Paul Ginsburg is President of the Center for Studying Health System Change (HSC). Founded in 1995 by Dr. Ginsburg, HSC conducts research to inform policymakers and other audiences about changes in organization of financing and delivery of care and their effects on people. HSC is widely known for the objectivity and technical quality of its research and its success in communicating it to policy makers and the media as well as to the research community. Ginsburg is particularly known for his understanding of health care markets and health care costs. In 2007, for the fifth time, Dr. Ginsburg was named by Modern Healthcare as one of the 100 most powerful persons in health care.
Dr. Ginsburg served as the founding Executive Director of the predecessor to the Medicare Payment Advisory Commission). Widely regarded as highly influential, the Commission developed the Medicare physician payment reform proposal that was enacted by the Congress in 1989. Dr. Ginsburg was a Senior Economist at RAND and served as Deputy Assistant Director at the Congressional Budget Office. Before that, he served on the faculties of Duke and Michigan State Universities. He earned his doctorate in economics from Harvard University.
Updated at 9:51 a.m. on Oct. 26. State opt out is appealing to some because political cultures vary across states, thus potentially permitting compromise on what is mostly an ideological issue. What the implications are beyond ideology depends heavily on what type of public option we are talking about. If it is the version where the public plan pays hospitals and physicians at Medicare rates, an extensive pattern of distortions could result. How Medicare rates compare with those negotiated by private insurers varies to a very large degree across geographic areas and also within a geographic area. One result could… Read more
Inducing physicians to leave small practices is not the key challenge for getting more integrated delivery through accountable care organizations (ACO). Physicians appear to shifting to larger practices at an increasing rate. Many hospitals are employing physicians or setting up affiliated groups because they see a need to “offer a salaried platform” for young physicians looking to concentrate on clinical work and seeking control over their work hours. Many physicians already in small practices are seeking to affiliate with hospitals or larger medical groups to gain access to higher payment rates from insurers through leverage. These trends provide hospitals an opportunity to create… Read more
Our medical malpractice system has long been disfunctional. Most patients injured by malpractice do not receive compensation and those who do have to wait many years and pay a substantial portion of the award to attorneys. A few receive awards way beyond medical costs and loss of income. The system is not an effective way to improve quality and works against systematic initiatives to reduce errors. The potential to improve both quality and efficiency by reforming the system have never been better. With developing abilities to measure and report quality and increasing development and acceptance of evidence-based medicine, more appropriate standards of care can… Read more
I am not sure if he intended it this way, but Len Nichols has contributed to the issue of whether a competing public plan is a good idea by forcing us to think about what is a public plan and what is a private plan. He points to state governments that offer a choice between a fully-insured HMO and a self-insured PPO to their employees as models for competing private and public plans. I have never perceived the latter as a public plan, however, nor what the advocates of a public plan really have in mind. When states offer a… Read more
Existing individual insurance markets have an inherent tendency to “fail,” meaning that many people willing to pay a premium that reflects their expected claims costs and competitive margins for administrative costs and profits are not able to obtain such an offer of coverage. The dynamic behind this failure is adverse selection. People who expect to use a lot of health services are more likely to purchase health insurance. The result is that the pool of people covered in the individual market will have higher-than-average medical costs, leading to higher premiums. In turn, high premiums further discourage healthier people from… Read more
Related Link: http://www.hschange.org
