NEJM – Health Policy & Reform News

"The subject of climatic and environmental changes that result from human activity has been much in the news recently," Alexander Leaf wrote in the Journal 30 years ago. Threatened by acid rain, greenhouse gases, ozone depletion, and global warming, the planet seemed vulnerable. Humans would face…
Posted: January 16, 2020, 12:00 am
Health care spending in the United States is heavily concentrated, with 5% of the population accounting for 50% of annual spending and 1% accounting for almost a quarter of annual spending. There is therefore substantial interest in interventions that can reduce spending and improve health care…
Posted: January 9, 2020, 12:00 am
Production of natural gas has grown by nearly 400% in the United States since 1950, and gas is now the country’s second-largest energy source. The main driver of this increase has been the wide-scale adoption of hydraulic fracturing ("fracking"). During the fracking process, large volumes of water,…
Posted: January 9, 2020, 12:00 am
In 2009, during a contentious national debate over health care reform, U.S. Representative Bob Inglis (R-SC) held a town hall meeting in Simpsonville, South Carolina. In a moment that would become infamous, a man stood up and told Inglis to "Get your government hands off my Medicare." Recalling the…
Posted: January 9, 2020, 12:00 am
Four years ago, the NEJM Group launched NEJM Catalyst as a forum for emerging ideas and practical innovations in health care delivery, creating robust dialogue among health care leaders, clinicians, researchers, and other experts. NEJM Catalyst is now entering a new phase with the creation of a…
Posted: January 2, 2020, 12:00 am
In 2017, a committee convened by the mayor of Philadelphia as part of a task force on the opioid-overdose crisis recommended opening safe consumption sites in the city. The core function of the more than 165 such facilities operating globally is to provide a place where people can consume drugs…
Posted: January 2, 2020, 12:00 am
During the past two decades, the hospital industry has consolidated substantially in the United States, including a surge in mergers and acquisitions beginning in 2010. Multiple studies have shown that consolidation of the hospital market has led to higher negotiated prices with private insurers,…
Posted: January 2, 2020, 12:00 am
An important transformation is under way in public health. Next-generation sequencing (also called "high-throughput sequencing") is reshaping communicable disease surveillance, allowing for earlier detection and more precise investigation of outbreaks. Next-generation sequencing helps characterize…
Posted: December 26, 2019, 12:00 am
More than 1.1 million U.S. adults are currently living with HIV, and 38,739 Americans were newly infected with the virus in 2017. Yet ending the U.S. epidemic — once unimaginable — has become a realistic endeavor. On February 5, 2019, the Trump administration announced the ambitious goal of…
Posted: December 26, 2019, 12:00 am
In 2017, a total of 19% of all new HIV infections in the United States and nearly half of infections globally were in cisgender (nontransgender) women. Women of childbearing potential shoulder a disproportionate burden, which raises further concerns about perinatal transmission of the virus.…
Posted: December 26, 2019, 12:00 am
Schistosomiasis is a parasitic neglected tropical disease that is estimated to currently infect more than 140 million persons. Ninety percent of the disease burden is in sub-Saharan Africa, where the main species that cause schistosomiasis in humans are Schistosoma mansoni (intestinal…
Posted: December 26, 2019, 12:00 am
Americans have ranked "taking action to lower prescription drug prices" as their top priority for Congress this year. Policymakers seem to be listening. Proposals have emanated from Senate and House committees, the Trump administration, and several Democratic presidential candidates. Though the…
Posted: December 19, 2019, 12:00 am
Although the growing obesity epidemic in the United States has been well documented, less is known about long-term trends and the future of obesity prevalence. Although national projections of obesity have been made previously, state-specific analyses are limited. State-specific projections of the…
Posted: December 19, 2019, 12:00 am
More than 25 years have passed since one of us helped draft the law that redefined the U.S. regulatory landscape for vitamins, minerals, botanicals, live microorganisms, and many other health products. The law, known as the Dietary Supplement Health and Education Act of 1994 (DSHEA), created a new…
Posted: December 19, 2019, 12:00 am
Artificial intelligence is a branch of computer science devoted to the performance of tasks that normally require human intelligence. A major subbranch of this field is machine learning, in which computers learn to perform tasks by analyzing data rather than requiring specific programming…
Posted: December 12, 2019, 12:00 am
To the Editor: Where people die is an important determinant of patient and caregiver experience. To assess changes in place of death, we analyzed data from the Centers for Disease Control and Prevention and the National Center for Health Statistics database for natural deaths in the United States…
Posted: December 12, 2019, 12:00 am
Ticks and tickborne diseases are increasingly becoming a major health concern for humans, domesticated animals, and livestock. Reported cases of bacterial and protozoan tickborne disease doubled in the United States between 2004 and 2016. More than 90% of the nearly 60,000 cases of nationally…
Posted: December 5, 2019, 12:00 am
In the 21st century, physicians in the United States are increasingly caught between the conflicting concepts of medicine as a humanitarian profession and health care as a competitive business. As a practicing neurologist and clinician–investigator who recently had the privilege of leading the Mayo…
Posted: December 5, 2019, 12:00 am
Last year, the world marked 100 years since the beginning of the 1918 influenza pandemic. Over a little more than 2 years, the virus infected more than half a billion people, spreading to remote parts of the globe and causing more deaths than either World War I or World War II — and possibly more…
Posted: December 5, 2019, 12:00 am
Health care organizations that are struggling to reorient themselves toward delivery of higher-value care often identify culture as their greatest barrier. As with any diagnostic process, accuracy and precision are essential. Despite health care’s widespread embrace and frequent use of the concept…
Posted: November 28, 2019, 12:00 am
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