Where is the sharp end and how did we get here?

Where is the sharp end and how did we get here?

As a definition, ‘the sharp end’ of medicine suggests to me an acute new illness and the period of decompensation of a chronic disease. Working with this group of patients is both fascinating and challenging. A decade ago, their management was typically an addition to the work of the general physician with a specialty interest. While the lion’s share of this work is still handled by the on-take...

How did we get here and where are we going?

How Did We Get Here?

W hen we talk among ourselves about our business, we use lots of abbreviations and acronyms. We take a lot of things for granted. To understand what I’m talking about all you need to do is try to explain how you get paid to somebody. AWP, WAC, discount, PBM, RA, EOB, DIR, copay, insured amount, rebate, clawback, etc. This is the barrier we face when talking to legislators. We are in a complicat...

How did we get here?

I t is rare that science owes a debt to law. To lawmakers, surely, such as those who regularly make generous appropriations to the National Science Foundation and the National Institutes of Health. But law, in the sense of the process and products of litigation? It’s hard to imagine. But this special supplement is deeply in debt to law in just that sense. The funding that supports the research ...

1 How Did We Get Here ?

The past three decades have seen an extraordinary transformation in the conduct of monetary policy. In the 1970s, inflation had risen to very high levels, with most countries, including the United States, experiencing inflation rates in the double digits. Today, almost all nations in the world are in a low inflation environment. Of 223 countries, 193 currently have annual inflation rates less t...