Lessons from variations in state Medicaid expenditures
Because Medicaid is absorbing a large and growing share of government spending in every state, policymakers are under intense pressure to control the cost of this budget-breaking program. In search of clues concerning Medicaid cost containment, this article examines state data on per-recipient Medicaid spending by type of service. This effort suggests focusing on nursing homes, because per-recipient payments to these institutions are highly variable across states. Indeed, the article concludes that a key explanation for cross-state differences in per-recipient Medicaid expenses is the ...
The trouble with managed care
Gasping over GASB
Post-retirement health benefits could bring a shock to governments, retirees
The government's role in the health care industry: past, present, and future
A look at some of the reasons behind the ascent in health care costs over the last few decades and an analysis of how government policy has both contributed to and tried to rein in these costs.
Medicaid has become Massachusetts preeminent budget buster. The largest single program in the budget, it will most likely be the most important source of spending increases between FY 1991 and FY 1995. But Massachusetts is not alone. Medicaid is producing budgetary headaches all across the country. This article explains why the Medicaid program has become a substantial burden for Massachusetts and other state governments and why that burden is likely to increase. It examines why Massachusetts Medicaid expenditures are above average and outlines some policy choices. ; One option involves ...
Mandatory and affordable health insurance
This paper asserts that America's health care system is broken and cannot be repaired with timid half-measures. It suggests that we need both universal coverage and a more efficient delivery system and that these are not competing objectives: Each is necessary to make the other possible. It further states that if we do not make health care more affordable and our delivery system more efficient and sustainable, a majority of Americans will be uninsured in short order. And the persistence of millions of uninsured impairs the efficiency we need to make health care and insurance affordable for ...
Small employers and expanded health insurance coverage
New England states have been national leaders in developing and enacting health insurance programs. But as the new laws play out on real ground, various constituencies are seeing real or perceived devils in the detail of the expansion laws. For one group in particular?small employers?efforts to extend coverage have become a two-edged sword.
Getting sick and paying for it
In certain situations, Americans who become chronically ill have to pay higher rates to continue their health insurance coverage. Indeed, although the majority of Americans are insured, hardly anyone is fully protected against the risk that their next insurance policy will cost considerably more than their current one.
The effect of an employer health insurance mandate on health insurance coverage and the demand for labor: evidence from Hawaii
Over the past few decades, policy makers have considered employer mandates as a strategy for stemming the tide of declining health insurance coverage. In this paper we examine the long term effects of the only employer health insurance mandate that has ever been enforced in the United States, Hawaii's Prepaid Health Care Act, using a standard supply-demand framework and Current Population Survey data covering the years 1979 to 2005. During this period, the coverage gap between Hawaii and other states increased, as did real health insurance costs, implying a rising burden of the mandate on ...