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Why California’s Proposition 61 Was a Bad Idea

New approaches to control state pharmaceutical costs are needed.1 This issue is particularly critical in California, the state with the largest pharmaceutical expenditures in the country.1 A controversial California ballot initiative aimed at reining in prescription drug expenditures was defeated on November 8, 2016 by a 54% to 46% margin.2The California Drug Price Relief Act, also known […]

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stethoscope on a graphic of the U.S.A.

Healthcare Disparities Affecting Americans in the US Territories: A Century-Old Dilemma

In 1917, the Jones Act granted US citizenship to natives of Puerto Rico, the first among the 5 territories acquired by the United States since 1898.1 A dilemma in that early period—“Does the Constitution follow the flag?”—was addressed in several cases considered by the Supreme Court between 1901 and 1932, known as the “Insular Cases.”2 These decisions ultimately […]

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The Hippocratic Oath, the US Health Care System, and the Affordable Care Act in 2015

  The original confines of medical knowledge under which the Hippocratic Oath was created have expanded considerably. Given the evolution of technology over the past 25 centuries, some of the Oath’s stances on issues such as abortion, euthanasia, and surgery have been subject to varied interpretations. However, 2 of its guiding principles have proven universal […]

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Why Are Drug Prices Higher in the US?

On 1000-Fold Pharmaceutical Price Markups and Why Drugs Cost More in the United States than in Mexico On July 15, The Washington Post’s Wonkblog posted a story titled “This $153,000 Rattlesnake Bite Is Everything Wrong with American Health Care,”1 accompanied by a striking photograph depicting ascending hemorrhagic lymphangitis and an image of the associated hospital bill, which included […]

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technology

Advantages of Health System Consolidation

Potential Advantages of Health System Consolidation and Integration A recent editorial in the Wall Street Journal1 decried hospital mergers, citing concerns that consolidation results in higher prices and less choice for patients. While Makary, the editorialist and a surgeon, agrees that quality initiatives might be facilitated through consolidation, he cites several recent court cases wherein […]

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