Past Articles

Skinner Honored for Lifetime Achievement in Health Economics

July 09, 2021 by Bill Platt

The Fuchs award cited the economics professor's work to improve health care systems.

Jon than Skinner research professor of economics and a professor at the Geisel School of Medicine, has received the Victor Fuchs Award for Lifetime Contributions to the Field of Health Economics from the American Society of Health Economists (ASHE).

"This is the highest honor one can achieve in the health economics field," says Nina Pavcnik, the Niehaus Family Professor in International Studies.

The real death toll from the pandemic in America may already be 300,000

Deaths from all causes — not just Covid-19 — are up since the pandemic started, a CDC report found.

By Julia Belluz@juliaoftoronto Oct 21, 2020, 10:10am EDT

The official Covid-19 mortality figures might be dramatically underestimating the real deathtoll of the pandemic in the US, according to a new report from the Centers for Disease Control and Prevention (CDC).

From late January to early October, nearly 300,000 “excess deaths” occurred in America, the report authors estimate. That’s about a third more than the 216,025 coronavirus deaths the US reported in the same period.

Where Have All the Hospital Patients Gone?

Weathered, wiry and in his early 60s, the man stumbled into clinic, trailing cigarette smoke and clutching his chest. Over the previousweek, he had had fleeting episodes of chest pressure but stayed away from the hospital.

“I didn’t want to get the coronavirus,” he gasped as the nurses unbuttoned his shirt to get an EKG. Only when his pain had becomerelentless did he feel he had no choice but to come in.

In pre-pandemic times, patients like him were routine at my Boston-area hospital; we saw them almost every day. But for much of thespring and summer, the halls and parking lots were eerily empty. I wondered if people were staying home and getting sicker, and Iimagined that in a few months’ time these patients, once they became too ill to manage on their own, might flood the emergency rooms,wards and I.C.U.s, in a non-Covid wave.

Coronavirus Is Spreading Fast in Areas of U.S. That May Reopen Soon: Study

The COVID-19 coronavirus has saturated the United States, and it appears to be spreading quickly in some places that are planning to ease social distancing restrictions soon, a new study shows.

Déjà vu all over again: Health-care spending back on the rise

As we approach the 10-year anniversary of the Affordable Care Act (ACA), Democratic presidential candidates are sparring over what to do in its second decade. Should we build on the ACA? Or scrap it, relying instead on private markets or “Medicare for All”? As the debate heats up, it’s worth reflecting on what the ACA has accomplished so far — and what it hasn’t.

Misconceptions About Health Costs When You’re Older

That does not mean that all the care provided to dying patients — or to any patient — is valuable. Another study finds that high end-of-life spending in a region is closely related to the proportion of doctors in that region who use treatments not supported by evidence — in other words, waste.

“People at high risk of dying certainly require more health care,” said Jonathan Skinner, an author of the study and a professor of economics at Dartmouth. “But why should some regions be hospitalizing otherwise similar high-risk patients at much higher rates than other regions?”

Why is US health care so expensive? Some of the reasons you’ve heard turn out to be myths.

There were two areas where the United States really was quite different: We pay substantially higher prices for medical services, including hospitalization, doctors’ visits and prescription drugs. And our complex payment system causes us to spend far more on administrative costs. The United States also has a higher rate of poverty and more obesity than any of the other countries, possible contributors to lower life expectancy that may not be explained by differences in health care delivery systems.

Just because other countries use the hospital more doesn’t mean that every hospitalization in the United States is appropriate. Jonathan Skinner, a professor at Dartmouth, who has studied patterns in health care use in the United States, noted that there probably is money to be saved by eliminating some of the extra scans and operations that are much more common in the United States than elsewhere.

Alex Azar ’88 confirmed as HHS secretary

According to economics professor and professor at The Dartmouth Institute for Health Policy and Clinical Practice Jonathan Skinner, lowering the prices of drugs is necessary.

“It’s certainly true that when you give drug companies a monopoly through the patent system on particular drugs that they’ve developed and there’s a general policy that Medicare and private health insurance have to pay whatever it is that the drug companies charge,” Skinner said. “It’s not surprising that the prices they charge are very high.”

Skinner added that he believes Azar to have a firm understanding of drug pricing from his experience in the private sector and said that it will be interesting to see whether the secretary is able to bring a “stronger set of tools” to cut back on prices based on his time at Eli Lilly.

The Integrity of MACRA May Be Undermined by “Incident to Billing” Coding.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 ended the Sustainable Growth Rate formula that for years had resulted in an eleventh-hour intervention by Congress to avoid drastic reductions in Medicare physician payments. MACRA also established incentives for clinician payments to become increasingly based on value with the intent of rewarding clinicians who produce better outcomes at lower costs. Efforts are underway to establish the outcomes and quality measures that will be included in the new payment systems.

How Much Should You Save for Retirement?

It's hard to plan for retirement, and one of the trickiest questions is: How much should I save?

The honest answer is: It depends. "The best-laid plans can be undone by a messy divorce, a disabling disease, or a stock market crash," Jonathan Skinner, a professor of economics at Dartmouth College, wrote in a study on the topic. Your future health-care expenses are almost impossible to predict, for example, especially as Congress considers big changes to the system.