Unbiased Analysis of Today's Healthcare Issues
A recent paper by Franco et al. (2007) claims that increased poverty may improve health (see also NPR’s Marketplace report). How is this possible? Lower income reduces excess food as well as cigarette consumption. Further, poverty makes public transportation less affordable and individuals may substitute walking for taking the bus. The authors study Cuba’s experience…
“Medicare adopted its [Medicare as a Secondary Payer] MSP policy in 1982, effective January 1, 1983. This legislation states that for individuals working at firms with 20 or more employees, and otherwise eligible for Medicare benefits, Medicare serves as a secondary payer for health care expenses. The employer’s health insurance is the first payer. Because…
Local governments provide a variety of services which are highly valued by their residents. From police protection to waste disposal, from snow plowing to utility meter reading, the local government is charged with providing the infrastructure necessary for a smooth functioning economy and a high level quality of life. But should local governments outsource these…
Despite much public rhetoric, why is preventative and chronic care so poor in the U.S.? The easy answer is that patients switch plans so frequently that insurance companies who invest in preventative care will incur the cost, but not reap the benefits. The harder question is why patients are switching health plans. According to a…
Many papers have attempted to calculate hospital efficiency before and after a policy change. Most research, however, does not take into account quality levels when analyzing these changes in efficiency. For instance, a doctor may increase the number of patients per hour that they visit by 50%, but if this is accomplished simply by lowering…
Should hospitals with long waiting times have higher or lower budget transfers? Offering hospitals who have low wait times more money will increase a hospital’s incentives to decrease wait times. On the other hand, thus policy may hurt the busier hospitals and may not alleviate the wait times of those who are waiting the longest.…
This is the question posed by a 2007 NBER working paper by Mary Beth Landrum, Kate A. Stewart, David M. Cutler. The authors use data from the National Long Term Care Survey (NLTCS) between 1994 and 1999. The data is panel in nature and has the benefit of combining Medicare administrative data with survey responses.…
Physician scorecards have been a highly touted means to improve healthcare quality. One example is NY state’s coronary artery bypass graft (CABG) Surgery Reporting System. One side effect of scorecards is that surgeons may choose to operate on healthier patients in order to maximize their scorecard grade. In fact, over 60 percent of NY cardiothoracic…
The popularity of specialty medical facilities (SMF) has increased over the years. The number of Medicare-certified ambulatory surgery centers (ASCs) has doubled to 3,371 during the past decade. A question remains: are these “Focused Factories” good for society? In an article by Casalino, Devers and Brewster, (“Focused Factories…“) the authors try to answer this question.…
The 2005 Deficit Reduction Act aimed to reduce Medicaid entitlements as one means to reduce the national deficit. One portion of the bill changed eligibility rules for the elderly to qualify for Medicaid payment of nursing home (NH) expenses. In the May edition of the Journal of Health Economics, authors David Grabowski and Jonathan Gruber…