ST. LOUIS — Missouri healthcare advocate Leslie Ortbals and her husband want to start a family, but she worries they can’t afford it. The 27-year-old said she takes 10 medications daily to manage multiple chronic illnesses. Now she worries the cost of those drugs could rise — not because of price increases, but because of…
By JOHN SAMARAS Ask what Ozempic costs. The honest answer runs from $25 a month to $1,100 a month, and every number in that range is real, published, and defensible. A phrase that covers a forty-four-fold spread is not a price. It is a fog, and patients make four-figure annual decisions inside it. I run…
That is the title of a Journal of Economic Literature article by Gottlieb and Nicholson (2026). Here is a Q&A summary of their article. What are the defining features of physician competition? The authors argue that competition in the physician market is a two-stage process: “First, potential physicians compete to enter medical school and then…
As the Trump administration’s January deadline looms for states to enforce new Medicaid work requirements, some state lawmakers are turning the tables by pushing to publicly name the largest companies that have employees enrolled in the government program covering low-income and disabled people. California lawmakers seek to revive an expired law that would require the…
By KIM BELLARD The most (unintentionally) amusing story I read this week was Tim Higgin’s Wall Street Journal article Alex Karp Is Saying What Every Angry CEO Is Thinking About AI. Dr. Karp (yes, he has a Ph.D.), co-founder and CEO of Palantir Technologies, is upset about how AI companies are using relationships with their…
Do Medicare Advantage enrollees like plans with more prior authorization? On the one han, one would think the answer is a clear ‘no’. However, higher levels of prior authorization could result in lower premiums, a tradeoff many enrollees may prefer. A paper by Marr, Trivedi and Meyers (2026) aims to answer the question using beneficiary…
Thousands of Americans who undergo a common knee surgery might be making their problems worse rather than better. Researchers who followed patients for 10 years after they received either the actual procedure, arthroscopic knee surgery to trim degenerative cartilage tears, or merely “sham surgery” — a skin incision — for knee pain, found that the…
When Gov. Gavin Newsom, using his executive power, refused to extradite a physician accused of prescribing and mailing abortion pills to a Louisiana woman, he said California would “not ever” allow “extremist politicians” to punish its doctors. Newsom, who is considering a run for president, has long championed reproductive rights, but state lawmakers in the…
By CRAIG HAUBEN Ask anyone outside healthcare who resists clinical AI and you’ll get a confident answer. The older doctors. The ones who spent thirty years building expertise and now see a machine coming for it. The story writes itself, which should have been the first clue it was wrong. I’ve spent thirty years in…
A paper by Mark Shepard and Jacob Wallace (2026) has a great overview of the Medicaid managed care program. The first question one may have is, how does Medicaid managed care differ from other forms of government procurement. “In standard public procurement—such as contracting for infrastructure projects—the government specifies desired services, solicits bids, selects winners,…