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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.

As Elections Approach, Health Care Is A "Second-Tier" Issue

Americans say that high costs and the lack of insurance and access to care are the most pressing health care problems for government to address, Robert Blendon and coauthors report in an article published October 17 as a Health Affairs Web Exclusive. Writing a month before the 2006 congressional election, the researchers also say that health care overall is a "second-tier issue" for the American public, ranking behind Iraq, the economy, and gasoline prices as a priority for government action. However, health care still ranks higher today than issues such as education, the environment (including global warming), Social Security, poverty, and crime.

Speeding Personalized Medicine Requires Scientific And Economic Steps

In the five years since the sequencing of the human genome, the movement toward personalized medicine has been slower than expected, and both scientific and economic challenges will have to be overcome if that is to change, Lou Garrison of the University of Washington and M.J. Finley Austin of F.Hoffmann-La Roche say in the Sep/Oct Health Affairs. On the scientific front, pharmacogenetics-based diagnostics and drugs are unlikely to be linked in large numbers until we develop much greater knowledge concerning the actual predictive power of biomarkers; this will require substantially greater public investments in both basic and translational research, according to the authors. On the economic front, the two authors stress the need for value-based, flexible pricing systems, backed by strong, consistent, intellectual-property rules.

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

Health IT, Pay for Performance Debated on Health Affairs Blog

Ashish Jha of Harvard University weighs in on a health IT discussion related to his paper benchmarking electronic health records for physicians and hospitals.

Gail Wilensky on health reform and P4P: "Having just finished participating in a two-year IOM study on P4P, I can tell you that the challenges of putting in place such a comprehensive measurement system are more than formidable."

Fitzhugh Mullan on the importance of the policy narrative: "The Narrative Matters section in Health Affairs was conceived in 1999 with the explicit intent of bringing personal experience into health policy debates. We believe that stories are quintessentially human, powerful, instructive, and, all said, unavoidable."

Coming up: Biotech drug pricing


Health Affairs, published by Project HOPE, is the leading journal of health policy. The nonpartisan, 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. The Sep/Oct 2006 issue was supported principally by the Blue Shield of California Foundation with additional support from Amgen and Genentech. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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