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Publications
Help, I've Fallen Into the Doughnut Hole and I Can't Get Up: The Problems with Medicare
Beverly Goldberg, The Century Foundation, 10/28/2008
Ever since the enactment of Medicare Part D, which pays private insurers to offer senior citizens plans to help cover the costs of their prescription drugs, bitter complaints about the program have been the norm. Most of the complaints have focused on the "doughnut hole," the coverage gap that occurs when someone spends more than the year's covered amount—$2,510 in 2008—on his or her medications. When that cap is reached, because an individual is on multiple medications or extremely expensive ones or both, the costs of medications must be paid for out—of—pocket until the person spends up to a level that is significantly higher than the covered amount—an additional $3,216 in 2008. At that point, the plan again begins to cover needed drugs under a catastrophic coverage provision. Continue Reading Here.  
Getting More Value from Medicare
Maggie Mahar, The Century Foundation, 9/29/2008
In “Getting More Value from Medicare,” The Century Foundation, fellow and HealthBeat Blog editor Maggie Mahar (www.healthbeatblog.org) points out that past proposals for containing Medicare’s costs, such as putting a cap on physicians’ fees or requiring beneficiaries to pay more for their care, have not worked. She calls for a fundamental set of reforms that would not only save money but also improve the quality of care that beneficiaries receive. Download the Agenda here.  
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News & Commentary
Unintended Consequences of Medicare Drug Benefit
Naomi Freundlich, The Century Foundation, 8/27/2010

In 2006, when the government began offering prescription drug coverage for seniors through Medicare Part D, the goal was to increase utilization of prescription drugs by the elderly who may not have been able to afford them before, and also to lower the average price of these drugs. The idea was that insurers—representing all the new Medicare Part-D recipients—would be able to use the clout of having this huge market to negotiate price discounts with pharmaceutical companies. Continue Reading on the Taking Note Blog.

EMR Technology Experiences Growing Pains
Naomi Freundlich, The Century Foundation, 8/26/2010

Last week I had my first visit with my new primary care doctor. I picked him based on recommendations (plus he’s one of the few that accepts my insurance), and also because he seemed to be an eager adopter of electronic medical records (EMR). On his website, there was a portal for making appointments on-line, asking questions of the doctor and staff by e-mail and once a registered patient, I could also use a secure system to access my medical records. With EMRs being portrayed as key drivers of quality and savings in health reform, I felt encouraged by my new doctor’s embrace of the technology. Continue Reading on the Taking Note Blog.

Putting a Lid on Health Care Inflation Is Possible
Maggie Mahar, The Century Foundation, 8/24/2010
Over the past ten years the amount that health care insurers pay out to hospitals, doctors and patients has spiraled, risng by 5% to 11% each year, from roughly $1.3 trillion in 2000 to $2.5 trillion in 2009..  Yet few patients would say that the care they receive today is twice as good as the medical attention they received in 2000. Continue Reading.  
On Regulating Insurers: Affordable Care Act
Maggie Mahar, The Century Foundation, 8/19/2010
After the House voted this week to approve a $26 billion aid package to states—$16 billion of which will go toward helping keep strained Medicaid programs limping along—Rep. Joe Barton, of Texas, the ranking Republican on the House Energy and Commerce Committee who voted against the measure said; "There is no emergency," "There is no pending financial catastrophe." House Republican leader John Boehner called the aid package a “payoff to union bosses and liberal special interests.” Continue reading on the Taking Note Blog.
Passage of $26 billion State Aid Package Is Merely a Stop-Gap Measure For Medicaid Woes
Naomi Freundlich, The Century Foundation, 8/16/2010
After the House voted last week to approve a $26 billion aid package to states—$16 billion of which will go toward helping keep strained Medicaid programs limping along—Rep. Joe Barton, of Texas, the ranking Republican on the House Energy and Commerce Committee who voted against the measure said; "There is no emergency," "There is no pending financial catastrophe." House Republican leader John Boehner called the aid package a “payoff to union bosses and liberal special interests.” Continue reading on the Taking Note Blog.
New "Small Area" Data From Census Reveal Wide Fluctuations in Insurance Coverage
Naomi Freundlich, The Century Foundation, 8/5/2010
The U.S. Census Bureau released a report last week that includes the latest figures on the number of uninsured in each county, of each state. It’s an exhaustive breakdown that highlights the wide fluctuations both between states and among individual localities. At 26.8%, Texas has the highest rate of uninsured residents under 65 in the nation—there are a whopping 6.1 million uninsured residing there. Continue Reading on the Taking Note blog.
The Individual Mandate: A Reply to the Cato Institute’s Report on Health Care Reform
Maggie Mahar, The Century Foundation, 8/3/2010
In “Bad Medicine” the Cato Institute white paper exploring “The Real Costs and Consequences of the New Health Care Law,” Cato senior fellow Michael Tanner declares the individual mandate "perhaps the single most important piece of health care legislation.” By insisting that citizens have insurance --or pay a penalty-- Congress has taken an “unprecedented” step, says Tanner. Like many who object to the mandate, he argues that “The government has never required people to buy any good or service as a condition of lawful residence.” Continue Reading on the Taking Note Blog.
Diagnosis Without Treatment: The Perils of New Tests for Early Alzheimer’s Disease
Naomi Freundlich, The Century Foundation, 7/27/2010
In April, an independent panel established by the National Institutes of Health came to the disheartening conclusion that currently, there is nothing to prevent or delay the progress of Alzheimer’s disease in those of us who are destined to join the 5 million Americans currently suffering from this dreaded ailment. Continue reading on the Taking Note Blog.

A Reply to the Cato Institute’s Report on Healthcare Reform
Maggie Mahar, The Century Foundation, 7/19/2010
This week, the Cato Institute released a 52-page report on health care reform titled: Bad Medicine: A Guide to the Real Costs and Consequences of the New Health Care Law. The tract was written by Michael Tanner, a senior fellow at the Institute, and it rests on the thesis that the Patient Protection and Affordable Care Act (ACA) is both Unaffordable and Unfair. Inevitably, Tanner’s claims about affordability are shaky; in truth no one can project how much reform will cost over ten years—and how much it will save. Continue Reading.
Obama's National AIDS Plan Is Short on Funding For Most Vulnerable
Naomi Freundlich, The Century Foundation, 7/15/2010
This week the White House unveiled its new national plan to cut HIV infections and curb the AIDS epidemic. The plan, the first ever since AIDS emerged on the scene some 30 years ago, has the goal of  "intensifying HIV prevention efforts in communities where HIV is most concentrated;” specifically in the gay and African-American communities who are disproportionately affected by the disease. It also aims to increase access to treatment and mount "a more coordinated national response to the HIV epidemic." Continue Reading on the Taking Note Blog.
Illicit Drugs on Campus Are Increasingly the Rx Variety
Naomi Freundlich, The Century Foundation, 7/13/2010
Here’s something that frankly, disturbed me. My daughter, who just finished her freshman year in college, recently told me, “I can’t believe how many kids at school take prescription drugs on a regular basis. They take Adderall to help them study, Ambien to get to sleep and Xanax to calm down.” It surprised me that at 18 she even knew all the names of these drugs. Had she said that her fellow students were using marijuana or even ecstasy I wouldn’t have been as shocked. Those are the kinds of drugs you expect to find--along with copious amounts of alcohol--on college campuses. Continue Reading.
Snapshot: Public Warms to Health Care Reform Law
Ruy Teixeira, The Century Foundation, 7/6/2010
Conservatives loudly predicted that health care reform, once it became law, would generate a tidal wave of opposition that would lead to its repeal and a devastating defeat for progressives. Recent data suggest their predictions are, to put it mildly, off the mark.
Should We Raise the Retirement Age?
Maggie Mahar, The Century Foundation, 7/1/2010
Speaking at a Third Way event recently, House Majority Leader Steny H. Hoyer (MD) had this to say about the deficit: “On the spending side, we could and should consider a higher retirement age, or one pegged to lifespan; more progressive Social Security and Medicare benefits; and a stronger safety net for the Americans who need it most. “ On the face of it, lifting the retirement age makes sense. Americans are living longer, so they could retire later and still enjoy their golden years. Continue reading on the Taking Note blog.
Media Myths about Dr. Donald Berwick
Maggie Mahar, The Century Foundation, 6/29/2010
Kaiser Health News (KHN) reports that “the nomination of Dr. Donald Berwick to run the agency overseeing Medicare appears to be languishing.”   Friday, KHN’s “Health Policy Week in Review” quoted a story that appeared in the New York Times a few days earlier:. KHN also points out that according to The Hill, although Senate leaders are nearing an agreement to allow more than 60 Obama nominees to be approved to begin work, Berwick is not on the list  . "'He will not get unanimous consent,' a spokesman for Senate Minority Leader Mitch McConnell (R-Ky.) told The Hill. I am not at all persuaded that Berwick’s confirmation is in trouble. Continue Reading on the Taking Note blog.
Medication and Kids: A Growth Industry
Naomi Freundlich, The Century Foundation, 6/14/2010
Children have become the new growth industry for prescription drug makers. A study released last month by the pharmacy benefit manager Medco found that 26% of kids under 19—almost 30% of those aged 10 to 19—are now taking prescription medications for a chronic condition. Meanwhile, spending on prescription drugs for children increased by almost 11% last year, the largest increase experienced by all segments of the market, including the elderly. Continue Reading on the Taking Note Blog.
Medicare and Medicaid are NOT like Social Security
Greg Anrig, The Century Foundation, 6/9/2010
In an otherwise admirable New York Times article about how deficit fears have impeded an adequate response to persistently high unemployment, David Leonhardt writes: “The federal government has promised to pay out vastly more in Medicare, Medicaid and Social Security over coming decades than it will collect in taxes.” But grouping Social Security together with Medicare and Medicaid presents a highly misleading description of the nation’s fiscal challenge. And that conflation, which advocates of cutting social insurance programs have strategically promoted, has a lot to do with Washington’s misplaced priorities that the rest of the article insightfully analyzes. Continue Reading on the Taking Note Blog.
When a Fire Breaks Out In the Operating Room
Maggie Mahar, The Century Foundation, 6/1/2010
Did you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone? When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical Fires Could Improve Patient Safety in Ohio, Experts Say,” I was stunned. (Many thanks to Helen Haskell, founder of Mothers Against Medical Error, for sending the piece my way). Continue Reading on the Taking Note Blog.
A Salute to the VA
Maggie Mahar, The Century Foundation, 6/1/2010
In 2007, a book by Phillip Longman sent lasting ripples through the U.S. health care establishment. The title was audacious: Best Care Anywhere. But it was the subtitle that shocked: Why VA Healthcare is Better than Yours. Was Longman suggesting that the Veterans’ Health Administration provides better care than the treatment that millions of well-insured Americans typically receive in the private sector?  Yes. Continue Reading.
Shining a Light on Conflict of Interest in Biomedical Research
Naomi Freundlich, The Century Foundation, 5/27/2010
Last week Francis Collins, the director of the National Institutes of Health proposed important new rule changes for federally-funded investigators that are designed to increase transparency and remove many of the conflicts of interest that abound in biomedical research. Continue Reading.
A Bold Move: FDA Suggests Drug-Makers and Device Makers Share Information
Maggie Mahar, The Century Foundation, 5/25/2010
When President Obama tapped former Baltimore Health Commissioner Joshua Sharfstein to become Deputy Commissioner of the Food & Drug Administration fourteen months ago, Sharfstein’s harshest critics called him “an inconceivably poor choice.”  They were particularly upset that the administration had “decided to divide responsibilities at the FDA, giving Margaret Hamburg, the newly appointed FDA Commissioner,  responsibility for regulating food and tobacco, while making Sharfstein the point man overseeing drugs and devices.” At first, I was dismayed at the suggestion that the White House had selected a weak candidate to oversee drug-makers and device makers, but as I read why they objected to the appointment, I began to smile. Continue Reading on the Taki
Taking Precautionary Action on Environmental Toxins
Naomi Freundlich, The Century Foundation, 5/20/2010
Last week I wrote about the President’s Cancer Panel Report which highlighted the “grievous harm” caused by environmental carcinogens and urged action that included removing the toxins from our food, water, and air that “devastate American lives.” Achieving this is will be no easy task for a nation whose primary tool for regulating chemicals, the Toxic Substances Control Act (TSCA), was added last year to a list of government programs at “high risk” of failure by the Government Accounting Office. The Cancer Panel authors write that TSCA, passed in 1976, is a weak law that doesn’t provide the Environmental Protection Agency with enough authority and “may be the most egregious example of ineffective regulation of environmental contaminants.” Continue Reading on the Taking Note Blog.
Cancer Panel Focuses on the "Grievous Harm" from Environmental Toxins
Naomi Freundlich, The Century Foundation, 5/14/2010
The recent report from the President’s Cancer Panel, entitled “Reducing Environmental Cancer Risk,” took the bold step of focusing on environmental toxins and their role in causing cancer. In it, the authors charge that “the grievous harm from this group of carcinogens has not been addressed adequately by the National Cancer Program” and they urge the President “to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase healthcare costs, cripple our nation's productivity, and devastate American lives.” Continue Reading on the Taking Note blog.
When Medicare “Cuts” are Medicare “Savings”
Maggie Mahar, The Century Foundation, 5/13/2010
In a post titled “Slowing Down that Revolving  Readmissions Door" the New America Foundation’s Joanne Kenen writes about avoidable readmissions. “I once interviewed a patient who literally could  not remember how often he had been hospitalized within just a few months,” Kenen recalls, referring to a story published in the Washington Post last year. Continue Reading on the Taking Note Blog.
Will One in Four Americans Die of Cancer?
Maggie Mahar, The Century Foundation, 5/10/2010
A recent New York Times editorial announced that the war on cancer is reaching "a state of crisis."   Citing the Institute of Medicine (IOM), the Times called for boosting funds that support cancer trials while also raising the academic rewards to encourage researchers to run clinical trials. Appealing to readers' pre-dawn terrors, the editorial concludes by declaring that "Nearly one in four Americans are projected to die from cancer. It is vitally important to find the best treatments for them." Continue Reading on the Taking Note Blog.
The Snapshot: Information Is Health Care Reform’s Friend
Ruy Teixeira, The Century Foundation, 5/3/2010
Conservatives believe that as the truth comes out about the Affordable Health Care Act, the public will become ever-more opposed to it. They’re hoping to capitalize politically on such sentiments in the 2010 election and beyond.
The FDA Resists the Siren Call of Lobbyists
Maggie Mahar, The Century Foundation, 4/29/2010
Imagine that you are taking a medication that works well for you. But the monthly co-pay is $75.  This is more than you can afford. A generic is available, and the co-pay is only $10. The FDA says that it is just as good. But when you take it, you’re not sure. It sometimes seems that the pain is worse—or that you are more tired, or more depressed than you were when you were taking the brand-name drug. How can you be certain? When you try to think about how you feel, you realize that your mind is trying to diagnose your mind.  It’s a standoff that leaves you totally flummoxed. Continue Reading on the Taking Note Blog.
Our Fear of Cancer
Maggie Mahar, The Century Foundation, 4/27/2010
The very word “cancer” inspires a degree of fear that “heart attack,” “stroke” or even “kidney failure” do not. Any of these conditions can kill. Even worse, in rare cases, a stroke can leave a patient “locked in”—conscious and able to think, but unable to speak or move. Yet, somehow, to many of us, the idea of cancer seems more horrifying.  Perhaps it is because the word calls up an image of something evil invading the body, and then spreading. It is a growing, living thing, crawling inside one’s own body, preying on the tissue. Continue Reading on the Taking Note Blog.
The Battle over Letting Nurse Practitioners Provide Primary Care
Maggie Mahar, The Century Foundation, 4/22/2010
Twenty-eight states are now engaged in a heated debate over the difference between a doctor and a nurse: Legislators in these states are considering whether they should let a nurse practitioner (NP) with an advanced degree provide primary care, without having an M.D. looking over her shoulder. Continue Reading.
Who Is Responsible for What Is Missing in the Health Reform Plan? Part 2
Maggie Mahar, The Century Foundation, 4/19/2010

Lobbyists representing the many who profit from our $2.6 trillion health care industry spent millions in the war over healthcare reform. Yet National Journal Contributing Editor Eliza Newlin Carney suggests that “it's unclear whether all that lobbying, advertising and check-writing yielded much.” No question, the reform legislation that finally passed falls short of many reformers’ hopes. The public option is gone. Continue Reading on the Taking Note Blog.

Who Is Responsible for What Is Missing in the Health Reform Plan?
Maggie Mahar, The Century Foundation, 4/16/2010
No doubt you have seen some of the numbers about the assault that corporate lobbyists mounted to try to block health care reform: In 2009 spending on health-care-related lobbying and TV advertising topped $700 million. The Center for Public Integrity reports that much of that money funded the 4,525 healthcare lobbyists who swarmed the capitol-- eight for every member of Congress. You couldn’t beat them off with a stick. Of course, many legislators didn’t want to. Continue Reading.
Myths & Facts about Health Care Reform: Doctors Who Take Medicare
Maggie Mahar, The Century Foundation, 4/12/2010
Back in 1997 Congress passed legislation which said that if Medicare spending on physicians exceeds a complicated “Sustainable Growth Rate” (SGR) formula in a given year, Medicare fees to all doctors would be trimmed the next year. Continue Reading.
Medical Mistakes: How Some Hospitals Reduce Malpractice Suits
Maggie Mahar, The Century Foundation, 4/12/2010
The New America Foundation’s Joann Kenen has posted an insightful piece on how some innovative medical centers deal with medical mistakes: Rather than stonewalling patients and relatives, they “Disclose. Apologize and Fix.” I’ve written in the past about how “Sorry Works.”   (You’ll find part 2 of the post here. )  But as Kenen points out, this is not just about apologizing.  Or as she puts it, it’s not enough to say: “Something went wrong. We’re sorry. Here’s a check. Ciao.” Continue Reading on the Taking Note Blog.
Where There's Back Pain There's Sure to be Profit
Naomi Freundlich, The Century Foundation, 4/9/2010
Back pain is endemic: It affects 8 out of every 10 people at one point in their lives. Americans spent some $86 billion in 2005 on doctor’s visits, surgery, imaging, and drugs to treat back and neck pain—and costs continue to rise each year. Despite being ubiquitous—and an enormous drain on medical resources—back pain continues to be poorly treated as well as over-treated. Continue Reading on the Taking Note Blog.
"Just Say No" Is Only Part of the Solution to Reducing Health Care Costs
Naomi Freundlich, The Century Foundation, 4/8/2010
David Leonhardt had a piece in the New York Times this week called “In Medicine, the Power of No,”  that focuses on reducing health care costs by scaling back our current “do everything possible” approach to care. “Deep down, Americans tend to believe that more care is better care,” he writes, “We recoil from efforts to restrict care.” Continue Reading on the Taking Note Blog.
Who Wins and Who Loses from Health Care Reform
Maggie Mahar, The Century Foundation, 4/7/2010
This is the first in a series of posts that will try to dispel the myths and reveal the facts about the reform legislation. What will reform mean for insurers, hospitals, doctors, Medicare patients, seniors who are now on Medicare Advantage, Medicaid patients and state budgets? Who wins and who loses? Continue Reading.
The Snapshot: Positive Signs for Health Care Reform
Ruy Teixeira, The Century Foundation, 3/31/2010
Health care reform, the biggest piece of social legislation passed since 1965, is now the law of the land. This historic achievement is getting some positive reactions from the public now that the painful congressional process has finally ended and there is an actual piece of legislation to consider. Of course, much of the public is still uncertain about what exactly is in the bill and how it will affect them, but these early reactions are nevertheless encouraging.
Who is Don Berwick and What Will This Mean for Health Care Reform
Maggie Mahar, The Century Foundation, 3/29/2010
The rumors that I wrote about Friday are, in fact, true. President Obama will name Dr. Donald Berwick, president of the Institute for Health Care Improvement (IHI), to run Medicare and Medicaid. Berwick, who is a professor of pediatrics and health care policy at the Harvard Medical School and a professor of health policy and management at the Harvard School of Public Health, will have to be confirmed by the Senate Finance Committee. Continue Reading on the Taking Note Blog.
What the Health Care Reform Bill Will Mean for You and Your Family
Maggie Mahar, The Century Foundation, 3/25/2010
Appearing on CNN yesterday morning, Senator Orrin Hatch (R, Utah) groused about what he called the “Europeanization” of health care. Translated, that means that we have decided to take a more collective approach to survival. If you cannot afford health insurance, your fellow citizens will help you pay for it. Hatch is correct: in 2014, a family of four earning $88,200 (or four times the federal poverty level) will get a subsidy to help buy insurance in the new Exchanges. $88,200 may sound like a fortune if you live in Idaho (where median income for a family of four is $58,000), but in Maryland, Massachusetts, Connecticut, and New Jersey, $88,200 is actually less than median income for a family of four. Continue Reading on the Taking Note blog.
“I Am Not Bound to Win, But I Am Bound to Be True”
Maggie Mahar, The Century Foundation, 3/21/2010

So many said it would never happen. But now, on Sunday, March 21, 2010, it appears that reformers have the votes. Politico.com has announced that the last hold-outs--legislators who oppose abortion-- have reached an agreement with the White House. Continue to Blog

Advice to Hospitals in a Downturn: “Market the High-Margin Service”
Maggie Mahar, The Century Foundation, 3/12/2010
One might think that hospitals would be recession-proof. After all, hospital care is a necessity. But one would be wrong. When times are tough, people put off elective surgery, and even avoid going to the hospital in an emergency. Although they may have insurance, often they can’t afford the co-pays that accompany hospital care. As for the uninsured, not long ago a study showed that uninsured patients suffering from gunshot wounds often leave the ER, voluntarily, without being admitted to the hospital. Continue Reading on the Taking Note Blog.
Peggy Noonan vs. the New England Journal of Medicine
Maggie Mahar, The Century Foundation, 3/9/2010
Let’s put to rest, once and for all, the idea--or rather, the  notion (it’s not even an idea,  just a vague impression, based on hearsay)--that the health reform legislation now under discussion includes no plans for containing health care spending. Continue Reading.

The Snapshot: Time for Comprehensive Health Care Reform
Ruy Teixeira, The Century Foundation, 3/8/2010

President Barack Obama made it very clear at the health care summit last Thursday that while he was open to ideas from every quarter, he was not willing to compromise away comprehensive health care reform where extending coverage and serious health insurance market reform are pursued at the same time. Baby steps, as he pointed out, just won’t do. He also pointed out that most of the components of comprehensive health care reform are popular with the public, suggesting that the bills in Congress would fare better if the public actually knew what was in them. Predictably, this claim was greeted with derision by conservatives.

Obama’s Letter to Congressional Leaders: We’re Almost There
Maggie Mahar, The Century Foundation, 3/3/2010
Today, President Obama sent this letter to Congressional leaders, offering to incorporate more Republican ideas in  health care legislation. Don’t panic:  Of the four ideas, two are excellent, one was almost certain to happen anyway, and one simply funds pilot projects in the states to explore alternatives to resolving medical malpractice disputes.   This provision does not call for capping malpractice awards—the president has made it clear that he opposes caps. Continue Reading.
The President’s Proposal-Everything Depends On...
Maggie Mahar, The Century Foundation, 2/23/2010
You might be wondering why I haven’t written about the President’s HealthCare bill. The reason is that I have very little to say. This, I realize, is unusual. But the truth is that the president’s proposal is very similar to the Senate bill—which is not a surprise.

Nevertheless, I am very glad to see the proposal. I was worried that the White House had put reform on the back burner.

Will it pass? As always, I’m trying to be optimistic. But I think that everything depends on whether the White House decides to twist arms. Continue Reading on the Taking Note Blog.

Does Health Insurance Save Lives? Maybe That’s the Wrong Question
Maggie Mahar, The Century Foundation, 2/19/2010
Do the uninsured die because they don’t have access to medical care—or because more than three-quarter of the uninsured are poor? In part 1 of this post, I explained that we know that poverty is a killer. It destroys mind and body, slowly but surely. In the U.S. the poor die seven years earlier than the rich. And most of the uninsured are poor. Continue Reading.
Why Reformers Must Forge Ahead
Maggie Mahar, The Century Foundation, 2/11/2010
While others seem ready to declare health care reform dead, Henry. Aaron explains why reformers must stay the course in the most recent issue of the New England Journal of Medicine. They have everything to lose, and nothing to gain if they abdicate their responsibilities now. More importantly the nation will be left with a health care system that fails society while threatening our economy. Continue Reading on the Taking Note blog.
Maryland’s Health Care Solution
Maggie Mahar, The Century Foundation, 2/8/2010
While health care reformers argue about what it would take to “break the curve” of health care inflation, the state of Maryland has done it, at least when it comes to hospital spending. In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. Continue Reading on the Taking Note Blog.
The Snapshot: Public Continues to Support Health Care Reform, but Needs Clarity on Congressional Bill
Ruy Teixeira, The Century Foundation, 2/5/2010
President Barack Obama in his State of the Union address doubled down on his commitment to health care reform, which disappointed conservatives who were hoping he’d run away from that commitment. And he left conservatives fuming about his claim that the health care reform plan in Congress suffered from a lack of clear explanation. How can he say that, the conservatives argue, when recent events like the Massachusetts Senate election show that voters have rejected the whole idea of comprehensive health care reform?
Autism and the MMR: Finally a Retraction
Naomi Freundlich, The Century Foundation, 2/4/2010
Are we finally ready to close the door on the much-disputed link between the MMR vaccine and autism? On January 30, Britain’s General Medical Council ruled that Andrew Wakefield, a gastroenterologist, had acted “dishonestly and irresponsibly” in conducting his research that established a link between autism and the MMR vaccine. Continue Reading.
Medicaid Needs More Than A Short-term Fix
Naomi Freundlich, The Century Foundation, 2/2/2010
Health reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans’ ability to afford and access medical care. At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. Continue Reading on the Taking Note blog
SOTU and Health Care
Maggie Mahar, The Century Foundation, 1/28/2010
In his address to the nation, President Obama made it clear: Jobs are now his #1 priority. This is what most Americans wanted to hear. They fear that he has spent too much time on health care, and has not paid enough attention to climbing unemployment. This does not mean that they oppose health care reform legislation—it’s just that there are tired of hearing about it. And the need for jobs is more pressing. Continue Reading on the Taking Note Blog.
The State of the Union and the Economy: Why We Need Health Care Reform Now
Maggie Mahar, The Century Foundation, 1/27/2010
According to the headlines, 10 percent of Americans are unemployed. The truth is that closer to 17 percent of  the population cannot find full-time work; this number includes workers who have become discouraged and have given up looking for work as well as those who have settled for part-time jobs because they cannot find the full-time employment that they need. Continue Reading.
Anecdotal Evidence Does Not Make Good Policy
Naomi Freundlich, The Century Foundation, 1/14/2010
Recently, a series of anecdotes appeared on the website People’s Pharmacy, posted by readers who suffer from depression. They detail how switching from name brand antidepressants to generics—or in some cases from one generic to another—caused a return in symptoms. Here’s one excerpt: Continue Reading.
The Unions Strike a Deal and The Truth About the Cadillac Tax
Maggie Mahar, The Century Foundation, 1/14/2010
The Washington Post reports that union leaders are close to cutting a deal with Democrats on the so-called “Cadillac tax,” the 40% tax on expensive insurance plans that the Senate has proposed to help fund health care reform. According to the Post, unions would be exempted from the tax, for two years following the 2013 effective date, giving them time to negotiate new contracts with employers. For other reports on the negotiations, see Kaiser Health News. Continue Reading.
Persuading Canadians to “Hustle Off to Buffalo”
Maggie Mahar, The Century Foundation, 1/12/2010
If you drive from Buffalo, New York to Ontario, Canada, you’re likely to see this message on highway billboards: “Fast-track Your Medical Procedure Here.” The red arrow on the sign points Canadians to Buffalo’s Kaleida Health, a five-hospital health care system located minutes from the U.S.-Canada border. Continue Reading.
The Snapshot: The Weakness of Conservative Opposition to Health Care Reform
Ruy Teixeira, The Century Foundation, 1/11/2010
In recent polls, more of the public opposes than favors the health care reform bills in Congress. Conservatives would have you believe that the opposition plurality in these polls is a result of public distaste for a big government takeover of our health care system. Not so. In a December CNN poll, a total of 55 percent either favored the Senate health reform bill outright (42 percent) or opposed it at this point because its approach to health care isn’t liberal enough (13 percent). Just 39 percent said they opposed the bill because its approach to health care was too liberal.
Fact-Check: The Cadillac Controversy
Maggie Mahar, The Century Foundation, 1/6/2010
“Cadillac Health Care Plans.”  Even the phrase suggests gilt-edged insurance for Greedy Geezers at Goldman Sachs . No wonder the Senate wants to slap a tax on insurers and self-insured employers who offer over-the-top policies beginning in 2013. After all, plans that fetch more than $23,000 for families (or $8,500 for individuals) must encourage over treatment, right?  Continue Reading on the Taking Note Blog.
Gawande and Berwick On Why Reform Legislation Cannot Lay Out A “Master Plan”
Maggie Mahar, The Century Foundation, 12/14/2009

“Where is the plan to make health care affordable?”

“I want to see the savings.”

“Show me the money: Lay it out in simple language-- on one page.”

Critics of health care reform legislation have become increasingly adamant on one point: They want to know how reformers are going to rein in the skyrocketing cost of care. Continue Reading.

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Events
90 Years of Progress
- 12/1/2009
This year marked the ninetieth anniversary of the founding of The Century Foundation (which was known for most of its history as the Twentieth Century Fund). Our founder, Edward Filene, created this organization with the goal of supporting studies and analysis that could lead to constructive action on our nation’s public policy. That heritage has compelled us to educate, provoke, and develop better answers when evidence and reason show that public debates are badly off track. Over the past nine decades, we have called attention to facts and analyses to correct widespread misconceptions and provide policymakers with new ideas for addressing the challenges facing the nation. We have created this video to provide a glimpse into our story and how it is intertwined with America’s story for much of the twentieth century and beyond.  
Health Care Transformation: In the Home Stretch
The Century Foundation - 11/10/2009
The nation’s quest to overhaul our healthcare system is nearing a decisive moment as both houses of Congress prepare for debate and votes on comprehensive legislation. Will these measures successfully resolve the core issues of access and affordability, and what remains to be done about them?

At this critical moment, we invite you to a screening in the New Jersey State House Complex Tuesday, November 10, from 5 till 7 p.m. of a new documentary, Money-Driven Medicine, followed by Q-and-A between participants and an exceptional panel.  

New York Premiere of Money-Driven Medicine
The Century Foundation and The New York Society for Ethical Culture - 6/11/2009
On June 11 The Century Foundation and The New York Society for Ethical Culture hosted the New York premiere of Money-Driven Medicine, a new documentary produced by Alex Gibney (Enron: The Smartest Guys In the Room and Taxi to the Dark Side) and directed by Andy Fredericks. The film is based on a book by TCF Fellow Maggie Mahar, (Money-Driven Medicine, Harper Collins) and explores how a profit-driven health care system squanders billions of health care dollars, while exposing millions of patients to unnecessary or redundant tests, procedures, and overpriced drugs and devices that, too often, are no better than the less-expensive products they have replaced. In remarkably candid interviews, both doctors and patients tell the riveting stories.  
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Press Releases
TCF Fellow Maggie Mahar Can Offer Insight and Analysis on the Results of the Upcoming Vote on the Health Insurance Reform Bill
3/18/2010
The U.S. Congress is poised to take a historic vote on health insurance reform in the coming days. What will the results of that vote—up or down—mean for health care delivery systems and the individual and families they serve? What happens next? Maggie Mahar, a fellow at The Century Foundation and editor of the highly respected Health Beat Blog (www.healthbeatblog.org), can help sort out the answers to these critical questions. She has been an intelligent and informed voice in the current debate over health care reform. Through her blog, media interviews, and as a part of the Health Reform panel for the Washington Post, she has become known for her ability to cut through the political posturing and rhetoric and hone in on the important policy issues arising from this debate. Through her “Truth Squad” series, she also offers commentary on various efforts to spin or mislead the public about issues related to the reform effort. Download the press release.

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