The New England journal of medicine
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A 42-year-old man presented with impaired nasal breathing and a slowly growing mass on the tip of the nose. Examination revealed a multilobulated sebaceous nodule protruding from the nasal tip.
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Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.
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In its decision on the Affordable Care Act, the Supreme Court opened the door for Congress to use its taxing power to achieve myriad policy objectives. The federal government may now increasingly make creative use of taxes to pursue public health goals.