maggie Mahar, The Century Foundation, 9/5/2008
A friend who lives in Boston complained, not long ago, about not being able to find a physician. In Boston?  “Come on,” I said. “This is like claiming you couldn’t find a liquor store.”

“They’re all oncologists and cardiologists,” he grumbled. “Last week I cut my hand badly enough that it needed stitches. I have good insurance. But I couldn’t get an appointment with my family doctor—or any of my friends’ doctors. I didn’t want to spend hours in the ER. So I wound up going to my sister’s house. She sewed it up at her kitchen table.” Continue Reading on the Taking Note Blog.

Lessons from Massachusetts
Niko Karvounis, The Century Foundation, 8/26/2008
The Massachusetts experiment in health care reform is all about expanding access. But it doesn’t try to control costs. This, in a nutshell, is why it’s running into trouble. The plan didn’t reform health care delivery, just coverage. Granted, in terms of bringing more people in under the tent, it’s been a success: Since the plan went into effect in 2006, 439,000 people have signed up for insurance—a number that represents more than two-thirds of the estimated 600,000 people uninsured in the state two years ago. Continue Reading on the Taking Note Blog.
The Geriatrician Shortage
Niko Karvounis, The Century Foundation, 8/12/2008
In a 2006 New York Times article, Dr. Amit Shah, a physician at Johns Hopkins, recalled how other doctors looked down on him during his residency because of his chosen field. "The most memorable discouragement came during his residency, from a pulmonologist," notes the Times. 'When I passed him in the hall, [the pulmonologist] would shake his head and mutter, 'waste of a mind,'" Shah said. Continue Reading on the Taking Note Blog.
Medicare Bill Could Lead to Tougher Hospital Inspections
Maggie Mahar, The Century Foundation, 8/5/2008
Reel back to 1965, the year Medicare and Medicaid legislation was passed. That year Congress gave the “Joint Commission,” a professional accreditation organization established in 1951, the unique authority to inspect hospitals and determine whether they meet the patient health and safety standards required to treat Medicare patients.Continue Reading on the Taking Note Blog.
Health Care in Singapore
Niko Karvounis, The Century Foundation, 7/31/2008
It’s always worth exploring how health care works in other countries, if for no other reason than that models in other countries give us the chance to see how some of the approaches discussed by American reformers might pan out. What do the experiences of Germany and Netherlands tell us about the possibility of a better mixed public-private system in the United States? How is China’s health care system a cautionary tale of market forces gone wild? Continue Reading on the Taking Note Blog.
Rating Health Care Performance
Niko Karvounis, The Century Foundation, 7/29/2008
The ever-insightful Commonwealth Fund has just released its 2008 National Scorecard on Health System Performance, and reports that “the U.S. health system continues to fall far short of what is attainable, especially given the resources invested. Across 37 core indicators of performance, the U.S. achieves an overall score of 65 out of a possible 100 when comparing national averages with U.S. and international performance benchmarks." Continue Reading on the Taking Note Blog.
Reforming Medicare: Options, Tradeoffs, and Opportunities
Jeanne Lambrew, Henry J. Aaron, Brookings Institution Press, 7/28/2008
Everyone agrees on the need to reform Medicare but not on how to do it. Some argue the program is too comprehensive, others that it is not comprehensive enough. Some suggest it pays too much for health care, others, too little. Meanwhile, the financial stakes continue to mount. Medicare spending exceeded $400 billion in 2007, making it more expensive than the entire health systems of most other nations, as well as the largest national public program other than Social Security and national defense.
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The Managed Care Roller Coaster
Niko Karvounis, Maggie Mahar, The Century Foundation, 7/17/2008
At a health care forum held last year in Las Vegas, then-presidential candidate Hillary Clinton declared that she was intent on "taking money away from people who make out really well right now” in order to fund health care reform. When asked exactly which fat cats she was referring to, Clinton responded: “well, let’s start with the insurance companies.” Continue Reading on the Taking Note Blog.
The Trouble With Medicare Advantage
Maggie Mahar, The Century Foundation, 7/15/2008
Everyone understands why Congress was so reluctant to cut physicians' fees. Reimbursements for primary care physicians are very low—so low that 30 percent of Medicare recipients who are looking for a new medical home can't find one. Cut fees, and fewer doctors will take Medicare patients. The AMA, seniors and the AARP are all up-in-arms. Few politicians like to disappoint this trio. Continue Reading on the Taking Note Blog.
Physicians 69; Insurers 30 – Ted Kennedy Shows Up For the Vote
Maggie Mahar, The Century Foundation, 7/9/2008

When Ted Kennedy came onto the Senate floor, his colleagues cheered. He was there to vote on the bill that would prevent a 10.6 percent cut to physicians who treat Medicare patients. Continue to the Taking Note blog.

Will Congress Cut Physicians’ Fees? Will Physicians Stop Taking Medicare Patients?
Maggie Mahar, The Century Foundation, 7/8/2008

This week, conservatives and liberals will face off on a question that has divided the Senate—and united the House:
The Dutch Health Care System
Maggie Mahar, Niko Karvounis, The Century Foundation, 6/26/2008
In a recent issue of Healtyh Affairs, Wynand van de Ven and Frederik T. Schut, two professors at Erasmus University in Rotterdam, authored an excellent profile of the Dutch health care system, which includes some appealing features that might serve as a model for the United States. Continue Reading on the Taking Note Blog.
Comparative vs. Cost-Effectiveness
Maggie Mahar, The Century Foundation, 6/24/2008
The idea of “comparative-effectiveness” research has become a hot topic in health care circles. Conservatives are adamantly opposed to it—as are drug-makers, device-makers and even some physicians who have become involved in designing and profiting from new tests and procedures. Continue Reading on the Taking Note Blog.
Do We Need to Ration End-of-Life Care?
Maggie Mahar, The Century Foundation, 6/19/2008
In the days and weeks before they die, fifteen to twenty percent of terminally ill cancer patients receive “palliative chemotherapy.” Their doctors do not expect chemo to cure them. Why then, do they receive it?Continue Reading on the Taking Note Blog.
As the Army Approaches a Breaking Point
Maggie Mahar, The Century Foundation, 2/26/2008
Since 9/11, one Army division has spent more time in Iraq than any other group of soldiers: the 10th Mountain Division, based at Fort Drum, New York. Over the past six years and and six months, their 2nd Brigade Combat Team (BCT) has been the most deployed brigade in the army. As of this month, the brigade had completed its fourth tour of Iraq. All in all, the soldiers of 2nd BCT have spent forty months in Iraq.
Will Consumer-Driven Medicine Really Cut Health Care Costs?
Niko Karvounis, The Century Foundation, 2/14/2008
One of the most common justifications for consumer-driven medicine is reduced health care costs. The reasoning here is two-fold:

  1. Since they’re high-deductible and low premium, consumer-driven health plans require more out-of-pocket spending. Consumers are more cost-conscious when they have to actively shell out for purchases. As a result, they will user fewer health care services—and thus overall health care costs will fall.
The Snapshot: Americans Agree, Time for Action on Health Care
Ruy Teixeira, The Century Foundation, 1/18/2008
President Bush’s forthcoming State of the Union address will most likely offer no practical solutions to address America’s burgeoning health care woes. That’s too bad because the public is definitely ready for action on this front. Consider these recent data from Gallup.
The Newest Last-Place Finish for U.S. Health Care
Niko Karvounis, The Century Foundation, 1/10/2008
Many people like to say that the U.S. has the best health care system in the world. But recent numbers from the Commonwealth Fund should put a stop to this cycle: the U.S. health care system places last in the world when it comes to stopping preventable deaths. In other words, we spend more but accomplish less—does that sound like success to you?
The Health Beat by Maggie Mahar Blog
The Century Foundation fellow, Maggie Mahar discusses today's most pressing health care policy issues in The Health Beat by Maggie Mahar blog. Click here to view.

A New Deal for Health: How to Cover Everyone and Get Medical Costs under Control
Leif Wellington Haase, Century Foundation Press, 6/1/2005

A Second Opinion
Dr. Arnold Relman, PublicAffairs, The Century Foundation, 4/23/2007

Breathing Easier? The Report of The Century Foundation Working Group on Bioterrorism Preparedness
Leif Wellington Haase, The Century Foundation, 1/13/2005

Medicare Tomorrow
The Century Foundation Task Force on Medicare Reform, Century Foundation Press

The Basics: Medicare Reform (Revised for 2001)
The Century Foundation, 6/1/2001

A Place at the Table: Women's Needs and Medicare Reform
Marilyn Moon, Century Foundation Press, 3/15/2002

Too Much of a Good Thing
Charles R. Morris, Century Foundation Press, 5/1/2000


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