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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.

In Health Care, U.S. Spends More For Less And Lags In Implementing IT

In 2003, despite its relatively young population, the United States spent $5,635 per capita on health care -- almost two-and-a-half times the median for industrialized nations, Gerard Anderson and coauthors write in the May/June Health Affairs. Those extra dollars went to pay higher prices, not to purchase additional health care: the U.S. had fewer physicians, nurses, hospital beds, and MRI machines than other industrialized-countries.

Moreover, the authors warn, the United States lags as much as a dozen years behind other OECD nations in adopting health information technology (HIT), which has been highly touted as a way to reduce costs and increase quality. In other industrialized nations, the cost of implementing HIT has been borne by the government or health insurers, or both.

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

Hip And Knee Replacements Less Expensive Than Ever, Says Industry Executive

The cost of orthopedic implants themselves might be going up, but the total costs of replacing a hip or a knee joint is going down, according to the former president and CEO of an implant manufacturer.

Dane Miller, who headed Biomet until March 26, makes this point in an interview published May 18 on the Health Affairs Web site. Medicare spending on implant cases has gone up over the past few years, but Miller argues for increasing reimbursements. "We're putting people back on their feet," he says.

Expensive Biotech Drugs Are Worth It, Says CalTech President

Is it worth paying for biotechnology products that carry large price tags and benefit relatively small groups of patients? It is according to David Baltimore, the biotech pioneer and retiring president of the California Institute of Technology.

His answer might be different if he "were in an underdeveloped country where resources were a very limiting factor," Baltimore says in an interview published May 16 on the Health Affairs Web site. But "we're in a highly developed country where it's a matter of, 'Do you spend the money to keep a few people alive, or do you spend the money on something crazy like the war in Iraq?'"


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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