President’s Blog: The View from Here

  • My New ER TV Drama

    Jul 28, 2016 | Christopher F. Koller, President

    I have a new emergency room (ER) drama for television in mind. In my TV drama, there are no sirens and no gurneys racing through the corridors. There are no overworked doctors or heart-tugging patients or gut-wrenching triage decisions. Instead, my TV drama commences with a more common ER scene—a crowded waiting room full of bored, sick people, many of them disoriented and distressed. Cut to … Read more

  • Evolving Hepatitis C Drug Coverage Policies: Seeing the Bigger Story

    Jun 24, 2016 | Christopher F. Koller, President

    With threats of lawsuits and pressure from government officials, some payers appear to be relaxing their coverage guidelines for expensive direct-acting antiviral drugs (DAAs), including drugs for Hepatitis C. Read more

  • Who is Responsible for Our Health?

    May 26, 2016 | Christopher F. Koller, President

    If I die before my time, is it my fault? If I drank a lot of alcohol, drove too fast, didn’t wear a seat belt, and crashed—most would say yes, I had it coming. If I got hit by that driver while walking on the sidewalk, it would be a terrible tragedy. What about groups of people who die early? Read more

  • Payment Reform: Innovation, Evaluation, and Perspiration

    Apr 25, 2016 | Christopher F. Koller, President

    My e-mail inbox is full of innovations—solicitations for health care meetings, most offering “unique opportunities” to hear from “national leaders,” all of whom are busy innovating. Much of the conference fodder focuses on payment reform. Read more

  • 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