Philip K. Howard

Whatever the Supreme Court decides about the individual mandate, the main battle remains to be fought: how to rein in the grotesque costs of the current system.… More »

The consensus is clear: America's school bureaucracy rots the quality of public education. Here's how we can move forward and reform the system.… More »

Successful schools don't have a formula, other than that teachers and principals are free to follow their instincts.… More »

Our founders didn't anticipate that it would be much harder to repeal a law than pass it in the first place. Here's how we can revise the status quo and build a more efficient democracy.… More »

A conversation with Guido Calabresi, a senior judge on the U.S.Court of Appeals's second circuit, on how outmoded legislation can be cleanly wiped from the books… More »

We elect new representatives, but continue on with policy from decades ago. To go forward, Congress needs to confront the past.… More »

The next president will be impelled and empowered to reform it.… More »

In his own words: "We have to abandon the arrogant belief that the world is merely a puzzle to be solved"… More »

American politics are dominated by narrow special interests. How can our country dismantle this politics of selfishness?… More »

Rather than focus on good reforms, the U.S. government should change its entire legal system… More »

Democracy can't function when essential choices are dictated by laws passed decades ago and armies of special interest groups… More »

Economic reforms are important, but regulatory reforms are also necessary to promote small business.… More »

Containing health care costs seems to me to be a moral imperative. If the experts are right that the inefficiency exceeds $700 billion per year, that's $700 billion that could be used for many critical needs, including restoring fiscal stability to America. Containing costs, as I and others have written, requires realigning incentives for both patients and providers. One source of waste--important but not the largest--is the defensiveness that pervades the…… More »

The Senate health care bill does nothing to address the unreliable malpractice system. Actually, it's designed to prevent fixing the malpractice system. How the bill does this is painfully apparent to me--because I put together the first draft of a malpractice amendment at the request of a Democratic policy expert who deals with members of Congress on these issues. Here's how the reform proposal got transformed into a bulwark for trial lawyers to bar possible…… More »

The big story of the health reform debate is not what the bills provide, but what they don't provide--no liability overhaul and no serious effort at cost-containment. American healthcare may bankrupt the country unless the waste and inefficiency--an estimated 30% to 40% of total costs--is wrung out of the system. The waste is $700 billion to $1 trillion every year. There can be no greater domestic priority. Building a coherent new framework, however, is almost…… More »

James Fallows has an insight on the Fort Hood shootings that I feel is wise: "The shootings never mean anything. Forty years later, what did the Charles Whitman massacre 'mean'? A decade later, do we 'know' anything about Columbine? There is chaos and evil in life. Some people go crazy." I would add that the felt need to learn a lesson from individual madness often leads to institutionalized madness--as with the "zero tolerance" rules that sprouted up in…… More »

The President committed in his speech to Congress to promote pilot projects to solve the problem of defensive medicine. "I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs," he stated. "So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine." Creating special health courts is the proposal advanced by most serious observers…… More »

President Obama took an important step away from special interest politics when he committed to changing justice to solve the problem of defensive medicine in his address to Congress. "I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. I know that the Bush administration considered authorizing demonstration projects in individual states to test these ideas. I think it's a good idea, and I'm directing my…… More »

It is incredible to me that, amid public concern over the leading healthcare proposals, congressional leadership continues to stonewall any discussion of legal overhaul. They have effectively left the field open to Republicans, who now have seized the center with proposals for special health courts and other ideas that enjoy broad support from almost all healthcare constituents, including consumer groups and patient safety advocates. See here, here and here. I know…… More »

For the past few weeks, I've been talking with healthcare experts with a variety of perspectives, trying to discover coherent principles for overhauling American healthcare. This requires, in my view, testing every idea against its likely effect on the real people who provide healthcare services and on the real people who need those services. What's ultimately required is to change the culture of healthcare delivery. Congress doesn't seem to be tethered to the…… More »