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05/14/2012 Poverty and Health: A Connection We Can't Ignore
04/30/2012 Cardiac Care - A Case Study in Practice Variation
04/16/2012 One Courageous Woman
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In a New York Times op-ed last December, Elizabeth Bradley and Lauren Taylor wrote about the study of global health spending published they published in the journal BMJ Quality and Safety. Their analysis broadened the concept of international health care spending to include spending on social services.

Everybody and their brother will be blogging about the Supreme Court arguments on health care reform over the next several weeks. I do not want to add to the noise by focusing on the arguments and/or who has the winning position: many others will offer that kind of analysis.

OK, I admit it: we made a mistake.

Last spring when my colleagues and I were teaching a class on health insurance in America at the U-M Ford School of Public Policy, we asked our students to write their final papers on what they would change about the Affordable Care Act. Three of our earnest and committed students took on the task of trying to make the Community Living Assistance Services and Supports program (CLASS Act) workable. All three came up with approaches for increasing enrollment in CLASS and making it more financially sustainable over the long term.

While there has been considerable attention of late focused on the Affordable Care Act and the courts, many states, health care providers, and employers are continuing to move forward on the assumption that the Affordable Care Act will stay in effect—at least in its broadest dimensions. While a Supreme Court decision is now expected by the end of the 2012 term, getting ready for implementation of the major provisions of the ACA that go into effect in 2014 cannot wait for that court decision.

Recently, 29 Republican governors sent a letter to the President and Congress advocating for more flexibility in the Medicaid program and a full repeal of the Affordable Care Act. The principles endorsed by these 29 governors (which notably did not include Governor Snyder of Michigan) essentially supported the concept of a block grant for the Medicaid program.

In the May 18 issue of the New England Journal of Medicine, Rashi Fein and Arnold Milstein tackled the question of why evidence-based care diffuses so slowly. The article is compelling because of its fundamental conclusion: institutionalized interest group pressure against change in health care and consumer misunderstanding of health care financing make it hard to envision how health care spending could be reduced in significant ways.

Health care policy happens at many levels, but health care delivery: just one. Policy is made at the federal, state and local levels—but delivery is at the local level: in organized systems of care or with individual or teams of practitioners working with patients and families.

Today we are releasing our Cover Michigan Survey, 2011. Like last year’s survey, this report looks at what Michigan residents say about their access to health care. Different from last year, this survey was designed to look more in-depth at access, along with health status.

Michigan Governor Rick Snyder deserves special notice and acknowledgement for the courage and focus he displayed in his decision not to sign on to the letter signed by all other Republican governors, asking for changes to the Medicaid program and advocating for the repeal of the Affordable Care Act.