Beyond Labels

A 360┬░ Discussion of Foreign, National and Local Policy Issues

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Medicare Advantage Networks Shrink

Attached is the article I referred to in our discussion on Monday. It describes the friction between doctors and Medicare Advantage insurers as the latter trim their networks. It seems clear that the insurers’ communication with doctors and patients left something to be desired but it raises the question about whether insurers should have the right to manage their own provider networks as the deem necessary. Continue reading “Medicare Advantage Networks Shrink”

Beyond Labels, December 30

For those of you in town, we will be meeting (as usual) today at 10:30am.

There is no set topic for the week, but I (Scott Miller) will come prepared with a couple of things to discuss if no one else has a compelling recommendation.

The Gap Between Spending and Results

This subject was discussed on December 23, 2013.

One of the key “talking points” used in the debate over the Affordable Care Act has been the fact that the U.S. spends substantially more than virtually any of our international “peers,” but has lagged those same peers in terms of health outcomes. ┬áSimilarly, the U.S. education system spends more per pupil than almost any other country, yet our students perform poorly on tests of reading, math and science skills. We could probably identify many similar situations…high spending, low outcomes…if we tried.

What is driving this enormous gap between financial commitment and results? To what degree does it have to do with:

  1. The role of Federal and local governments in education and, increasingly, in health care?
  2. Our expectations that, given our success of the last 50 years, we are somehow “entitled” to continued success?
  3. The changing roles and attitudes of our people, whether parents, children, healthy or infirm?
  4. In short, is this more a problem with the “system”…teachers, doctors, health care companies and administration…or with our “culture”?
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