The law authorizes “the circulation of a digital currency whose value answers exclusively to free-market criteria.”

On June 8, the legislative assembly of El Salvador enacted its “Bitcoin Law,” making the country the first to adopt bitcoin as a legal currency usable for all payments within the country. (For background on the policy, please read my June 7 article in Forbes.) The full text of the law, in English, appears below, with slightly different formatting for clarity. The Spanish version can be found here.

  1. That in accordance with Article 102 of the Constitution of the Republic, the State is under the obligation to promote and protect private enterprise, generating the necessary conditions to increase national…


Unprecedented tax increases in the New York Health Act would impose job losses, wage reductions, and higher costs on low-income workers.

Photo: Rob Martinez / Unsplash

In New York state, efforts to abolish private health insurance and enact a single payer, government-run health care system have steadily advanced. In November 2020, Democrats gained a two-thirds, veto-proof majority in both chambers of the New York state legislature, raising hopes that a single payer bill called the New York Health Act is close to passage.

In 2017, we analyzed an earlier version of the New York Health Act, concluding that it “would require approximately $226 billion in new tax revenue per year, nearly quadrupling the state’s tax burden and leading, at minimum, to the loss of 175,000 jobs…


In an analysis of 31 high-income nations, Asian countries have performed the best.

Photo: Rumman Amin / Unsplash

The COVID-19 pandemic has been a challenge for the entire world. But, clearly, some countries are performing better than others. What can we learn from those that have done well — and also from those who have done poorly?

These questions animated the pandemic response measure in the FREOPP World Index of Healthcare Innovation, a comprehensive look at health care systems in 31 high-income countries.


A new bill introduced in Congress would expand health insurance coverage while reducing costs and increasing innovation.

Sen. Mike Braun (Ind.) co-sponsored the Fair Care Act of 2020. (Photo: Sen. Mike Braun)

In Washington, it is commonly thought that the debate about health care reform is hopelessly partisan and ideologically intractable. But a group of congressmen, including Sen. Mike Braun (Ind.), Rep. Bruce Westerman (Ark.), Rep. Jim Banks (Ind.), Rep. Denver Riggleman (Va.), and Rep. Lloyd Smucker (Pa.), have produced an ambitious and far-reaching health reform bill, the Fair Care Act of 2020, that could provide the basis for bridging these conventional divides.


Younger Americans appear to have a significantly lower chance of dying from COVID-19 than they do of more common infectious diseases.

Photo: Eye for Ebony / Unsplash

(Due to high demand, this article is regularly updated. The analyses discussed below are based on CDC data as of January 27, 2021.)

As Americans struggle to understand the risks of COVID-19 relative to other infectious diseases, a common benchmark is influenza, commonly known as the flu. So what is the relative risk of dying from COVID-19 vs. the flu? The answer: it depends on your age, and also your assumptions about how deadly COVID-19 will turn out to be.

However, based on mid-range assumptions, it appears that those under 15 have a significantly lower risk of dying from COVID-19…


Congress and federal regulators have obstructed biosimilar competition, increasing patient costs by over $30 billion.

Photo: National Cancer Institute / Unsplash

By Gregg Girvan and Avik Roy

Executive Summary

The U.S. spends well more on prescription drugs, per capita, than any other country in the world. This has long been a source of concern for American patients struggling to afford their medicines.

There are, however, those who argue that high drug prices are justified by a “social contract” under which drug companies can—and should—charge high prices while their drugs are protected by patent monopolies, in exchange for those medicines becoming effectively free once their patents have expired.

That social contract—while never perfect—works reasonably well for traditional, chemically synthesized, small molecule drugs. For these…


The UAE’s two largest emirates have achieved universal coverage. Will the others follow?

Photo: Fredrik Ohlander / Unsplash

The United Arab Emirates ranks 22nd in the World Index of Healthcare Innovation, with an overall score of 44.68. UAE scored highest on Fiscal Sustainability (#4, 72.61), owing to its low debt-to-GDP ratio of 19.7%, and its low public spending growth.

UAE’s heterogeneous system performed poorly in Choice (#28, 32.71) and Science & Technology (#29, 22.77), despite efforts by the Emiratis to attract foreign medical investment.

The United Arab Emirates is a confederation of seven emirates—Dubai, Abu Dhabi, Sharjah, Ras al-Khaima, Ajman, Fujairah, and Umm al-Quwain—of which the first three represent 96.5% of the population. …


Slovakia suffers from limited health insurance choices and poor health outcomes.

Photo: Martin Katler / Unsplash

By Gregg Girvan and Avik Roy

Slovakia ranks 26th in the World Index of Healthcare Innovation, with an overall score of 41.36. Slovakia performed strongest in Fiscal Sustainability (#11, 59.80), owing to its low cost of care.

On the other hand, Slovakia performed poorly in Science & Technology (#23, 27.46) and Quality (#29, 43.70) due to its poor standing in medical infrastructure, lack of patient-centered care, and poor health outcomes.

Prior to World War I, Slovakia was part of the Austro-Hungarian Empire, which in 1887 instituted a health care system similar to the one installed by Otto von Bismarck…


Switzerland’s universal system of individually-purchased health insurance is a model for U.S. reform.

By Gregg Girvan and Avik Roy

The Swiss health care system ranks first overall out of 31 countries ranked in the World Index of Healthcare Innovation, with a score of 59.56, just ahead of second-ranked Germany and third-ranked Netherlands.

Switzerland scored well across the board, but especially in Quality (#1, 73.35), thanks to a high degree of patient-centered care and high-quality infrastructure; and Fiscal Sustainability (#5, 71.06), owing to its low debt-to-GDP ratio of 14.5% and its lower dependence on public financing.

Switzerland ranked fifth for Choice (46.53), because it allows for freedom of choice both of providers and payers…


Portugal’s partly private system boasts excellent quality, but struggles to find a sustainable fiscal footing.

Photo: Tania Mousinho / Unsplash

By Gregg Girvan, Mark Dornauer, and Avik Roy

Portugal ranks 21st in the World Index of Healthcare Innovation, with an overall score of 44.82. The Iberian nation is a top-tier performer in Quality (#3, 69.22), garnering high marks for patient-centered care and health outcomes.

Portugal’s ranking was hampered by poor scores for Science & Technology (#25, 27.01) and Fiscal Sustainability (#27, 42.88). Portugal is not a major engine of scientific discovery, and its 128% debt-to-GDP ratio of 128% is the third-highest among WIHI countries, only behind Japan and Greece.

The modern Portugal health care system was founded in 1979…

Avik Roy

President, The Foundation for Research on Equal Opportunity (@FREOPP). Policy Editor @Forbes. Sr. Advisor @BPC_Bipartisan. Pronounced “OH-vick” (thanks mom).

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