Health affairs
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The RAND Future Elderly Model illustrates important principles about the relation among medical technologies, health spending, and health. New technologies add to spending because the costs of the new technologies and the health care costs during the added years of life they bring outweigh reductions in annual spending from better health. Many technologies with a low cost per patient per year result in high aggregate costs because of an expanded population being treated. However, the jury is still out on whether a better health-risk profile among future sixty-five-year-olds could moderate health spending for the elderly.
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Managing health care cost growth is a fundamental challenge facing our health care system. Through analysis of semistructured interviews, we conclude that barriers to health plan-level cost containment activities and strong forces outside the control of individual health plans will prevent many health system reforms (such as more competition among plans or modest increases in patient copayments) from stemming health care cost inflation. Policy debates and budgetary discussions must recognize that health care cost growth in excess of gross domestic product (GDP) growth is likely inevitable in the foreseeable future. The policy focus should be directed toward encouraging value.
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Securitization of the Master Settlement Agreement (MSA) payments from tobacco companies is hotly debated in states and policy circles. Securitization is issuing a bond backed by future payments in return for up-front money. Many public health advocates are strongly against securitization. ⋯ Rather, the issue is lack of commitment to tobacco control by states. Further, securitization can mitigate states' conflict of interest between keeping tobacco companies fiscally healthy to ensure their MSA payments and reducing tobacco sales for health reasons. States should not align with tobacco companies with the common interest of keeping tobacco companies fiscally healthy.
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We examine trends in outpatient prescription drug spending by the Medicare civilian, noninstitutionalized population in 1997 and 2001 using nationally representative data from the Medical Expenditure Panel Survey. We find that the 72 percent increase in drug spending over this period, in excess of price inflation for all goods and services, is primarily attributable to increases in the number of prescriptions per drug user and in the price per prescription. We also find, however, that an increase in the number of users is the primary reason for growth in a number of the fastest-growing subclasses of drugs.
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This paper reviews recent reports that demonstrate disparities in health care for children and current federal efforts to eliminate them. Instead of simply describing disparities, this paper also presents recommendations that can reduce disparities. ⋯ S. Department of Health and Human Services that would monitor progress and coordinate efforts for eliminating disparities.