The late, great economist Uwe Reinhardt and colleagues published a seminal 2003 paper titled, “It’s the Prices, Stupid,” to explain why U.S. health care spending was so different from that of other industrialized nations. The answer: higher prices, not higher utilization of services. The authors found that the U.S. spends more on health care than any other country and “the difference in spending is caused mostly by higher prices for health care goods and services in the United States.”

If prices are the main driver of high health care spending, it’s even more astonishing that prices have long been shrouded…


Lies and misinformation campaigns have fueled the COVID-19 pandemic that has killed more than 618,000 Americans — and counting. Social media posts have promulgated conspiracy theories about the origins of the coronavirus, the severity of the pandemic, treatment options, and, of course, vaccines.

Earlier this year when vaccines were in short supply, many people were desperate to get vaccinated. They stayed up all hours, constantly refreshing their internet browsers in hope of nabbing an elusive appointment as soon as a slot opened up. We seemed on track to reach the goal of 70% of Americans vaccinated by the Fourth of…


In health care circles, primary care is akin to mom and apple pie. Everyone says they love it. And rightly so; there is a mountain of scientific evidence proving its virtues. Research shows that people who receive primary care are significantly more likely to get preventive care like cancer screenings, flu shots, and counseling related to eating well, exercising, and quitting smoking. Patients with better access to primary care exhibit better health outcomes and management of chronic diseases like diabetes and asthma. …


May is the month for celebrating moms. It’s sometimes said that motherhood is the hardest job, but for some moms, it’s even harder from the moment they give birth. Depending on where she delivers her baby and where she lives, a new mom may have to pay a lot more to give birth. And her race could make the likelihood of serious childbirth complications a lot higher.

Childbirth is the most common reason for hospital admission and is among the most expensive health care events for nonelderly New Yorkers. And prices differ. Across the five boroughs of New York City…


At the beginning of the pandemic, a meme started circulating pointing out that Gen-Xers were built for pandemic times. A whole generation of latchkey kids knew how to stay at home, fend for themselves, and not open the door to anyone. For many people with an income and a stable home environment, working from home for a bit seemed like an experiment. And Millennials — and even younger kids — seemed especially well prepared. They had grown up online, after all. They knew how to do almost everything, including socializing, virtually.

The gravest concerns early in the pandemic were for…


It was just about one year ago that COVID-19 arrived in New York. The first case of COVID-19 was confirmed on March 1st, and New York quickly became an epicenter of the pandemic. Since then, there have been 1.75 million confirmed cases and nearly 50,000 deaths in New York State. Numbers like that are hard to grasp, and behind the numbers are individuals, lives, and families forever changed. And beyond those clinical statistics, there are the human, psychological, and economic tolls. The past year has changed just about everything.

Pre-pandemic, most conversations started with the most casual question: “Hi. How…


Yesterday, the U.S. Senate confirmed Denis McDonough, in an 87–7 vote, as the new Secretary for the U.S. Department of Veterans Affairs. Secretary McDonough is an unusual choice for the position. He is not himself a military veteran (he’s only the second non-veteran to serve as VA Secretary). He also lacks health care experience, which could be a challenge for the person charged with overseeing the single largest health care system in the United States.

So what makes him the right person for this job? He’s an experienced leader with a solid track record of delivering results, and he has…


Throughout the COVID-19 pandemic — now more than 10 months and counting — we’ve rightly been lauding health care workers and other frontline workers as heroes. New Yorkers have taken to their balconies and porches at 7:00 p.m. to bang out symphonies of appreciation on pots and pans. We’ve hung thank-you signs in our windows and planted them in our front yards. We’ve contributed to programs that deliver meals to frontline workers both to boost their spirits and to support local restaurants. But our health care workers need more than cheers and free lunches during this stressful time.

People from…


Photo by Sharon McCutcheon on Unsplash

Her Majesty Queen Elizabeth II referred to 1992 as an “annus horribilis,” Latin for “horrible year.” Why? That was a year that three royal marriages dissolved, a fire destroyed much of Windsor Castle, and there were some tabloid scandals. With typical understatement, she said, “1992 is not a year on which I shall look back with undiluted pleasure.”

Frankly, that all seems like child’s play compared with what we’ve been through in 2020. Since the spring, we have had to face anxiety and uncertainty, hardships, and unprecedented challenges. The COVID-19 pandemic brought great pain and suffering to New York. The…


It appears that the Affordable Care Act (ACA) will survive another near-death experience. It has the dubious honor of being the most challenged law in modern American history. It has faced more than 1,700 lawsuits in lower courts, and Congress has tried more than 70 times to repeal it. Since those assaults failed, the Trump Administration pursued a “death by a thousand cuts” strategy to undermine and weaken the law. Despite all that, the ACA has exhibited remarkable staying power. …

David Sandman

David Sandman, Ph.D., is President and CEO of the New York State Health Foundation. www.nyshealth.org www.twitter.com/DavidSandman1

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