iOS app Android app

Jim Jaffe

Entries by Jim Jaffe

Health Reform War Won

(3) Comments | Posted February 25, 2015 | 11:58 AM

The war to reform American medicine has been won.

The transformation began with the enactment of Medicare and Medicaid during the Johnson years -- which allowed prices to be contained as a growing percentage of bills were paid by large entities, especially the government -- and the HMO act during...

Read Post

Is Bigger Medicine Better Medicine?

(0) Comments | Posted January 17, 2015 | 5:19 PM

For better and worse, American medicine is increasingly controlled by large corporate entities and Obamacare is accelerating the transition. Observers including me who see our medicine as highly inefficient view this trend as an opportunity to impose rationality, but there are also clearly pitfalls.

My best guess is that this...

Read Post

Low Health Bills Slow Economy

(0) Comments | Posted October 23, 2014 | 2:44 PM

Teasing out the link between moderation in health spending and subpar economic growth is a daunting but important task that could have a big and unpredictable impact on the American economy in the years and decades ahead.

On the one hand, the growth in health spending, which has been...

Read Post

Medical Education: Capitalism's Next Frontier?

(1) Comments | Posted July 18, 2014 | 12:26 PM

Conventional wisdom holds that America faces a growing physician shortage and that one way of responding is by creating new medical schools. Starting a new school is an expensive proposition, which may explain the modest number that have opened in the past decade. But now the private sector may be...

Read Post

Dare to Do Tax Reform

(0) Comments | Posted March 4, 2014 | 1:44 PM

There was a fairly recent time when the word most associated with the chairmanship of a major committee in the House of Representatives was powerful. Retiring Representatives Dingell and Waxman enjoyed the aura that came with the gavel.

That was then. Confirmation of how things have changed came this...

Read Post

Lobbying by Stealth

(0) Comments | Posted February 18, 2014 | 6:46 PM

There are two interesting current additions to the annals of political influence, with its focus on quiet issue lobbying as opposed to the campaign contributions that are much more obvious and less effective.

The first is an effort to put paper back into government, undermining efforts at cheaper...

Read Post

Obamacare Rocks

(20) Comments | Posted January 17, 2014 | 1:43 PM

The relentless flow of good news about Obamacare may explain why a growing number of elected Republicans are walking away from the issue. Two new bits of insurance news suggest progress that backers of reform find quite encouraging.

The first explains how governments are competing in the...

Read Post

Evaluating Obamacare: A Guide for the Perplexed

(0) Comments | Posted December 18, 2013 | 8:24 AM

Any serious effort to evaluate Obamacare must begin with a basic question: Compared to what?

Once today's administrative glitches are resolved, the basic goal is to provide Americans with an improved relationship with the nation's health care system. There are many ways to do so.

The dream standard, which Obamacare...

Read Post

Syria: What Would Neville Do?

(4) Comments | Posted September 27, 2013 | 5:51 PM

Advocates of American military action in Syria have, with a predictable lack of both creativity and historic relevance, invoked the memory of Neville Chamberlain, who announced the achievement of "peace in our time" after negotiating a deal that gave Hitler a piece of Czechoslovakia the Nazis coveted. Chamberlain is regularly...

Read Post

The Snowden Portent

(0) Comments | Posted August 18, 2013 | 4:16 PM

My probes for precedents to the Snowden NSA leaks inevitably yield references to Daniel Ellsberg's release of the Pentagon Papers in 1971 and while there are more than a few similarities (someone within the government sharing documents that challenged the official narrative), there are some significant differences that suggest the...

Read Post

Environmental In-fighting

(3) Comments | Posted July 12, 2013 | 5:37 PM

The next battle in America's war on global warming is a quiet but robust debate among those who seek a larger government role, but disagree about why an earlier Obama effort failed.

This debate is worth watching because it may have implications beyond climate policy. It features a...

Read Post

Adding Docs Will Boost Health Bill

(0) Comments | Posted March 19, 2013 | 11:17 AM

While much of Washington worries about how to constrain Medicare costs, two contrarian legislators want the program to spend $1 billion more annually to fund residency training for new doctors.

Their plan responds to a projected physician shortage. There's heated debate about whether there will be a physician deficit in...

Read Post

Medicare Means Tested -- Who Knew?

(12) Comments | Posted March 5, 2013 | 1:20 PM

Rich people have paid more for Medicare coverage since the program began in 1966. Subsequent changes have regularly increased the extra amount those with high incomes must pay for coverage. That history often seems totally forgotten into today's Medicare reform debate about whether the program should be means tested (if...

Read Post

Recasting the Medical Morality Play

(2) Comments | Posted February 28, 2013 | 1:12 PM

Many Americans have an unhelpful habit of viewing the health reform debate as a morality play where those who treat us -- usually doctors and hospitals - are viewed as the good guys and those who pay for those services - generally insurance companies or government programs like Medicare --...

Read Post

Shopping for Surgery?

(0) Comments | Posted February 15, 2013 | 10:07 AM

If you're an uninsured New Yorker shopping for a hip replacement, the going rate in Manhattan is $18,260. If that sounds steep and you're willing to try medical tourism, the rate drops to $7,500 in Boston, $7,099 in Baltimore or $6,399 in Washington.

If you're willing to go further...

Read Post

Power to the GOP Moderates

(0) Comments | Posted January 2, 2013 | 1:22 PM

In a surprising outcome better ascribed to the law of unanticipated consequences than a clever plot, a small group of moderate Republicans, particularly in the House of Representatives, are now poised to play an extremely powerful pivotal role.

This group, recently nominated for inclusion in the endangered species list, was...

Read Post

Tax Reform Is Irrelevant

(12) Comments | Posted January 2, 2013 | 11:37 AM

No issue with less potential impact on public good gets more attention than tax reform. It is possible to argue that the amount of taxes collected from the public impacts the national economy, but there's no compelling evidence suggesting that the mechanism used (income tax vs, value-added tax vs. personal...

Read Post

Happy Days Here Again?

(0) Comments | Posted December 13, 2012 | 10:47 AM

It's looking like a very merry holiday season with an extremely prosperous new year ahead for the lobbying community. Fiscal austerity is an ill wind that does blow some good to those paid to influence where the painful spending cuts will be made. And the growing possibility of tax reform...

Read Post

Real Test for Obamacare Now Begins

(1) Comments | Posted July 2, 2012 | 11:09 AM

A Supreme Court decision, surprising to many, has allowed the health reform experiment to proceed, but it doesn't guarantee its success. If President Obama wins re-election, that may still be unclear at the time of the 2016 election and could be an issue then.

As Massachusetts is...

Read Post

Death to Social Security Trust Funds

(2) Comments | Posted May 1, 2012 | 3:44 PM

The annual report of the Social Security trustees predicting when the funds they monitor (retirement, Medicare and disability) will be depleted has become a meaningless rite of spring that provides more heat than light. The news is always viewed as bad and ignored, a response that's helpful only to those...

Read Post