Every so often someone asks me one of the questions I hate: “What is the most important and under-discussed health policy issue right now?” or some variant thereof.
I hate it because of how I’m wired, not because it’s a bad question. The truth is, just about every health policy issue of import right now is a variant of an issue that has been important for decades and isn’t going away anytime soon either, whether under-discussed or not. My brain just isn’t as tuned to what’s hot and under-discussed as to what’s interesting (to me) or important (for one reason or another) all the time.
This got me thinking, just what is it that I find interesting and important all the time? These would naturally be the issues that attract me to whatever papers I pull from the dozens of journal tables of contents I receive each week. Some papers are must reads (to me). Others I pass up.These are also issues I’m very likely to write about again and again.
In no particular order, here’s the list I’ve been making on subject areas I almost always care about, with some notes on whether I think each is broadly important for policy or mostly just interesting to me (because I’m weird):
- Medicaid access—important
- Narrow networks—important
- ACO performance—important
- Effects of payments level and manner on health care quality and outcomes—important and basically a generalization of interest ACOs
- Wellness programs, specifically how they affect health and spending—important. Many companies really are interested in or implementing these. They ought to really care what the impacts are.
- Consolidation in the health care market (horizontal and vertical) and implications—important
- Medicare advantage market, growth, value, costs, including premium support-like reforms—important
- Part D market—important
- Consumer decision-making in health insurance markets—interesting. I just don’t see results of work in this area binding on policy, but I could be wrong.
- Cost shifting—interesting
- Reference pricing—important
- The opioid epidemic—important
- Hospital or health sector productivity—interesting
- Comparative effectiveness, cost effectiveness, and the management of health care technology—important
- Observational methods for causal inference/big data—interesting
- Labor market and health care (job lock, premium-wage trade-off)—interesting
- Consumer directed health plans—important
- Quality measurement and incentives—important
- Management of and leadership in health care—interesting
- Data access for research—important
- Placebo effects—interesting
- Any clinical area with which I have personal experience as a patient (insomnia, kidney stones, etc.)—interesting
- Scientific communication—important
I probably forgot some things I’m actually interested, and have revealed as much in my posts. If you think so, remind me! Also, maybe you think I should find something not on this list to be important or interesting enough to pay close attention to. If so, what is it? Tell me on Twitter or by email.
