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A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, largely because of greater use of medical technology and higher prices, compared to other high-income countries. By benchmarking the performance of the U.S. health care system against other countries — and updating with new data as they become available — we can gain important insights into our strengths and weaknesses and help policymakers and delivery system leaders identify areas for improvement. (Tikkanen and Abrams, 1/30)

The share of Americans who say they cannot afford to see a doctor has increased over the last two decades, even with some coverage gains stemming from the Affordable Care Act. Working-age adults who reported being unable to see a physician due to cost increased from 11.4% in 1998 to 15.7% in 2017, according to a new analysis of nationwide survey data collected by the Centers for Disease Control and Prevention. The findings were published Monday in JAMA Internal Medicine. (Johnson, 1/27)

Using data from US adults aged 18 to 64 years in 1998 (n = 117 392) and in 2017 (n = 282 378) who responded to the Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System, this study found that from 1998 to 2017 the inability to see a physician because of cost increased 2.7 percentage points owing to worsening access to care among the insured. In contrast, the proportion of chronically ill adults receiving checkups did not change; results for receiving guideline-recommended preventive services were mixed. (Hawks et al, 1/27)

Eating fermented soy products may reduce the risk of premature death, researchers report. Some soy products, like tofu, are not fermented. But others — miso, natto and tempeh, for example — are made using bacteria or mold in a fermentation process. Soy sauce, if made in the traditional way, is also fermented. The study, in BMJ, followed the diets and health of 92,915 Japanese men and women aged 45 to 74 for an average of 15 years. During this time, 13,303 of the study participants died. (Bakalar, 1/29)

The Democratic presidential primary campaign featured extensive discussions of different health care reform proposals. As Democratic primary voters in early primary states begin casting their ballots to select their nominee, the latest KFF tracking poll finds that a majority of Americans favor a national Medicare-for-all health plan (56%) but a larger share favors a government-administered “public option” (68%). Notably, nearly half of adults (48%) favor both of these proposals. (Lopes, 1/30)

Providing a disposal method nudged parents to dispose of their children’s leftover opioids promptly after use, whereas STOMP boosted prompt disposal and reduced planned retention. Such strategies can reduce the presence of risky leftover medications in the home and decrease the risks posed to children and adolescents. (Voepel-Lewis, 1/1)

harmaceutical companies spend more on clinician office visits (also known as detailing) and free drug samples (also known as sample closets) than any other forms of professional marketing in the United States (totaling $18.5 billion in 2016). Detailing and free samples affect prescribing quality and expenditures, often by promoting new and expensive brand-name drugs over equally effective, older, and less expensive options. Some hospitals and medical centers have restricted these activities. We surveyed a national sample of US outpatient practices delivering primary care to determine the prevalence of detailing and sample closets. (King et al, 1/27)

A new CMS-funded study suggests surgeons are overpaid for certain bundled procedures and proposes a solution it says could save the agency billions of dollars annually. The New England Journal of Medicine report found that just a fraction of post-operative visits the CMS pays for as part of procedure bundles actually take place. The report says reducing the payments accordingly would have saved Medicare $2.6 billion in 2018 by decreasing payments for 10- and 90-day global procedures by 28%. (Bannow, 1/22)