Are we getting the most health improvement possible for our money. In other words, are all the things that we do in medicine really worth it? That is where cost-effectiveness comes in. As a nation, we have been unwilling, at least publicly, to look explicitly at the value, in terms of improved...

Reports that the Social Security Trust Fund will be exhausted sometime in the early part of the next century reinforce the need to make retirement policy in the United States more accommodating for those who want to work. While there is general agreement that disincentives to work at older ages...

The heart of the model is this: to quote Pogo, "We have met the enemy and it is us." We doctors are the problem, not because wqe are venal or self-serving or insulated from reality. Far from it. Most of us are hard-working, dedicated professionals. We are the problem, though, because of the way...

New York State provides aid to local schools through a confusing maze of aid programs that are, according to many commentators, unfair to the neediest school districts, often defined as those with many students who are poor or otherwise "at risk." For example, New York City, which, by any...

While the developed world is starting to limit emissions of greenhouse gases, emissions from the developing world are increasing as a result of economic growth. Reducing these emissions while still enabling developing countries to grow requires the use of new technologies. In most cases, these...

This policy brief talks about what managed care for Medicaid is, how it influences kids, and how it relates to the State Child Health Insurance Program (CHIP). It focuses on what we have learned over the last 20 years through research about cost, use, and quality. It also discusses some of the...

There's limited information available about measuring the quality of medical care that is targeted to the needs of older patients. And there's very limited pressure on the system to provide high quality geriatric care. Why is that? Because the quality measures haven't been adequately developed...

The last few years have witnessed a quantum leap in the enforcement of fair housing and fair lending legislation. The 1988 Fair Housing Amendments Act gave newe enforcement powers to the U.S. Department of Housing and Urban Development (HUD) and the Department of Justice. For example, HUD can...

There are various reasons for the burgeoning interest in detailed research into the determinants of social well-being among older immigrants in this country. As a result of shifting federal government policies, the total volume of immigrants has increased significantly, the countries from which...

As a greater number of people reach old age, medicine is challenged to develop new approaches to this population. Health promotion, not just treatment of disease but improving the quality of life for older persons, must play a role. What happens to individuals in terms of health status as they...