Public Health

Making Stories Visible: The Task for Bioethics Commissions


Meera Lee Sethi, Adam Briggle


Narrative explanations can help us understand difficult scientific issues, but they can also mislead us. Critical skepticism is always appropriate. A little before lunchtime on December 6, 1957, when the United States made its first attempt to match the triumph of Russia’s Sputnik 1 by launching its own Vanguard TV3 satellite into orbit around Earth, […]




This article is in Energy Update, Winter 2011

The Path to Continuously Learning Health Care


Robert Saunders, Mark D. Smith


The United States has a timely opportunity— and pressing need—to build a smart health care system that provides best care at lower cost. Here’s how. Health care in the United States has experienced an explosion in biomedical knowledge, dramatic innovations in therapies and surgical procedures, and expanded capacity to manage conditions that previously were debilitating […]




This article is in Health Care That's Not for Dummies, Spring 2013

Where Are the Health Care Entrepreneurs?


David M. Cutler


The United States lacks a culture of organizational innovation in health care. As we begin to implement the new health care law, there’s a lot we can do to change that. Health care in the United States is notorious for market imperfections. Costs are higher and outcomes worse than almost all analyses of the industry […]




This article is in The Need for Geoengineering Research, Fall 2010

Personal Health Records: Why Good Ideas Sometimes Languish


Amitai Etzioni


Sigmund Freud has the key to understanding how deep-rooted and often unacknowledged resistance can thwart the implementation of popular and meritorious innovations. At first blush it would seem that maintaining a personal health record (PHR) has many merits. Almost everyone would want to have health information about themselves readily available in a digital format and […]




This article is in Making College Affordable, Summer 2010

Better U.S. Health Care at Lower Cost


Arnold Milstein, Helen Darling


We know what steps must be taken to improve the performance of the health system. Now we must develop the political will. In the United States, the amount of money spent on health care by all sources, including government, private employers, and individuals, is approximately $7,500 a year per person. In other advanced industrial nations, […]




This article is in Better U.S. Health Care at Lower Cost, Winter 2010

From Human Genome Research to Personalized Health Care


Gilbert S. Omenn


The potential is widely recognized, but much more knowledge is needed to make the science clinically useful. “Big Science” in the life sciences was launched in 1986 with a bold plan to develop the technologies to determine the sequence of the 3 billion nucleotide base pairs (letters of DNA code) in the human genome. The […]




This article is in What Science Can Do, Summer 2009

Electronic Health Records: Their Time Has Come


Don E. Detmer


After almost two decades of advocacy, the health care system might finally be ready to take full advantage of information technology to improve quality and efficiency. In 1991, when portable computers were the size of sewing machines and the World Wide Web was aborning, the Institute of Medicine proposed a plan for how emerging technologies […]




This article is in What Science Can Do, Summer 2009

Tapping Talent in a Global Economy: Biomedical Enhancements: Entering a New Era


Maxwell J. Mehlman


Products and services to boost performance, appearance, or capability are here to stay, and better, more sophisticated ones are on the way. Banning them would be misguided, but regulation will be needed. Recently, the Food and Drug Administration (FDA) approved a drug to lengthen and darken eyelashes. Botox and other wrinkle-reducing injections have joined facelifts, […]




This article is in Tapping Talent in a Global Economy, Spring 2009

Global Bioethics: Hopes, Fears, and New Voices


Jennifer Liu, Deborah Gardner


As science increasingly crosses borders, so do the implications of deeply personal health sciences. Can new voices help in bioethical dialogue? During the 1990s, James Grifo, a physician and researcher at New York University, had been working to develop a technique to help treat certain kinds of infertility. Although in vitro fertilization (IVF) treatments had […]




This article is in Applying New Research to Improve Science Education, Fall 2012

Time to Act on Health Care Costs


Peter Orszag


Near-term changes to the consumer and provider sides of health care financing are essential to prevent the nation from being overwhelmed by rapidly rising health care expenditures. Popular discussions of the long-term fiscal challenges confronting the United States usually misdiagnose the problem. They typically focus on the government expenses related to the aging of the […]




This article is in Health Care Touchstones: Cost and Quality, Spring 2008

Eight Questions for Drug Policy Research


Mark A. R. Kleiman, Jonathan P. Caulkins, Angela Hawken, Beau Kilmer


The current research agenda has only limited capacity to shrink the damage caused by drug abuse. Some promising alternative approaches could lead to improved results. Drug abuse—of licit and illicit drugs alike—is a big medical and social problem and attracts a substantial amount of research attention. But the most attractive and most easily fundable research […]




This article is in Social Science and Environmental Policy, Summer 2012

Learning to Deliver Better Health Care


Elliott S. Fisher


Rigorous study of the most effective ways to deliver care as well as what care works best can result in not only better treatment but also significant cost savings. Most Americans assume that the health care they receive is determined by firm medical evidence, that the practice of medicine is fundamentally scientific. But this is […]




This article is in Health Care Touchstones: Cost and Quality, Spring 2008

Perspective: Medical Devices: Lost in Regulation


Paul Citron


The implanted medical device industry was founded in the United States and has been a major economic success and the source of numerous life-saving and life-improving technologies. In the 1950s and 1960s, technological innovations such as the cardiac pacemaker and prosthetic heart valve meant that thousands of suffering Americans had access to treatment options where […]




This article is in The Energy/Climate Complex, Spring 2011

From Medical Malpractice to Quality Assurance


Frank Sloan, Lindsey Chepke


A properly designed malpractice insurance system could actually decrease the prevalence of errors and enhance the overall level of care. Every decade or so, the United States is seized with a fervor to reform medical malpractice. Unfortunately, this zest is typically motivated by circumstances that have little to do with the fundamental problems of medical […]




This article is in Health Care Touchstones: Cost and Quality, Spring 2008

Real Numbers: Why Don’t U.S. Women Live Longer?


Barney Cohen


Over the past 25 years, female life expectancy at older ages has been rising in the United States at a slower pace than has been achieved in many other high-income countries, such as France, Italy, and Japan. Consequently, the United States has been falling steadily in the world rankings for level of female life expectancy, […]




This article is in The Energy/Climate Complex, Spring 2011

Dealing with Disability


Marilyn J. Field, Alan M. Jette


Disabilities will touch nearly everyone in some manner. Here’s a plan for preparing the nation for this future, but choices should not be put off. Between 40 million and 50 million people in the United States—at least one in seven residents—currently report having some kind of disability that limits their daily activities or restricts their […]




This article is in Ending the Inertia on Energy Policy, Winter 2008