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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

May-June Health Affairs Focuses On "Mental Health: Progress and Pitfalls"

State and local budget pressures and a surge in efforts to contain Medicaid spending have led to a "noticeable erosion" in community-based services for low-income people with serious mental illnesses, particularly those who lack health insurance, researchers from the Centers for Studying Health System Change report in the in the May/June Health Affairs. The new issue of the journal, released May 9, is a thematic volume focusing on mental health.

Lead author Peter Cunningham and his HSC colleagues studied twelve communities around the United States. They say that the erosion in services for the mentally ill has led to emergency room overcrowding, a shortage of psychiatric beds, a shortage of residential housing, and a high prevalence of serious mental illnesses among prisoners and homeless people.

Print editions of Health Affairs may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

Surgeons, But Not Patients, Paying Attention To NY State CABG Report Cards

Heart patients who pick a top-performing hospital or surgeon are half as likely to die as those who pick a poor-scoring provider, Ashish Jha and Arnold Epstein write in the May/June Health Affairs assessing the merits of New York's 15-year-old public report card system for deaths from coronary artery bypass graft (CABG) surgery. Despite this disparity, patients and their cardiologists are not giving top performers more business. However, one in five surgeons who were graded poorly relocated or discontinued practice within two years.

Study Says AMA Data Belie Claims Of Medical Malpractice Premium Crisis

Despite claims by the American Medical Association and others that rising malpractice premiums are driving physicians out of business, self-employed physicians paid lower premiums in 2000 than they did in 1986, according to data from surveys conducted by the AMA itself from 1970 to 2000. In constant 2000 dollars, mean malpractice premiums rose from $5,934 in 1970 to $20,106 in 1986, then declined to $15,478 in 1996, Mark Rodwin and coauthors state in a May/June Health Affairs article that analyzes the AMA data. Premiums rose from 1996 until the AMA discontinued the surveys after 2000; however, in 2000 mean premiums were $18,400, still below the 1986 level and representing only 7 percent of total practice expenses.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free in perpetuity. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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