Will Vermont Ever Get a Single-Payer System?

 

money-rollsJust two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it.

Although Act 48 required Vermont to create a single-payer system by 2017, the state hasn’t drafted a bill spelling out how to raise the additional $1.6 billion a year (based on the state’s estimate) the system needs. The state collected only $2.7 billion in tax revenue in fiscal year 2012, so that’s a vexingly large sum to scrape together…

Paying for this program would likely make Vermont the highest-taxed state in the nation, by quite a lot.

Megan McArdle.

Employers Switch from Commercial Insurance to Self-Insured Plans

 

According to Citibank’s top ranked analyst Carl McDonald:

By our analysis, since 2002, risk enrollment at the publicly traded plans has fallen by over 14 million lives…The emergence of private exchanges that rely on a risk model (like the exchange product offered by Aon Hewitt) could help slow the loss of risk enrollment but the benefits of self-funding are so significant for many employers that we believe risk enrollment will continue to shrink.

Is The Health Care Spending Slowdown Over?

 

risingAmericans used more medical care in 2013 as the economy recovered, new reports show. Federal data suggests that health care spending is now growing just as quickly as it was prior to the recession.

“We’re at the highest level of growth since the slowdown began,” Paul Hughes-Cromwick, a senior health economist at the Altarum Institute, which tracks health spending. “You have to go back seven years to see growth like this.”

Sarah Kliff.

Did You Fill Out Your Tax Return Correctly?

 

Toy Businessman on a Pile of MoneyThe results for the EITC are not pretty. The Internal Revenue Services estimates that 21 to 25 percent of EITC payments were issued incorrectly during the fiscal year 2012, totaling from $11.6 to $13.6 billion in too much money being paid out to taxpayers. As a result, the Office of Management and Budget has labeled the EITC a “high-error” government program. Projections by the government show that the rate of error is expected to remain stubbornly high.

…[T]he IRS estimates that 21 percent of those who are eligible do not claim the credit at all. And so the EITC cuts both ways: both too much being handed out to taxpayers and too little.

Jia Lynn Yang.

Why Are The Poor, Poor?

 

Have you ever wondered why poor people are poor? It’s not as though there aren’t plenty of role models around. Millions of people live highly successful, productive lives in this country. So why don’t people at the bottom of the income ladder copy the behavior of those several rungs above them and better their lot in life?

If this question doesn’t really interest you, that’s understandable. What’s not understandable is why it is not an interesting question for those who regard inequality of income the burning issue of the day.

For example, when is the last time you saw a Paul Krugman column on why poor people are poor? When Krugman writes about poverty, he can’t get more than a few sentences into the piece without launching into an attack on Republicans for being racists and indifferent to the plight of the poor. And that’s on a good day. When he’s in a bad mood, he depicts Republicans as actually delighting in the suffering of the poor. What motivates Krugman more: Concern for the poor? Or hatred of Republicans? You decide.

Okay. What about the rest of the paper? When is the last time you saw a New York Times unsigned editorial on why the poor are poor? How about any editorial in The New York Times?

Actually, there was one — just a few days ago. Under the heading “Where The GOP Gets It Right,” Nicholas Kristof writes that Republicans have been right all along — especially in stressing the role of strong families, job creation and education reform. (You wonder if Paul Krugman and Nicholas Kristof ever talk to each other.)

Yet good as it is, the Kristof column has one gaping hole: it totally neglects the role of incentives.

Cooking the ObamaCare Stats?

 

caduceus_blogOut of the blue, the Census Bureau has changed how it counts health insurance — at the precise moment when ObamaCare is roiling the insurance markets.

Since 1987, the Current Population Survey, or CPS, has collected information on the health-insurance coverage status of Americans. The annual reports are widely cited because their large sample sizes improve accuracy, the data are gathered constantly, and they tease out state-by-state details. But this year the Census revamped the CPS household insurance questions, muddying comparisons between the pre- and post-ObamaCare numbers. The results of the new method will be disclosed this fall. (WSJ)

Hits and Misses

 

Could a single protein make our organs repair themselves?

The Tax Code is not 70,000 pages long. But how long is it?

SAT tests are really IQ tests; contrary to conventional wisdom, they predict college performance reasonably well; and prep courses matter very little.

Headlines I Wish I Hadn’t Seen

 

Food Stamp recipients outnumber women who work full-time

Obama has proposed 442 tax hikes since taking office

Which chain do you think is more heavily celebrated on the website of the American Cancer Society? CVS, which will stop sales of all tobacco products, or Walgreens, which won’t?

Will Cuts in Home Health Care Increase Overall Health Care Spending?

 

On Jan. 1, Medicare‘s home health care services, formerly serving 3.5 million elderly beneficiaries across the country, were cut under ObamaCare. The cut deleted exactly 14 percent, or an estimated $22 billion, from these lowest-income Americans over four years…

Using 2009 as a reference year, Medicare‘s average Part A and Part B payment for a home health care visit was $145, compared to $373 per day in a skilled nursing facility or a whopping $1,805 per day in a hospital. In addition, according to one leading expert, skilled home health care services saved the Medicare program $2.8 billion during the most recent three-year period. Approximately $670 million of that savings is attributable to 20,000 fewer hospital readmissions. (More)

The Cost of ObamaCare Is Down 8%, but That May Not Be Good News

 

But so is access to doctors and hospitals in the plans offered on the health insurance exchanges.

A Congressional Budget Office report estimates lower federal spending (see the figure). The reason: Health plans in the exchanges look more like Medicaid than like employer-based coverage. Jason Millman reports:

The CBO report points out that it previously thought ObamaCare’s exchange plans would look more like employer-based coverage, but that hasn’t turned out to be the case so far — hence, the cheaper premiums. “The plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans,” CBO wrote.

The CBO projects 42 million people will remain uninsured this year. In fact, the ACA will never cover more than 45% of the uninsured.

GH