Linking Survey and Administrative Data to Measure Income, Inequality, and Mobility.

Background: Income is one of the most important measures of well-being, but it is notoriously difficult to measure accurately. In the United States, income data are available from surveys, tax records, and government programs, but each of these sources has important strengths and major limitations when used alone.

Objectives: We link multiple data sources to develop the Comprehensive Income Dataset (CID), a prototype for a restricted micro-level dataset that combines the demographic detail of survey data with the accuracy of administrative measures.

Unlike Medical Spending, Medical Bills In Collections Decrease With Patients' Age.

Health policy is often designed to help protect patients' financial security. However, there is limited understanding of the role medical debt plays in household finances. We used credit report data on more than four million Americans to study the age profile of people whose medical bills were sent to a US collections agency in 2016.

RNAseq analysis of bronchial epithelial cells to identify COPD-associated genes and SNPs.

Background: There is a need for more powerful methods to identify low-effect SNPs that contribute to hereditary COPD pathogenesis. We hypothesized that SNPs contributing to COPD risk through cis-regulatory effects are enriched in genes comprised by bronchial epithelial cell (BEC) expression patterns associated with COPD.

Methods: To test this hypothesis, normal BEC specimens were obtained by bronchoscopy from 60 subjects: 30 subjects with COPD defined by spirometry (FEV1/FVC < 0.

Healthcare reform.

Catholic social teaching provides the essential framework for thinking clearly about societal problems, but it cannot be applied like a recipe in a cookbook. It is the responsibility of informed citizens to take what Catholic social teaching offers and use their own knowledge and reason to advance concrete approaches for addressing complex issues of public policy. In health care, full governmental control would lead to a decline in the quality of services provided to all patients.

Mystery Of The Chargemaster: Examining The Role Of Hospital List Prices In What Patients Actually Pay.

Hospitals in the United States maintain chargemasters that contain the official list prices for all billable services. The prices vary widely across hospitals and are more than three times what hospitals are paid for treating a patient, on average. From this it is tempting to conclude that list prices are a strange, yet ultimately inconsequential, quirk of US health care.

A guide to the anti-innovation "pharmaphobia" narrative for the aspiring innovator.

Thomas P. Stossel is an American Cancer Society Professor of Medicine Emeritus at Harvard Medical School, Honorary Physician in the Hematology Division of Brigham & Women's Hospital, founding scientist of BioAegis Therapeutics, Visiting Scholar of The American Enterprise Institute and cofounder of Options for Children in Zambia.

Pediatric Dentists' Knowledge Concerning the Physician Payments Sunshine Act and Their Predictions of its Effects on Their Interactions with the Industry and its Impact on Patient Care.

Purpose: This study surveyed pediatric dentists' knowledge of the Physician Payments Sunshine Act (PPSA) and their impressions of its effect on their future interactions with the dental products industry and on their clinical practice.

Methods: Seven hundred seventy four practicing dentists responded to a survey, with 13 responding to a follow-up survey.

Results: Most respondents were unfamiliar (43 percent) or only vaguely familiar (33 percent) with the PPSA.

If We Pay for Value, Will We Get It?

Quality measurement and performance-based payment systems are intended to promote high-value health care. Medicare is beginning to shift from process to population-based outcome measures, but the service (rather than the outcome) remains the focus under fee-for-service payment. An emerging challenge: how to mesh the differing perspectives of payers, providers, and consumers on what constitutes value in health care.

Generics Substitution, Bioequivalence Standards, and International Oversight: Complex Issues Facing the FDA.

The regulations for assessing the quality of generic drugs and their bioequivalence to innovator products are outdated and need to be substantially modernized. There are multiple reasons why these changes are needed, including: (i) the regulations remain largely unchanged since the passage of the Hatch-Waxman Act in 1984; (ii) medication therapies have become substantially more complex over the three decades since the passage of the Act; (iii) a switch from an innovator drug to a generic drug, or switching from one generic to another, is not a benign process - there is substantial clinical professional judgment involved and in some instances these decisions should be better informed; and (iv) pharmaceutical ingredients for finished products, whether innovator or generic, are from multiple sources of supply, adding variability in their production, and which may not be accounted for in specification tolerances. When these elements are viewed together, they clearly suggest that more transparency of responsible manufacturers in product labels and updated standards for bioequivalence are required.

A market approach to better care at lower cost.

The Affordable Care Act expanded health insurance coverage in the United States but did little to address the structural problems that plague the U.S. health care system.

The role of retiree health insurance in the early retirement of public sector employees.

Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health coverage raises the probability of stopping full time work by 4.

Substandard and falsified anti-tuberculosis drugs: a preliminary field analysis.

Setting: Pharmacies in 19 cities in Angola, Brazil, China, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, India (n = 3), Kenya, Nigeria, Russia, Rwanda, Thailand, Turkey, Uganda, United Republic of Tanzania and Zambia.

Objective: To assess the quality of the two main first-line anti-tuberculosis medicines, isoniazid and rifampicin, procured from private-sector pharmacies, to determine if substandard and falsified medicines are available and if they potentially contribute to drug resistance in cities in low- and middle-income countries.

Design: Local nationals procured 713 treatment packs from a selection of pharmacies in 19 cities.