The poorly named Affordable Care Act created the office of the Center for Medicare and Medicaid Innovation (CMMI). As Joe Albanese explains in National Review the new agency’s mission
…is to test new ways of paying for and delivering health-care services in federal health programs through pilot programs called “models.” These models are required by law to reduce costs and/or improve quality of care, which they pursue by enacting major policy changes.
Americans are suffering a crisis of mental health. The crisis is especially pronounced among young people. This extends beyond the Covid-19 outbreak when schools were closed, kids were taught from home and shut off from their peers. Research has found that Millennials and Generation Z experience more negative emotions (stress and anxiety) than older generations, with Gen Z worse off than Millennials. Perhaps the explanation is that younger adults are new at adult life. Beginning careers, getting married and starting families is stressful in the beginning.
Implanted hips and knees don’t last forever. Surgeons try to schedule them in such a way that patients who get implants won’t need another, but there is no guarantee. For example, patients in their 60s are often advised to hold out for a few years so they won’t need a second hip or knee replacement in their 80s. A rule of thumb is that an implanted hip or knee should be good for at least 15 to 20 years, and possibly longer. A study in The Lancet found that knee implants were still good after 10 years in 96% of patients, and still working after 20 years in 90% of patients. Another study found more than 80% of knee replacements last 25 years or more.
Many states have passed laws limiting prior authorization. Physicians hate prior authorization and claim insurers and health plans use it to ration care. I tend to be more sympathetic to prior authorization because in an industry where patients are insulated from the cost of their care, there needs to be some checks and balances over unnecessary care and care that is unnecessarily expensive. I often tell the story about the time my wife unknowingly tried to schedule a CT scan at a hospital outpatient clinic near our house.