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NEJM—Health Policy and Reform

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Katherine Peeler
I met Beatrice when she was 18 years old. She came from one of the larger countries in West Africa and was seeking asylum in the United States. During our meetings, Beatrice often gazed at the floor and sometimes spontaneously broke out in tears. Before coming to the United States, she had suffered..
February 22, 2017: New England Journal of Medicine
Nathan C Lo, Michele Barry
During his first week in office, President Donald Trump reinstated an executive order banning U.S. aid to any international organization that supports abortion-related activities, including counseling or referrals. The so-called Mexico City Policy — colloquially referred to as the "global gag rule"..
February 22, 2017: New England Journal of Medicine
Timothy Stoltzfus Jost, Simon Lazarus
Within hours after taking the oath of office, President Donald Trump executed his first official act: an executive order redeeming his campaign pledge to, on "day one," begin repeal of the Affordable Care Act (ACA). The New York Times characterized his action as itself "scaling back Obamacare," and..
February 22, 2017: New England Journal of Medicine
Audrey L Gassman, Christine P Nguyen, Hylton V Joffe
In 2015, approximately 4 billion prescriptions were filled at retail pharmacies in the United States. The Center for Drug Evaluation and Research (CDER) within the Food and Drug Administration (FDA) ensures that prescription drugs have reliable quality and purity and that they provide benefits that..
16, 2017: New England Journal of Medicine
Richard G Frank, Harold A Pollack
Fentanyl, a powerful synthetic opioid, poses an increasing public health threat. Low production costs encourage suppliers to "cut" heroin with the drug, particularly white powder heroin sold in the eastern United States. Fentanyl also appears as a prevalent active ingredient in counterfeit..
February 16, 2017: New England Journal of Medicine
Michael L Barnett, Andrew R Olenski, Anupam B Jena
Background Increasing overuse of opioids in the United States may be driven in part by physician prescribing. However, the extent to which individual physicians vary in opioid prescribing and the implications of that variation for long-term opioid use and adverse outcomes in patients are unknown. Methods We performed a retrospective analysis involving Medicare beneficiaries who had an index emergency department visit in the period from 2008 through 2011 and had not received prescriptions for opioids within 6 months before that visit...
16, 2017: New England Journal of Medicine
Amy Finkelstein, Matthew Gentzkow, Peter Hull, Heidi Williams
In the U.S. health care system, payments and performance measures are often adjusted to account for differences in patients’ baseline health and demographic characteristics. The idea behind such risk adjustments is to create a level playing field, so that providers aren’t penalized for serving..
February 16, 2017: New England Journal of Medicine
Deborah Williamson, Benjamin Howden, Timothy Stinear
To the Editor: Recent articles have described patients with infections due to a form of nontuberculous mycobacteria, Mycobacterium chimaera, that developed after cardiac surgery. Infections have been publicly reported in five countries, and it has been noted that these infections developed after..
9, 2017: New England Journal of Medicine
Melinda B Buntin, John Z Ayanian
Medicare is steadily shifting from volume-based fee-for-service payments to value-based payment models, including accountable care organizations, episode-based bundled payments, and penalties for hospitals with relatively high Medicare readmission rates. These models typically provide financial..
February 9, 2017: New England Journal of Medicine
Yaseen M Arabi, Hanan H Balkhy, Frederick G Hayden, Abderrezak Bouchama, Thomas Luke, J Kenneth Baillie, Awad Al-Omari, Ali H Hajeer, Mikiko Senga, Mark R Denison, Jonathan S Nguyen-Van-Tam, Nahoko Shindo, Alison Bermingham, James D Chappell, Maria D Van Kerkhove, Robert A Fowler
Summary. Between September 2012 and January 20, 2017, the World Health Organization (WHO) received reports from 27 countries of 1879 laboratory-confirmed cases in humans of the Middle East respiratory syndrome (MERS) caused by infection with the MERS coronavirus (MERS-CoV) and at least 659 related..
9, 2017: New England Journal of Medicine
Dean B Andropoulos, Michael F Greene
For more than 15 years, the potential for lasting neurotoxic effects of agents used to induce general anesthesia and sedation when administered to young children — and indirectly through pregnant women to fetuses with developing brains — has been a subject of concern and considerable research..
February 8, 2017: New England Journal of Medicine
Mark A Schuster, Elena Fuentes-Afflick
A mother brings her toddler in for a well-child visit. When the pediatrician asks how things are going, the mother says everything’s fine. The pediatrician asks whether she’s getting enough support at home, to which she cautiously responds that some days can feel like more than she can handle...
February 2, 2017: New England Journal of Medicine
Ahmad Masri, Mourad H Senussi
On January 27, 2017, U.S. President Donald Trump signed an executive order banning nationals of seven countries — Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen — from entering the United States for at least 90 days, with the possibility of a wider "Muslim ban" in the works. Setting the..
February 1, 2017: New England Journal of Medicine
Andrew J Goodman-Bacon, Sayeh S Nikpay
In the summer of 2016, Representative Paul Ryan (R-WI) released "A Better Way," a wide-ranging proposal that included a plan for reforming Medicaid. Its fate depended heavily on the presidential election, and now that Republicans hold majorities in both the Senate and the House of Representatives..
February 1, 2017: New England Journal of Medicine
Muhammad H Majeed, Fahad Saeed
To the Editor: In an embarrassed tone, an 87-year-old patient with end-stage chronic renal disease who is now receiving palliative care asked one of us, "Will you be able to stay in the United States for a few more months? I don’t want to change my physician during the last few months of my life."..
February 1, 2017: New England Journal of Medicine
Katrina Armstrong, Mark E Anderson, John M Carethers, Joseph Loscalzo, Michael S Parmacek, Robert M Wachter, Mark L Zeidel
On January 27, 2017, President Donald Trump issued an executive order suspending "entry into the United States, as immigrants and nonimmigrants" of aliens from Iraq, Iran, Libya, Somalia, Sudan, Syria, and Yemen for 90 days, suspending the U.S. Refugee Admissions Program for 120 days, and..
February 1, 2017: New England Journal of Medicine
Craig Garthwaite, John A Graves
The results of the 2016 election portend a vigorous 2017 debate about the future of the Affordable Care Act (ACA). Both President Donald Trump and large fractions of the Republican majority party in the House and Senate campaigned on an explicit pledge to repeal and replace the ACA. At least part..
February 1, 2017: New England Journal of Medicine
Karin A Kasza, Bridget K Ambrose, Kevin P Conway, Nicolette Borek, Kristie Taylor, Maciej L Goniewicz, K Michael Cummings, Eva Sharma, Jennifer L Pearson, Victoria R Green, Annette R Kaufman, Maansi Bansal-Travers, Mark J Travers, Jonathan Kwan, Cindy Tworek, Yu-Ching Cheng, Ling Yang, Nikolas Pharris-Ciurej, Dana M van Bemmel, Cathy L Backinger, Wilson M Compton, Andrew J Hyland
Background Noncigarette tobacco products are evolving rapidly, with increasing popularity in the United States. Methods We present prevalence estimates for 12 types of tobacco products, using data from 45,971 adult and youth participants (≥12 years of age) from Wave 1 (September 2013 through December 2014) of the Population Assessment of Tobacco and Health (PATH) Study, a large, nationally representative, longitudinal study of tobacco use and health in the United States. Participants were asked about their use of cigarettes, e-cigarettes, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah, snus pouches, other smokeless tobacco, dissolvable tobacco, bidis, and kreteks...
26, 2017: New England Journal of Medicine
Deborah A Zarin, Tony Tse, Rebecca J Williams, Thiyagu Rajakannan
Laws and policies to establish a global trial reporting system have greatly increased the transparency and accountability of the clinical research enterprise. The three components of the trial reporting system are trial registration, reporting of aggregate results, and sharing of individual..
26, 2017: New England Journal of Medicine
Scott D Halpern, David Goldberg
Should patients’ cognitive function be weighed in the allocation of scarce organs? This question has been raised by several highly publicized cases that, on October 12, 2016, culminated in 30 members of the U.S. Congress petitioning the Department of Health and Human Services to "issue guidance on..
January 26, 2017: New England Journal of Medicine
2017-01-27 05:30:10
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