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John R. Graham Archive

John R. Graham is a Senior Fellow at The Independent Institute.
Full biography and recent publications

Telehealth Opportunity versus Telehealth “Parity”



A great opportunity to reduce costs and improve quality in U.S. health care is telehealth, which uses information technology to eliminate distance between a patient and a medical provider. A subset of telehealth is telemedicine, which allows physicians to consult patients over the phone, by text, or by video. Take a couple of obvious...
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Single-Payer Setback: Canadian Doctors without Contract for Two Years and Counting



Physicians in Canada’s largest province, Ontario, have rejected a contract negotiated between the Ontario Medical Association and the provincial health ministry. The more than two-year-old dispute shows no sign of ending. Every Canadian is covered by a provincial government health plan. Doctors therefore have only one plan with which they must contract. Individual doctors,...
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Obamacare Authorities Actually Think Health Costs Fell



The Centers for Medicare & Medicaid Services (CMS) has just made the remarkable claim that medical costs paid by health insurers operating in Obamacare’s exchanges declined in 2015 from 2014: Per-enrollee costs in the ACA individual market were essentially unchanged between 2014 and 2015. Specifically, after making comparability adjustments described below, per-member-per month (PMPM)...
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The “Right to Shop” for Health Care



Anyone who has undergone a medical procedure knows it is very difficult to figure out how much an insured patient will pay out-of-pocket. It is often not clarified until months after the procedure, when a flurry of incomprehensible paperwork from insurers, doctors, labs, et cetera, has landed in the patient’s mailbox. (Personal aside: A...
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Medicare Changes Have Reduced Hospital Readmissions, but More Reforms Are Needed



In 2012, Medicare began to penalize hospitals that readmitted too many patients. For a small number of targeted conditions, the program compares actual readmissions within 30 days to what an acceptable readmission rate should be. This measure is an important part of the drive to “pay for value, not volume.” The problem it was...
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The Dead-Weight Cost of Obamacare’s Loopy Tax Credit



Obamacare crushes jobs because of its loopy distribution of tax credits. As discussed previously, the (premium-reducing) tax credits for Obamacare coverage phase out in such a way that beneficiaries face very high marginal income tax rate hikes at household incomes up to 400 percent of the Federal Poverty Level. However, even those who increase...
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Another Obamacare Architect Recognizes Its Unintended Consequences



Dr. Bob Kocher, an Obamacare architect turned venture capitalist, has admitted the law has had a significantly negative unintended consequence: When I joined the Obama White House to advise the president on health-care policy as the only physician on the National Economic Council, I was deeply committed to developing the best health-care reform we could to...
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Chemotherapy Payment Reform: Medicare Is Missing the Elephant in the Room



Last May I wrote about the uproar over Medicare’s proposed changes to how it will pay doctors who inject drugs at their offices. This largely concerns chemotherapy. Currently, physicians buy the drugs and Medicare reimburses them the Average Sales Price (ASP) plus 6 percent. The proposed reform would cut the mark-up to 2.5 percent...
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The Democratic Platform on Health Care: Bad, but Not Universally Bad



The Democratic National Convention has produced a 51-page campaign platform that devotes five pages to health care. Leaving aside the promotion of abortion as a partisan wedge issue, the platform asserts the goal of “universal health care,” which is “a right, not a privilege.” The notion of health care as a “right” is now...
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Should the Feds Regulate Physicians’ Scope of Practice?



Writing in the Wall Street Journal, economics professor Shirley Svorny of California State University, Northridge, and the Cato Institute argues that Congress should use the power granted by the U.S. Constitution’s Commerce Clause to pre-empt states’ historical power to regulate physicians’ scope of practice: Telemedicine has made exciting advances in recent years. Remote access...
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