Why Medicaid Patients Go to the ER, and Other News
Why Medicaid patients go to the hospital emergency room: they can’t get care anywhere else.
Obama budget defeated 99-0 in Senate.
May 22, 2012 | 4 comments | by John Goodman
Is the Medicare Advantage Bonus Program a Sham?
Because criteria for evaluation are not published until after the period for which performance will be evaluated, there is no possibility that MA plans will be able to improve their performance to achieve the goals CMS intends to incentivize … patients whose preferences, health status, and even counties of residence, don’t match the CMS model of a highly rated plan will be at a disadvantage. Simultaneously, the system will likely reduce the scope of choice available to MA-eligible beneficiaries, and reduce competition among MA plans.
More from Douglas Holtz-Eakin, et. al. at American Action Forum.
May 22, 2012 | 3 comments | by John Goodman
Buying Health Insurance across State Lines
Last year, Georgia became the first state to allow insurers licensed in other states (and subject to other states’ mandates and regulations) to sell insurance in Georgia. But so far, no insurer has even applied. Why is that?
In an exchange between Richard Unger and Michael Cannon, Unger comes across as a general naysayer (offering no explanations of his own) but Cannon’s excuses seem weak: it’s administratively expensive for out-of-state insurance companies to enter the Georgia market, negotiate contracts, create new networks, etc. Here’s the problem: You don’t need out-of-state insurers to do this. In-state insurers (with contract and networks already in place) could in principle start selling insurance under some other state’s laws. Cannon also says that the uncertainty created by the Supreme Court ruling on ObamaCare and the general uncertainty about the implementation of ObamaCare are the culprits – an argument also endorsed by Avik Roy.
Okay, but how hard could it be to file and start selling a new type of insurance for companies already in the trade? After all, they’ve got to sell something.
I’m not convinced we have the right explanation here.
May 21, 2012 | 10 comments | by John Goodman
Employers as Insurance Companies
We find evidence that women more dependent on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer – the estimate difference is about 5.5 to 7 percent. Women’s subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior.
NBER Study byCathy J. Bradley, David Neumark, and Scott Barkowski.
May 21, 2012 | 4 comments | by John Goodman
Income Inequality vs. Upward Mobility, and Other News
There is almost no relationship between income inequality and upward mobility among the states.
Do ObamaCare grants reflect Chicago-style cronyism?
Washington State legalizes home cooking. Somewhat.
David Friedman describes TSA vandalism.
May 21, 2012 | 5 comments | by John Goodman
Why Do We Regulate?
I came across an answer to this question the other day by Uwe Reinhardt at The New York Times economics blog. Professor Reinhardt tells us that “regulations are usually a legitimate response to mischievous games played by some parties in the private sector.”
If you’re not an economist, that statement may not strike you as especially odd. After all that’s what you would likely hear in just about any garden variety history class. Or sociology class. Or political science class. But then again, most historians, sociologists and political scientists have never mastered even rudimentary economics.
To understand economic regulation one must turn first to people with a bit more knowledge. Interestingly, the father of economics, Adam Smith, devoted a good bit of his treatise, An Inquiry into the Nature and Cause of the Wealth of Nations, to the subject of regulation of economic activity. Smith observed that the vast majority of government regulations serve no useful social purpose at all.
Far from protecting consumers, most government intervention in Smith’s day was designed to protect producers and other special interests. They served the interests not of buyers of goods and services, but of the sellers. Further, society would be much better off if these laws were simply repealed.
What about the modern era? It’s amazing how little things have changed.
Hollywood depicts the downside of regulation.
May 21, 2012 | 17 comments | by John Goodman
Aging Population Will Depress Economic Growth, and Other News
Aging of the population will depress economic growth by 1.6–3.7 percentage points from current levels. HT: Tyler.
More than a third of the nation’s prescriptions now are electronic.
Personalized cancer drugs appear to work.
May 18, 2012 | 6 comments | by John Goodman
Indian Reservations Have Always Had a Single-Payer System
Half the population over 40 on Pine Ridge has diabetes, and tuberculosis runs at eight times the national rate. As many as two-thirds of adults may be alcoholics, one-quarter of children are born with fetal alcohol spectrum disorders, and the life expectancy is somewhere around the high 40s — shorter than the average for sub-Saharan Africa. Less than 10 percent of children graduate from high school.
Editorial by Nicholas D. Kristof in the NYT.
May 18, 2012 | 7 comments | by John Goodman
Regulation of Telemedicine Costs Lives
Jason Shafrin writes:
In response to concerns about tele-medicine’s effect on patient safety, many states have begun prohibiting physicians from prescribing drugs without conducting a prior physical examination. In fact, more than 30 states have instituted this type of rule since 1998.
A paper by Cotet and Benjamin investigates this regulation which they call the physical examination requirement (PER).
The findings:
The adoption of PER is associated with a 1% rise in disease-related mortality rates the equivalent of 8.5 deaths per 100,000 people, presumably because it raised the implicit cost of, and thus reduced access to, medical care. In addition, the adoption of the PER is associated with a 6.7% reduction in injury-related mortalities, the equivalent of 2.5 deaths per 100,000 people. Thus, the reduction in injury mortality is smaller than the elevation of disease-related mortality, yielding a rise in overall mortality.
May 18, 2012 | 8 comments | by John Goodman
