Last week’s presidential debate at the Reagan Library elevated Social Security as a national issue that could reshape the 2012 campaign. Candidates spent the week trading blows about the role of the 76-year-old social insurance program. Leaving aside the political rhetoric, one thing is certain: Social Security needs to be reformed or America will face a dismal future. As one of the three major entitlement programs — along with Medicare and Medicaid — Social Security is contributing to a very dire long-term budget outlook. Spending on the three entitlement programs …
Last week, the state of Wisconsin released a report summarizing the effects of Obamacare on the Badger State’s health care system. The study, which was conducted by Gorman Actuarial and MIT Economist Jonathan Gruber—an Obamacare supporter—and commissioned by former Governor Jim Doyle (D), provides further proof that Obamacare is on track to break the promises President Obama made to the American people regarding his plan for health care reform: “It will provide more security and stability to those who have health insurance. It will provide insurance for those who don’t.” …
In a recent article in Health Affairs, health economist James Robinson reveals that in areas where hospitals consolidate and enjoy a larger market share, providers are more likely to charge higher prices, as low competition gives them a monopoly in delivering patient care in the region. The lack of competition allows hospitals and other providers to raise the sticker price for the privately insured as reimbursements from Medicare and Medicaid fall. Economists call this “cost shifting,” when a lower payment from one group is made up for by a higher …
The recent proposal from the Gang of Six has received attention as a possible deal for raising the debt ceiling. On health care, the G6 proposal was initially weak, and as the story goes, the Gang allegedly beefed up its changes to health care spending to attract more support. But in reality, the improvements are small, and the plan ultimately fails to adequately address federal spending on health entitlements or to promise acceptable solutions down the road. Medicare, the health entitlement for the elderly and disabled, represents the largest driver …
States are desperate for ways to make their budgets more cost-effective. Illinois found a way—but the federal government won’t let the state implement a requirement that would help repair its faulty Medicaid system. Federal government health care laws are preventing a new Medicaid ID requirement—passed by bipartisan majorities in the state—from going into effect. The legislation gained the support of Republican and Democratic caucuses in the state with Rep. Patti Bellock (R-Westmont) and Rep. Barbara Flynn Currie (D-Chicago) moving the bill forth. Gov. Pat Quinn (D) signed it into law. …
Conservatives should beware of policies that simply meet a budget target number without considering whether the underlying policy changes move a program in the right direction. Case in point: the Medicaid blend rate, which would replace the various federal matching rates for different categories of enrollees with one unified federal rate. Yes, those on the left are attacking the blend rate proposal that would set one federal match rate in Medicaid and the Children’s Health Insurance Program (CHIP). That could lead conservatives to think it must be a good idea. …
Red Alert! Conservatives in Congress and elsewhere should be warned: The Administration’s latest signal for “compromise” may end up as little more than an expansion of existing bad policy, rather than a serious effort to enact substantive reforms. And only substantive reforms can change the perverse incentives that plague giant entitlement programs and have worsened America’s deepening financial crisis. Consider some of the latest ideas that have surfaced in the media for finding “savings” in health policy: Importing Medicaid drug policy into Medicare. In Medicaid, patients do not have the …
The Hill reports that conservatives in Congress are considering extending Medicaid drug rebates to low-income seniors participating in the Medicare prescription drug program (Part D) as part of a deficit reduction deal to increase the debt limit. Transforming certain federal health programs—i.e., Medicare and Medicaid—is crucial to making a meaningful dent in the debt, but ideas like this one are best left in the Pandora’s box of bad health policy. Low-income seniors dually eligible for Medicare and Medicaid used to receive drug coverage solely from Medicaid, but after the advent …
The literature on the quality of Medicaid has mixed findings—some shows that having Medicaid is better than being uninsured; some shows the opposite. But virtually all of these studies suffer from a statistical issue that makes it impossible to tell whether or not it’s Medicaid or something else driving the results. This is because there are lots of reasons why people may enroll in Medicaid or decide to remain uninsured—and some of the reasons are completely unknowable to the researcher. For instance, developing a chronic condition that’s expensive to treat …
The Wall Street Journal recently reported on bureaucratic barriers for patients covered by both Medicare and Medicaid. These two programs serve the elderly and the poor, respectively, and people who fall into both categories—the “dual-eligibles”—should get better-quality care with more efficient taxpayer spending. According to the WSJ, an estimated 9.7 million Americans fall under the dually eligible criteria. They account for 16 percent of the Medicare population but 27 percent of Medicare spending, and 15 percent of Medicaid’s population but 39 percent of its spending. More efficient financing for this …
