HispanicPundit + healthcare   733

Socialized Medicine Is Bad for Your Health | National Review
The NHS compensates for this problem in two principal ways: first, by centrally controlling the fees that doctors, hospitals, drug manufacturers, et al. receive for their goods and services; and second, by aggressively restricting the consumption of costly services that would otherwise blow up the British health-care budget.
healthcare  single-pay  Britain  NRO 
4 weeks ago by HispanicPundit
Why the Prices Are So Damn High: Reply to Alex - Econlib
I say that when these technological changes come, education will barely change, and health care change only modestly.  Why?  First, because when you’re funded by the government, you have little incentive to cut costs.  Second, even if you want to cut costs, many long-standing regulations (not increasing regulation!) get in the way.

In any case, why isn’t Alex equally willing to predict the “70+ year price trends to reverse” if we deregulate the movement of labor?  Or just slash the education and health care budgets?  I am puzzled by his fatalism in the face of gross government failure.
healthcare  baumol  tabarrok  Caplan 
5 weeks ago by HispanicPundit
Was Obamacare truly evil, or just a missed opportunity? - Econlib
1. Elimination of all tax subsidies, such as the deductibility of health insurance costs.
2. Radical deregulation, including no barriers to market entry, no quality regulations, open borders for doctors, abolishing the FDA, no barriers on the type of insurance that can be offered.
3. Government healthcare would be provided at the lowest cost possible, even if it meant flying Medicaid patients to Thailand. (It probably would not after open borders for doctors, and no barriers to entry.)

I do favor some role for the government. One idea for overcoming the free rider problem is mandatory health saving accounts and catastrophic insurance. (The alternative is letting people who choose not to be insured simply die when they are sick. Even if that’s the right policy, society is not willing to adopt it—so health savings accounts seem like a good second best policy.)
healthcare  Sumner  ObamaCare 
6 weeks ago by HispanicPundit
It's Surprising How Few Countries Have National, Single Payer, Health Care Systems
I'm making an observation about the economics of systems which seem to work in other places. The exemplars we're all asked to look at are not national, universal and single payer. They tend to be either almost hyper-local in their financing if they're single payer or if they're national then they use insurance companies--they're multi-payer. My assumption would be that both single payer and national is just too inefficient. There's neither local pride nor profit lust keeping the system efficient.

There are indeed national and single payer systems out there, most notably the National Health Service in Britain. That's very fair, very equitable, but performs horribly on "mortality amenable to health care" which is otherwise known as curing people of what ails them. That's not a recommendation.
healthcare  single-pay  nationalize  Britain  nordic  forbes 
6 weeks ago by HispanicPundit
A Closer Look at Adverse Selection and Mandatory Insurance - Econlib
Bottom line: Real-world insurance regulation has little or nothing to do with economists’ “moral hazard and adverse selection” mantra.  The “intellectual” bases of real-world regulation of insurance are rather populism and paternalism: Big bad insurers won’t cover people unless it’s profitable, and simple-minded consumers don’t care enough about their own health to pay for it themselves. 

Contrary to e.g. Krugman, insurance isn’t a “special” market where laissez-faire doesn’t work.  Instead, it’s a normal market where democratic politics doesn’t work, because both the public and economists remain wedded to populism and paternalism.
healthcare  market-failure  Politics  Krugman  Caplan 
6 weeks ago by HispanicPundit
Long-Run Health Care Cost Drivers
On health care issues, you see, economists divide into two subtribes depending on whether they think the big problem with America's health system today is adverse selection or moral hazard--two terms from the insurance industry.

Those economists on the left tend to think that the real big problem with American health care is adverse selection: Those who know they are healthy and likely to stay that way skimp on purchasing insurance. Insurance companies work like dogs to avoid selling insurance to people who are expensively sick or likely to get expensively sick. As a result, a huge amount of people's work-time and information technology processing power are wasted on the negative-sum game of trying to pass the hot potato of paying for the care of the sick to somebody else. The more people separate themselves or are separated into smaller and smaller pools with calculably different exposures to risk, the worse this problem gets. The way to solve it is to shove people into pools as big as possible. Ultimately, this line of thought goes, single-payer national health insurance is the best option, for the administrative and bureaucratic inefficiencies introduced are vastly outweighed by the reduction in the gaming the system that goes on under our current plan where profits are made by those insurance companies that are best able to avoid covering the sick.

Those economists on the right tend to think that the real big problem with American health care is moral hazard: that patients soak up scarce and valuable doctor and nurse time even when there is no benefit to the visit, and that doctors use up vast resources conducting tests and procedures that do patients very little good. And, this side argues, patients do this because their copays don't penalize them enough for wasting health professionals' time and doctors do this because their bottom lines don't suffer when they carry out barely effective, expensive, and inappropriate procedures. Sometimes economists on this side say these market failures are all the government's fault: the subsidy the government provides for low-deductible and first-dollar insurance. Sometimes economists on this side say that these market failures arise because of human irrationality: we half-intelligent jumped-up East African Plains Apes have a psychological propensity to overvalue certainty and thus to pay much more for first-dollar and low-deductible health insurance than we should.
healthcare  costs  libertarianism  foundational  DeLong 
7 weeks ago by HispanicPundit
What I Told the Liberaltarians - Econlib
There are two health policies that liberals and libertarians would both prefer to the status quo.  The first is a free market plus redistribution for the poor.  The second is bare bones, high-deductible national health care, with a free market for all add-ons.

The reason neither are likely to happen is mistrust.  Liberals think that if they sign on for the free market plus redistribution, the redistribution won’t actually happen.  Libertarians think that if they sign on for bare bones national health care, the cost will quickly increase.
healthcare  libertarianism  Liberalism  fundamentals  foundational 
7 weeks ago by HispanicPundit
(82) Pro-Government and Pro-Market Edition | Robert Wright & Brink Lindsey [The Wright Show] - YouTube
Brink Lindsey and Wright discuss the 2020 election, on why healthcare is so expensive in USA vs Europe, the liberal democratic capitalism model, education.
campaign2020  healthcare  Europe  costs  podcasts  bloggingheads  Wright  lindsey  youtube  capitalism 
8 weeks ago by HispanicPundit
Why the Prices Are So Damn High: A Deeper Look - Econlib
Let’s start with the obvious: government spends an enormous amount on both education and health care.  This spending has dramatically increased over time.  Imagine, then, what would have happened if government had practiced extreme austerity instead.  Demand for labor in education and health care would clearly have increased far less, so wages in these industries would have risen far less, so the prices in these sectors would be much less damn high.  So while Helland and Tabarrok are not wrong to invoke the Baumol effect, they are wrong to fail to blame government for dramatically amplifying it.  If paying customers bore the full financial burden of education and health care, prices could easily fall by 50% or more.
Education  costs  healthcare  tabarrok  Caplan  baumol 
10 weeks ago by HispanicPundit
Rationally Speaking | Official Podcast of New York City Skeptics - Current Episodes - RS 236 - Alex Tabarrok on "Why are the Prices So D*mn High?"
The argument that the lack of drastic productivity gains in professional industries like healthcare and education are the primary reason for the long rise in costs vs other theories.
productivity  healthcare  costs  Education  free-college  tabarrok  podcasts  RationallySpeaking  baumol 
11 weeks ago by HispanicPundit
Will price transparency in health care markets work? - Marginal REVOLUTION
The scholarship suggests that more transparency in health care could backfire, causing prices to rise instead of fall…
healthcare  costs  TrumpAdministration  Cowen 
june 2019 by HispanicPundit
The White House Says Socialism Is a Threat. It’s Right. - Bloomberg
And though some critics have mocked the point, the idea that, all things considered, consolidated government control is cheaper than a market-based system does in fact come from socialist and communist thinkers. What’s more, implementing that view is likely to stymie innovation for the same reasons that socialism does more broadly. Arguably well-functioning mixed systems produce the greatest innovation, as illustrated by the connections between the military and Silicon Valley, or for that matter the National Institutes of Health. The health-care bills under consideration move much too far in the direction of government control.
healthcare  Socialism  TrumpAdministration  Cowen 
october 2018 by HispanicPundit
The Grumpy Economist: Supply-side health care
Fixing the supply of health care strikes me as the policy win-win. Instead of the standard left-right screaming match, "we're spending too much," "you heartless monster, people will die," a more competitive health care market giving us better service at lower cost, making a cash market possible, makes everyone's goals come closer.
healthcare  costs  cochrane 
september 2018 by HispanicPundit
The Grumpy Economist: Options on health insurance
For newcomers to this blog, guaranteed renewability and the option to buy health insurance is the key to escaping the preexisting conditions problem in a free market for health insurance. I'm delighted to see the idea take hold, if at the edges. Great tress grow from saplings.
healthcare  insurance  ObamaCare  cochrane 
august 2018 by HispanicPundit
The Grumpy Economist: Cross-subsidies
Cross-subsidies are an under-appreciated original sin of economic stagnation. To transfer money from A to B, it would usually be better to raise taxes on A and to provide vouchers or otherwise pay competitive suppliers on behalf of B. But our political system doesn't like to admit the size of government-induced transfers, so instead we force businesses to undercharge B. Since they have to cover cost, they must overcharge A. It starts as the same thing as a tax on A to subsidize B. But a cross-subsidy cannot withstand competition. Someone else can give A a better price. So our government protects A from that competition. That ruins the underlying markets, and next thing you know everyone is paying more for less.
economics  fundamentals  Airlines  healthcare  cochrane 
june 2018 by HispanicPundit
Fake Indian, fake research: New study debunks Elizabeth Warren's signature 'scholarship'
The new study finds that a whopping, 4% – repeat, 4% – of all bankruptcies among the non-elderly are for reasons of hospitalizations.  For the uninsured, the rate was 6%.  The rest are for overspending on credit cards, etc.  Warren's research claimed that 60% of all bankruptcies in that group were for hospitalization expenses.  Where did she get that figure?  Apparently, out of the air.
bankruptcy  ObamaCare  healthcare  costs  AmericanThinker 
march 2018 by HispanicPundit
Fact-Based Health Care Reform - The American Interest
The harmful impacts of this ill-conceived approach are now well documented: Insurance premiums have skyrocketed; many insurers have withdrawn from the state marketplaces; and for those with coverage, doctor and hospital choices have narrowed dramatically. The ACA will also undoubtedly accelerate the development of the kind of two-tiered health care system characteristic of other nationalized systems, where people with money or power are able to circumvent the substandard government systems that the lower classes must endure. The result will be an end to the superior access, broad freedom of choice, and exceptional quality of care that distinguishes American health care from the centralized systems that are failing the world over.
ObamaCare  healthcare  fundamentals  AmericanInterest 
january 2018 by HispanicPundit
American health equality is rising - Marginal REVOLUTION
Recent research shows increasing inequality in mortality among middle-aged and older adults. But this is only part of the story. Inequality in mortality among young people has fallen dramatically in the United States converging to almost Canadian rates. Increases in public health insurance for U.S. children, beginning in the late 1980s, are likely to have contributed.
healthcare  mortalityrates  Inequality  cowen  Canada 
december 2017 by HispanicPundit
Intellectual fallout from the likely failure of Graham-Cassidy - Marginal REVOLUTION
Of course my points #1 and #2 relate.  I agree Graham-Cassidy is a bad idea, but every time I hear the critics say it is heartless, or would “take away” people’s health insurance, or “kill people,” what I really hear is “If we let everyone vote again on Obamacare, with a real time balanced budget constraint, they wouldn’t vote for nearly as much health care next time around.”

Which is why you should not be obsessing over single-payer systems.
healthcare  single-pay  cowen 
september 2017 by HispanicPundit
The Grumpy Economist: Single payer food?
Scott reveals deeply the deliberate confusion among "progressives," between your right to do something, to purchase a good or service from another, and an "entitlement" to have the Federal government pay for it by taxing others. No, you do not lose "access" to something just because you have to earn the money to pay for it. But by deliberately confusing the issue, and repeating the mantra over and over, they can ride the moral authority of the former to the illogical conclusion of the latter.
progressive  liberalism  insurance  healthcare  cochrane 
june 2017 by HispanicPundit
How much do people value health insurance? - Marginal REVOLUTION
For at least 70 percent of the low-income eligible population, we find that willingness to pay for insurance is far below the average cost curve – what it would cost insurers to provide coverage to all who would enroll if the premium were set equal to that WTP. Adverse selection exists, despite the presence of the coverage mandate, but is not the driving force behind low take up. We estimate that willingness to pay is only about one-third of own costs; thus even if insurers could offer actuarially fair, type-specific prices, at least 70 percent of the market would be uncovered.
healthcare  coverage  costs  cowen  NBER 
may 2017 by HispanicPundit
Cost of Health Insurance Isn't All About Fairness - Bloomberg
Second, uniform pricing increases the incentive for some insurance policyholders to try to leave the system. To the extent that men are systematically subsidizing women, for instance, men will be less keen to sign up for insurance, even if there is a legal mandate. Many insurance companies think there is a preponderance of high-expense individuals on the exchanges, and so they have been withdrawing their participation, creating a sustainability problem for Obamacare.
healthcare  genderissues  cowen  bloomberg  Trumpcare 
may 2017 by HispanicPundit
UBI and Health Care: What's Wrong With Murray's Approach, Bryan Caplan | EconLog | Library of Economics and Liberty
Regulation #1. UBI recipients must purchase health insurance. 

Regulation #2. "Legally obligate medical insurers to treat the population, of all ages, as a single pool."  Health insurance is still private and competitive.  But if an insurer wants to cut its price, it must cut it for everyone.
BasicIncome  murray  healthcare  caplan 
march 2017 by HispanicPundit
Supply Side Health Care Reform - Marginal REVOLUTION
By greater spending on medical research, I mean not only greater spending through the NIH but also a commitment to innovation policy more broadly. We know, for example, that price controls kill medical research so no price controls. We can also improve the FDA. I would favor less regulation but there are other methods to speed up the approval process which could command bipartisan support such as greater funding of the FDA. The FDA is also not monolithic, some departments are better than others, so we can reform the FDA by making it more like the better parts of itself.
pharmaceuticals  healthcare  tabarrok 
march 2017 by HispanicPundit
Initial thoughts on Obamacare 2.0, Scott Sumner | EconLog | Library of Economics and Liberty
Some libertarians are confused about the "Cadillac tax", which isn't really a tax in the ordinary sense. Rather it essentially removes the government subsidy to health insurance currently provided to the most expensive health care plans. The original hope of reformers was that over time health care inflation would cause this tax to affect more and more health care plans. It was the single best provision of Obamacare, and now the GOP has delayed it until 2025. That tells me that Congress has no intention of ever allowing the tax to be implemented. The delay of the Medicaid reforms until 2020 also leads me to doubt that they will ever be enacted, and in any case they've been greatly watered down, with high spending states now losing only 1/4th of their extra Medicaid spending. This still might be a net plus, but it's a very small one.
TrumPCare  Sumner  healthcare  costs  obamacare 
march 2017 by HispanicPundit
Private versus Public Health Care in India - Marginal REVOLUTION
The bottom line is that the private market for health care is much bigger and less expensive than the public health regime in rural India and once we control for knowledge it’s of higher quality. These results have important implications for reform. In particular, much more effort should go into improving the knowledge of the private sector.
healthcare  India  privatization  cowen 
december 2016 by HispanicPundit
Don't Be Scared of a Health-Insurance Public Option - Bloomberg View
The biggest downside, though, is the possibility that with private insurers eliminated from the market by Medicare-for-all, government costs might creep up faster than they have in recent years. Part of the reason for Medicare’s cost advantage might have come from political pressure to keep prices substantially lower than the private sector. With the private sector reduced to a high-end add-on market, that pressure might go away, and administrative bloat or unresponsiveness to changing technology might send government health costs soaring.
healthcare  single-pay  Smith 
september 2016 by HispanicPundit
Debunking the EPI on the Cadillac tax
Defending the healthcare vs wages trade-off from pro-union EPI.
EPI  healthcare  costs  wages 
april 2016 by HispanicPundit
Is Prostate Screening Worthless? The Icon Box Speaks, Bryan Caplan | EconLog | Library of Economics and Liberty
That's right. Statistically speaking, prostate cancer screening is worthless. Over the course of ten years, 1-in-100 men dies of prostate cancer regardless of screening. 20-in-100 die for any reason, regardless of screening. The only difference: 2-in-100 screened men - and screened men alone - endure hellish treatments, and another 18-in-100 endure milder torments and a false alarm.
healthcare  statistics  costs  caplan  cancer 
august 2015 by HispanicPundit
Is Breast Cancer Screening Worthless? The Fact Box Speaks, Bryan Caplan | EconLog | Library of Economics and Liberty
In plain words, there is no evidence that mammography saves lives. One less women in a thousand dies with the diagnosis breast cancer, but one more dies with another cancer diagnosis. Some women die with two or three different cancers, where it's not always clear which of these caused death.
statistics  healthcare  costs  caplan  cancer 
august 2015 by HispanicPundit
CONVERSABLE ECONOMIST: A Global Health Care Spending Slowdown: Temporary or Permanent?
As I've argued in the past (here and here), U.S. health care spending seemed to slow down in the mid-2000s, well before any cost-constraining measures of the 2010 legislation could take effect. In addition, the slowdown in health care costss has been international, which suggests that changes in U.S. law are not the driving factor. In the December 2014 issue of Finance & Development, Benedict Clements, Sanjeev Gupta, and Baoping Shang offer more explanation on the international dimensions of health care costs in high-income countries in their article, "Bill of Health."
healthcare  costs  obamacare  timtaylor 
december 2014 by HispanicPundit
The Myth of Americans' Poor Life Expectancy - Forbes
A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fatal injuries from the life expectancy tables? Among the 29 members of the OECD, the U.S. vaults from 19th place to…you guessed it…first. Japan, on the same adjustment, drops from first to ninth.
healthcare  Lifeexpectancy  medicare  forbes 
november 2013 by HispanicPundit
Why Not Medicaid For All? - NYTimes.com
Douthat lays out the intelligent, conservative, criticism of the liberal 'single payer' drive for healthcare.
fundamentals  douthat  conservatives  liberalism  healthcare 
october 2013 by HispanicPundit
Agoraphilia: Breaking Bad and the Healthcare System
Eventually, health costs do become an issue when Skyler pressures Walter to undergo treatment after all. But it’s not because his HMO won’t pay. It’s because Skyler finds an oncologist who is not just one of the best in Albuquerque, but one of the top 10 oncologists in the nation. It turns out this super-doctor with his fancy cancer treatment is not covered by the HMO, and the out-of-pocket price is $90,000. Some will say that’s the smoking gun that indicts the U.S. healthcare system. But there is no system in the world that offers high-end care to everyone. The vaunted U.K. and Canadian systems offer care to every citizen, but they don’t offer the best care to every citizen. That’s just not possible.
agoraphilia  healthcare 
september 2013 by HispanicPundit
What Has Caused the Slowdown in Health Care Spending? | John Goodman's Health Policy Blog | NCPA.org
Not ObamaCare. The slowdown occurred before the Affordable Care Act was passed and the growth rate has been flat since then.
goodman  obamacare  sidebar  spending  healthcare 
august 2013 by HispanicPundit
Why We Like Jason Furman | John Goodman's Health Policy Blog | NCPA.org
The impact of such a proposal on health spending by the insured is largely independent of the details. Requiring workers to include employer contributions to premiums would reduce health spending by the insured for two reasons. First, it would eliminate any subsidy at the margin to purchase more generous health insurance. This would encourage people to purchase of more non-health consumption goods and spend less on health insurance. And unlike HSAs, this change would be neutral about how exactly individuals reduce their premiums. Individuals would be free to spend less by engaging in more cost sharing, but they would also be able to spend less by choosing health plans that have more managed care features that reduce utilization.
goodman  furman  sidebar  costs  healthcare 
august 2013 by HispanicPundit
The Grumpy Economist: Health Insurance and Labor Supply
They study an interesting event ... In 2005, Tennessee discontinued its expansion of TennCare, the state’s Medicaid system. ... Approximately 170,000 adults (roughly 4 percent of the state’s non-elderly, adult population) abruptly lost public health insurance coverage over a three-month period. The result was a large and immediate labor supply increase....we find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage.
labor  cochrane  obamacare  sidebar  healthcare 
july 2013 by HispanicPundit
Who Pays For An Employer Mandate?
I think it's fairly easy to reconcile these two pieces of empirical research as saying that in the short-term the incidence falls on employers but in the longer-term employers succeed in shifting it back onto employees. That thought, plus the fact that Gruber & Krueger are both familiar faces in the Obama administration, is what made me confident back in 2010 that the kinks would all get worked out before any harm was done. Now I'm more worried that we're going to get stuck in a kind of dead zone around this where we don't even make minor fixes to things like the 50 employee cliff or changing it to be 50 full-time equivalent employees rather than 50 full-timers. Part of the upshot of conflict empirical research findings, after all, is that the specifics of program design may matter a great deal.
yglesias  mandates  sidebar  healthcare 
july 2013 by HispanicPundit
Which market segment is being targeted by Kaiser in California?
…California is headed for two-tier service on the Exchanges. The carriage trade will head for full-service networks like Kaiser, with full access to the whole network of doctors and hospitals. The price conscious buyers–likely to be a sizeable majority–will crowd into plans with restrictive networks. And those networks will be very, very crowded. Effectively, they may end up as quasi-catastrophic insurance, simply because it will be difficult to actually access care outside of the emergency room. Lower down the income scale, the new Medicaid patients–about half the expected additional coverage in states like California–will be similarly crowded, simply because Medicaid’s low reimbursement rates make doctors reluctant to take it.
cowen  california  sidebar  healthcare 
june 2013 by HispanicPundit
CONVERSABLE ECONOMIST: Why Does the U.S. Spend More on Health Care than Other Countries?
The U.S. spends vastly more on hospitalization and acute care, with a substantial share of that going to high-tech procedures like surgery and imaging. The U.S. does a poor job of managing chronic conditions, which then lead to episodes of costly hospitalization. The U.S. also seems to spend vastly more on administration and paperwork, with much of that related to credentialing, documenting, and billing--which is again a particular important issue in hospitals. Any honest effort to come to grips with high and rising U.S. health care costs will have to tackle these factors head-on.
timtaylor  sidebar  WHO  spending  healthcare 
june 2013 by HispanicPundit
Ideas: International Healthcare Comparisons
By my count, U.S. medical outcomes (including things such as speed of treatment) are superior to U.K. outcomes (in some case English outcomes) on five different measures, inferior on three. On two measures the U.K. (or England) is the worst of the five countries considered, on two the best; on three the U.S. is the best of the five (counting one tied for best), on none the worst. There are four pure outcome measures, mortality and survival rates from various causes. The US was superior to the UK on all of them, best of the five countries on two. The UK was worst of the five countries on two.
friedman  sidebar  WHO  britain  healthcare 
june 2013 by HispanicPundit
Medicare Part D is cheaper than expected because the drug pipeline has dried up.
But this completely misses the main reason Part D has been cheaper than the CBO thought it would: We haven't invented very many new drugs. Over time, existing drugs become cheap because they lose patent protection. Consequently, if newly unpatented drugs aren't replaced by newer and better drugs then drug spending naturally falls. Unfortunately, you also don't get any new and better treatments for disease. And it turns out that some things are worse than high levels of health care spending. Getting sick and dying, for example, is worse.
yglesias  medicare  sidebar  pharmaceuticals  costs  healthcare 
march 2013 by HispanicPundit
The High Price of Doctors: A Disease of Regulation, Bryan Caplan | EconLog | Library of Economics and Liberty
If you're not horrified, consider that the senior population - doctors' best customers - increased by over 50%. As a result, new M.D.s per senior fell by about a third over the last three decades:
caplan  regulations  sidebar  costs  healthcare 
march 2013 by HispanicPundit
Inequality Results Explained | John Goodman's Health Policy Blog | NCPA.org
If you graph health care spending against income you will generally get a U-shaped curve. (See below.) The reason: poor people are sicker and need more health care and since health care is a luxury good, wealthier people spend more on it. An NCPA study found that for Medicare patients, the highest level of spending was among the highest and lowest income enrollees. So where you have inequality (poor and rich bunched together) you will get high spending and where you have equality (everybody’s average) you will have low spending.
goodman  sidebar  inequality  healthcare 
february 2013 by HispanicPundit
What’s Wrong with Pay for Performance? | John Goodman's Health Policy Blog | NCPA.org
This same principle also applies to the practice of medicine. Paying doctors or hospitals based on outcomes would be fine as long as the outcomes can be reliably measured and we know how much each entity contributes. Until that is possible, we run the risk that we will inadvertently punish the good practitioners and reward the bad ones. (Pay for performance wouldn’t be a problem if we actually knew how to measure outcomes and each person’s contribution to it.)
healthcare  goodman  sidebar 
february 2013 by HispanicPundit
Contraceptive Coverage is Probably Not a Freebie for Insurance Companies | Mother Jones
Is it plausible that insurance coverage has such a small impact on contraceptive use? Probably. In fact, my little scenario may have been generous on this score. Last year, Emily Gray Collins and Brad Hershbein of the University of Michigan took advantage of a natural experiment in which the cost of contraceptives tripled for a group of college women. Their conclusion: use of contraceptives dropped by only a few percentage points and there was no evidence of an increase in unintended pregnancies. These results would probably be different among low-income women, but low-income women are also the ones least likely to be covered by employer insurance plans. So it's hard to say what the net impact would be for a typical group policy.
drum  contraceptions  sidebar  costs  moralissues  healthcare 
february 2013 by HispanicPundit
Money Is Fungible, Contraceptive Edition | Mother Jones
And, let's be honest, it is a kludge. There's no such thing as "no cost." If an insurance carrier covers contraceptives, that's a cost they're going to make up somewhere else. And that somewhere else is in the premiums for the main policy. There's really no way around that.
obamafailures  drum  contraceptions  sidebar  moralissues  healthcare 
february 2013 by HispanicPundit
Sweden is Privatizing Health Care | John Goodman's Health Policy Blog | NCPA.org
Despite its reputation as a leftwing utopia, Sweden is now a laboratory for rightwing radicalism. Over the past 15 years a coalition of liberals and conservatives has brought in for-profit free schools in education, has sliced welfare to pay off the deficit and has privatized large parts of the health service…
sidebar  goodman  healthcare  vouchers  sweden 
january 2013 by HispanicPundit
Are health care costs really slowing down?
The New England Journal of Medicine published a paper this week titled “When the Cost Curve Bent,” where researchers from the Center for Sustainable Health Costs suggest that the slowdown happened way before the recession. Their analysis shows — and you can see it in this chart — that excess health-care spending growth (any spending above and beyond potential gross domestic product) began to moderate in the early 2000s:
healthcare  costs  graphs  cowen  sidebar 
august 2012 by HispanicPundit
The Buck Stops Here: Don't Insure Small Items
Cutler on insuring small things: no for consumer electronics, but yes on healthcare???
sidebar  buck  cutler  fundamentals  insurance  healthcare 
july 2012 by HispanicPundit
Saving for Health Care | John Goodman's Health Policy Blog | NCPA.org
In what follows, I will review some of the advantages and disadvantages of the various health savings options, based on a recent post of mine at Health Affairs. But let’s begin by jumping to the bottom line: none of them is ideal. As Mark Pauly and I explained in Health Affairs some time ago, an ideal account is one that does not distort incentives.
healthcare  HSA  goodman  sidebar 
may 2012 by HispanicPundit
Counting benefits does not much change the income stagnation story — Marginal Revolution
To address these second and third concerns, we can turn to a more encompassing measure of household income. The data are from the Congressional Budget Office (CBO). The measure includes all sources of cash income. It adds in-kind income (employer-paid health insurance premiums, food stamps, Medicare and Medicaid benefits), employee contributions to 401(k) retirement plans, and employer-paid payroll taxes. Tax payments are subtracted.

We can use average household income in these data as a substitute for GDP per capita. The CBO data set doesn’t tell us the median income, but it provides something quite similar: the average income of households in the middle quintile of the distribution (from the 40th percentile to the 60th). The following chart adds these two series. The story is virtually identical.
inequality  wages  healthcare  CBO  cowen  sidebar 
march 2012 by HispanicPundit
CONVERSABLE ECONOMIST: Health Care Costs are Eating Your Pay Raise
"To paint an accurate picture of how health care cost growth is affecting the finances of a typical American family, RAND Health researchers combined data from multiple sources to depict the effects of rising health care costs on a median income married couple with two children covered by employer-sponsored insurance. The analysis compared the family’s health care cost burden in 1999 with that incurred in 2009. The take-away message: Although family income grew throughout the decade, the financial benefits that the
family might have realized were largely consumed by health care cost growth, leaving them with only $95 more per month than in 1999. Had health care costs tracked the rise in the Consumer Price Index, rather than outpacing it, an average American family would have had an additional $450 per month—more than $5,000 per year—to spend on other priorities."
healthcare  wages  timtaylor  costs  sidebar 
march 2012 by HispanicPundit
Aborting the contraception policy follies
2. More broadly, it makes little sense for "insurance" to cover small, predictable expenditures. No one does this with their car insurance. The reason they do it with health insurance is because of the tax favoring mentioned above, which overcomes the lost output due to the administrative overhead associated with the insurance system. We should be trying to move away from this equilibrium, not swimming further out into the seething ocean of bad policy design.
sidebar  jeffsmith  abortion  fundamentals  healthcare  contraceptions  catholic 
february 2012 by HispanicPundit
The Grumpy Economist: The Real Trouble With the Birth-Control Mandate
Why should the Department of Health and Human Services (HHS) decree that any of us must pay for "insurance" that covers contraceptives?

I put "insurance" in quotes for a reason. Insurance is supposed to mean a contract, by which a company pays for large, unanticipated expenses in return for a premium: expenses like your house burning down, your car getting stolen or a big medical bill.

Insurance is a bad idea for small, regular and predictable expenses. There are good reasons that your car insurance company doesn't add $100 per year to your premium and then cover oil changes, and that your health insurance doesn't charge $50 more per year and cover toothpaste. You'd have to fill out mountains of paperwork, the oil-change and toothpaste markets would become much less competitive, and you'd end up spending more.

How did we get to this point? It all leads back to the elephant in the room: the tax deductibility of employer-provided group insurance.
fundamentals  sidebar  cochrane  moralissues  costs  healthcare 
february 2012 by HispanicPundit
Why the Pilot Programs Failed | John Goodman's Health Policy Blog | NCPA.org
So why is none of this working? Because it all involves people on the demand side of the market trying to take the place of entrepreneurs who would ordinarily be on the supply side in any other market.

Successful innovations are produced by entrepreneurs, challenging conventional thinking — not by bureaucrats trying to implement conventional thinking. There are lots of examples of successful entrepreneurship in health care. There are very few examples of successful bureaucracy. Can you think of any other market where the buyers of a product are trying to tell the sellers how to efficiently produce it?
sidebar  goodman  ObamaCare  CBO  costs  healthcare 
february 2012 by HispanicPundit
Do We Really Spend More and Get Less? | John Goodman's Health Policy Blog | NCPA.org
Here is the kicker: since each separate purchase involves an artificial price, no one knows what the aggregate number really means. To make matters worse, other countries are more aggressive than we are at shifting costs and hiding costs. They use their buying power to suppress the incomes of doctors, nurses and other medical personnel much more than the United States does, for example. In addition, formal accounting ignores the cost of rationing in other countries. In Greece, patients spend nearly as much on bribes and other “informal” payments as they do on “formal” costs such as insurance co-pays. Yet these bribes do not show up in the official statistics. Bottom line: in comparing international spending totals, we are usually comparing apples and oranges.
healthcare  costs  sicko  goodman  sidebar  Lifeexpectancy 
january 2012 by HispanicPundit
Intentional Ignorance | John Goodman's Health Policy Blog | NCPA.org
This Rand study is not the only example. The proof of the effectiveness of Consumer Driven Health Care and other forms of cost sharing is piling up so high one would have to have their head in the sand to miss it.
healthcare  costs  goodman  sidebar 
december 2011 by HispanicPundit
The health spending 1 percent: Healthcare fact of the week « The Enterprise Blog
The 1 percent of the population that has the highest annual health expenses accounts for one-fifth of health spending (figure 12.1a). Their annual spending in 2011 likely exceeded $115,000. (These figures exclude those institutionalized in nursing homes and long-term mental hospitals; their inclusion would drive these figures even higher). Those in the top 5 percent account for just under half of all spending, with average annual expenditures that exceed $50,000. With the average U.S. worker earning less than $45,000 a year, these numbers demonstrate the desirability of some kind of health insurance coverage. Few but the wealthiest families are in a position to self-insure spending at these amounts. It would be only a slight exaggeration to observe that only the 1 percent could comfortably afford to be in the health spending 1 percent.
healthcare  costs  aei  sidebar 
december 2011 by HispanicPundit
A Voucher is a Voucher is a Voucher is a Voucher | Mother Jones
It's a free country and Paul Ryan can call his plan anything he wants. But that doesn't make it so. The fact is that liberal wonks didn't object to Ryan's plan because it included premium support, they objected to it because it's not premium support. It's a voucher with a very slow rate of growth that (a) does very little to actually rein in healthcare costs and (b) within a couple of decades would leave seniors paying enormous out-of-pocket expenses for medical care. It was that stingy rate of growth and unwillingness to tackle cost growth that turned off liberal wonks from the start. There are still plenty of us willing to support variations on genuine premium support plans that genuinely try to rein in medical costs and insure that seniors can continue to receive reasonable care at a reasonable price.
PaulRyan  healthcare  drum  sidebar 
november 2011 by HispanicPundit
America Needs More Doctors | ThinkProgress
It seems like common sense that if America is going to devote an above-average share of output to medical care while having close to the highest per capita output, we should have an above average number of doctors. Instead, we’re way below average. The upshot seems pretty clear to me. We need more doctors and we need more ways to get by without doctors. That means expanding what nurses are allowed to do without a doctor’s supervision, it means expanding the number of slots in American medical schools, and it means establishing clear paths for foreign-trained doctors to immigrate to the United States. I’m reasonably optimistic that improved technology will ameliorate this problem in the near future, but the fact that we’re using existing doctor-producing technology so poorly right now means there’s no guarantee that future policy will unleash future technology in the best possible ways.
healthcare  costs  graphs  europe  yglesias  sidebar 
november 2011 by HispanicPundit
What Matters in Health Care: Money, or Time? - Megan McArdle - Business - The Atlantic
Note that this implies a totally different solution to the problem of "non-emergent ER visits": urgent care or "Minute Clinics" that work odd hours.  Otherwise, you just cram even more people into the same ER space*.  It is easy to come up with "Just So" stories in health care. The reforms always sound wonderful, and the benefits always unfold in a beautifully logical way.  Unfortunately, people, and reality, are rarely as predictable as the models.
healthcare  costs  medicaid  goodman  mcardle  sidebar 
october 2011 by HispanicPundit
What David Cutler Doesn’t Understand about Health Economics | John Goodman's Health Policy Blog | NCPA.org
I thought I had already answered these questions. When hospitals don’t compete on price, they don’t compete on quality either. The reason they don’t compete on price or quality is third-party payment of medical bills.
healthcare  costs  cutler  fundamentals  goodman  sidebar 
october 2011 by HispanicPundit
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