Latest Blog Posts & Articles

Holy Life Expectancy!

Look at this trend in life expectancy, U.S. vs other developed countries, as a function of healthcare spending:

Holy Life ExpectancyKeep in mind, I DO NOT think life expectancy is a good way to judge the quality of healthcare or the efficiency of healthcare spending. But the graph should make us think about what we need to do, outside of our healthcare system, to help Americans live longer and better lives.

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Is This Enough Competition for You?

Some people look at the figure below, and say that too few insurance companies have too much of the market for Medicare Advantage (a program that allows Medicare recipients to get private coverage). But I look at it and think it looks like a pretty robust market:

Is this enough competition for youWhat do you think?

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Another Obamacare Failure: It Wasn’t a Job Killer!

According to many conservative pundits, Obamacare is a job killer. Five days before Obama signed the law, in fact, speaker John Boehner declared that the president was pushing “his job killing government takeover of healthcare that will hurt small businesses.” Years after the law was passed, critics continued trumpeting this theme, Ted Cruz calling Obamacare “the biggest job-killer in this country,” and even claiming that “millions of Americans have lost their jobs” because of the law.

Are the critics right? Liberals point to steady national job growth since passage of the law as evidence that Obamacare has not killed jobs. Conservatives point out that, for all we know, job growth would have been even higher had Obamacare not become the law of the land. Both sides are caught in a rhetorical standoff, seemingly with no way to confirm or refute either side’s argument.

Fortunately, social science gives us ways to move beyond data-deficient arguments to something more substantial. In the case of Obamacare, a strange twist in the law has given social scientists an opportunity to study a natural experiment. That experiment relates to the expansion of Medicaid that was written into the law, an expansion that was supposed to be mandatory for all states. Medicaid is a program jointly run by the government and individual states to provide healthcare coverage to low income people. After Obamacare was passed into law, the Supreme Court ruled that this Medicaid expansion cannot be mandatory, and gave states the option of deciding whether or not to expand their programs. This variation in expansion is what allows policy analysts to study this natural experiment.

Here’s the basic idea: If Medicaid expansion kills jobs, then all else equal, states that expanded Medicaid should have worse job growth than those that did not. For instance, Medicaid could reduce people’s incentives to work, because they no longer need jobs to pay for healthcare coverage. Or it could kill jobs by increasing federal and state taxes, thus leaving Americans with less money to invest in the economy. To test out the effect of Medicaid expansion on employment rates, Angshuman Gooptu and colleagues compared employment rates before and after the Obamacare Medicaid expansions went into effect, and compared these before and after differences in states that did and did not expand Medicaid eligibility. This is what is known as a difference in difference analysis or, as the cool kids call it: “diff in diff.” In studying employment, the researchers focused on low income workers, the ones most likely to be affected by Medicaid expansion.

(To read the rest of this article, please visit Forbes.)

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Behavioral Science Of Eating – In One Picture!

The Journal of the Association for Consumer Research (yes, there is such a thing!) had an outstanding issue dedicated to eating behavior recently. Here is a picture from that issue worth sharing:

Behavioral Science Of Eating

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6 Tips for Determining if a Doc-in-the-Box Is Right for You

A friend of mine recently had a very sore throat. She knew how to manage her symptoms–lozenges, warm tea and the like. But she was worried she might have strep and would therefore need antibiotics. That should be a simple question to answer with a quick trip to the primary care clinic. Except that her primary care physician was booked, and if she wanted an unscheduled appointment with someone else in the clinic, she was told that she would probably wait a couple of hours.

So she went to a “doc-in-the-box,” which according to the Urban Dictionary is “any doctor at a walk-in clinic.” She paid a modest fee and in a short time received a throat swab. The swab didn’t detect any strep, so she was soon back at home, with a tea kettle brewing and no fear of serious illness.

Primary care clinicians have a new competitor. Minute clinics, retail health clinics and other convenient alternatives are rapidly arising in many parts of the country, meeting unmet demand for timely, affordable care for minor complaints. The biggest players in this field include companies like CVS. These minute-like clinics are a real growth industry.

(To read the rest of this article, please visit Forbes.)

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You Know Who Loves Obamacare? U.S. Hospitals

You Know Who Loves Obamacare U.S. HospitalsBecause of Obamacare, more Americans have healthcare insurance and therefore more people are able to pay for medical care when they receive it. As a result, there has been a $5.7 billion drop in uncompensated hospital care just in those states that, per Obamacare, expanded Medicaid eligibility:






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Post Op Narcotics

Recovering from surgery can be painful. That’s why lots of surgeons give patients narcotics post-operatively. But that is also the time when people can get hooked on narcs. Here is a picture of how many patients take narcotics for at least 3 months following a surgical procedure:

Post Op Narcotics

Perhaps orthopedic surgeons should ask for help from palliative care/pain specialists for more of their patients!

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Why Charging Smokers More for Health Insurance Costs All of Us Money


Cigarette smokers have rights. No one should be able to tell an adult that she can’t spend her hard earned money on cigarettes. But non-smokers have rights, too. Specifically, they shouldn’t have to pay to subsidize health care costs of people who choose to smoke. In fact, smokers hurt non-smokers by racking up health care expenses brought on by the hazards of their habit.

The folks behind Obamacare thought they’d figured out how to respect everyone’s rights, by giving healthcare insurance companies the ability to charge higher premiums – a surcharge – for smokers, up to 50% higher in some parts of the country. The idea is simple: smokers have the right to smoke, but not the right to pass on the increased cost of their health care to others.

The idea is also dead wrong. Higher insurance premiums price smokers out of insurance markets. When an uninsured smoker gets emergently sick, that means hospitals and clinicians don’t get reimbursed, which forces them to pass those costs on to people with insurance. When insurance companies price smokers out of their products, we all pay.

Fortunately, there’s a simple solution to the problem. To appreciate the solution, let me expand on the flaws in healthcare insurance surcharges.

(To read the rest of this article, please visit Forbes.)

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A Benefit of Medical Marijuana

Is medical marijuana legal in your state? That probably means less narcotic use and abuse:

Benefit of Medical Marijuana

Something to keep in mind as we fight our opiate epidemic.

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The Rise of the Healthcare Administrators!

We probably have a shortage of physician in the U.S., especially primary care providers. Our population is rising faster than the number of docs. But we don’t seem to be suffering from a shortage of healthcare administrators:

Rise of Healthcare Admin

Oh in addition, doesn’t look too convincing that all those administrators are finding ways to reduce healthcare spending.


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