Blog: The View from Here

  • For a Surgical Operation: 200 Pesetas

    Mar 23, 2016 | Christopher F. Koller, President

    We are not the first country to wrestle with the effects of fee-for-service medicine, it seems. I recently picked up the book, The Forging of a Rebel, an autobiography of Spanish Civil War veteran Arturo Barea—and encountered the durable power of economic incentives in medical care. Read more

  • Letter to Health Care Payers: Getting on the Same Page

    Feb 16, 2016 | Christopher F. Koller, President

    Dear Health Care Payers: We gathered 25 of you—insurance company staff, Medicaid officials, and Medicare staff—earlier this month to compare notes on your work with Medicare’s Comprehensive Primary Care Initiative, a multi-payer initiative that fosters collaboration between public and private health care payers in seven markets to strengthen primary care. It is apparent that this sort … Read more

  • State and Federal Relationships: Always Negotiating

    Jan 20, 2016 | Christopher F. Koller, President

    The hip-hop Broadway musical about Alexander Hamilton’s life may be the hottest ticket in town, but Hamilton’s well-known advocacy for a strong national government is not getting much love on the campaign trail or in political discourse. Read more

  • Five Reasons for Population Health Hope in 2015

    Dec 17, 2015 | Christopher F. Koller, President

    At the end of 2015, it is worth taking a look at some of the progress that has been made this year advancing population health in this country. A little bit of love is called for: advocacy to improve the health of large numbers of people can be a lonely trail. It is far easier to arouse public sympathies for health care—for named victims, heroic healers, and miracle therapies. Health improvement … Read more

  • When Values and Evidence Collide: Reducing Teen Pregnancy Rates in Colorado

    Nov 17, 2015 | Christopher F. Koller, President

    Few policies intended to help people live longer are more effective than those targeting teen pregnancy rates. Yet even when those policies work, they are fraught with controversy and conflict. A look at what’s currently going on in Colorado demonstrates some of the challenges in addressing the social determinants of health. The evidence regarding factors that contribute to premature death is … Read more

  • Better Health Care Systems—A Mutual Effort

    Oct 19, 2015 | Christopher F. Koller, President

    When I regulated commercial health insurance in Rhode Island, I would point out that the politically conservative notion of a free market for health insurance depends on the liberal principle of collectivism. Health insurance only works if enough people come together so the many who are healthy can pay for the few who are sick—and if payments from insurers actually help improve the … Read more

  • Non-Partisan, but Not Neutral

    Sep 21, 2015 | Christopher F. Koller, President

    Bipartisanship in health policy is hard to find. Pick your topic—Medicaid expansion, Medicare reform, or health insurance exchanges—and voices are shrill, slogans are wielded like swords, and opinions ossified. Powered by easy ideologies and campaign cash, the outcomes of partisanship are misunderstandings, distrust, and a lack of progress on important issues. The Milbank Memorial Fund, in … Read more

  • Improving State Health Policy Leadership

    Aug 17, 2015 | Christopher F. Koller, President

    You would think a billion-dollar-a-year organization that pays its chief 20% of the market rate and turns that role over every two years—as is the case with state Medicaid programs—might start to consider the importance of leadership. Leadership also seems important for a public health agency charged with guarding the safety of food, water, and patient care, or a child welfare or human … Read more

  • They Called It “Secret,” We Call It “Confidential”

    Jul 21, 2015 | Christopher F. Koller, President

    “Secret Health-Law Huddle.” The headline made me shudder. It appeared in a national newspaper, describing a meeting hosted by the Milbank Memorial Fund. “Secret” implied scandal where there was none. That the meeting happened was no secret. The proceedings were, however, confidential. Yes, we had a meeting. No, we weren’t going to talk about what was said. There is a world of nuance … Read more

  • “Oh, Baltimore. Man, It’s Hard Just to Live”

    Jun 16, 2015 | Christopher F. Koller, President

    Randy Newman had it right 28 years ago and today—judging from recent events in Baltimore. Riots tore apart the city at the end of April in the wake of Freddie Gray’s death in police custody, and the after-effects continue to ripple. Homicides in May of this year were 50% higher than May of last year driven, some say, by the large amounts of drugs in circulation looted from 27 pharmacies and … Read more