Here are Casey B. Mulligan’s estimates of the impact of emergency unemployment compensation ending in December 2013:
State budgets are still under stress because revenues are not growing fast enough to replace the funding from the federal stimulus program. And now states are being pressured to expand Medicaid.
According to the National Association of State Budget Officers, Medicaid will account for 23.9 percent of total state expenditures in fiscal 2012. In most states, able-bodied working age adults are not eligible for Medicaid. One of the pillars of ObamaCare was the provision requiring states to either expand Medicaid to everyone with incomes up to 133 percent of the federal poverty level (plus a five percent income set-aside) or lose all of their federal matching funds. This provision was struck down by the Supreme Court.
But state governments are still being pressured to expand Medicaid, even though estimates suggest that more than 25 percent of people in the expansion group have private health coverage and that a sizeable fraction of them are college students. The federal government promises to pay 100 percent of Medicaid medical costs for the first three years of the expansion, and 90 percent of them in 2020 and thereafter. A variety of interest groups think that it would be a shame to leave this “free” money on the table.
When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.
But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.
Regulators say physicians have changed the way they bill for office visits similarly, increasing their payments by billions of dollars as well.
Source: The New York Times.
When assessed against a probability based sample of U.S. workers in other professions, physicians fare significantly worse. About 38% of physicians have burnout compared to 28% of all other workers. About 40% of physicians are unhappy about their work-life balance compared to 23% of all other workers.
Wal-Mart Stores Inc. will start offering vaccinations for infectious diseases beyond influenza and pneumonia at 2,700 U.S. stores on Monday as the retailer continues edging into health-care services. The Bentonville, Ark., chain will offer 10 immunizations recommended by the Centers for Disease Control and Prevention, including shots for shingles, meningitis, hepatitis and the human papillomavirus or HPV, which can lead to cervical cancers.
Read more on Wal-Mart’s health-and-wellness business segment expansion in the WSJ.
Corporate political spending yields a variety of benefits, such as lower taxes, more favorable regulation or in some cases earmarks that help the business. This improves returns for shareholders by 2% to 5% a year, depending on the study, but the authors find “no credible evidence” that political activity harms firms.
See full WSJ editorial on corporate participation in politics.
Mayor Bloomberg wants to ban large sodas. The Institute of Medicine wants to tax unhealthy folks. As John Goodman showed in a previous post, it’s hard to justify any of this. Here are some additional considerations.
Population obesity seems to have plateaued. The National Health and Nutrition Examination Survey (NHANES) shows no trend in US child and adolescent BMI since 1999. US men and women have had constant obesity rates and mean BMI since 2003. NHANES BMI measurements date suggest that the growth in U.S. overweight occurred between 1976-80 and 1988-94.
In 1997, the government made 35.4 million adults overweight overnight. It redefined overweight as a BMI greater than or equal to 25 regardless of age. Before that, overweight was BMI ≥ 27 for those 35 or older. Kathleen Flegal of the National Center for Health Statistics estimates that the change increased the fraction of overweight adults from roughly a third of the population to over half of it.