A majority of U.S. adults continue to think the federal government should ensure universal healthcare coverage, while they also prefer that the U.S. healthcare system be based on private insurance rather than government-run.
The Oregon Health Insurance Experiment: Evidence from the First Year*
Abstract In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.
Restrictive ID Policies: Implications for Health Equity
Official websites use .gov A .gov website belongs to an official government organization in the United States.
Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture
Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year.
Why Do Americans Have Shorter Life Expectancy and Worse Health Than Do People in Other High-Income Countries?
Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.
Review of <i>The Ethics of Public Health Paternalism</i>
Martin Wilkinson’s book The Ethics of Public Health Paternalism is a normative analysis of paternalistic governmental policies within liberal democracies that …
Want More Policies Based on Evidence?
Medicine teaches us it will take time, effort, and investment.
Taxpayers spend about $2 billion annually on Medicaid for Amazon and Walmart employees
American taxpayers are spending billions every year providing Medicaid benefits to hundreds of thousands of employees of Amazon and Walmart, a new analysis by Popular Information reveals.
Choose to Lose: Health Plan Choices from a Menu with Dominated Option*
Abstract We examine the health plan choices that 23,894 employees at a U.S. firm made from a large menu of options that differed only in financial cost-sharing and premium. These decisions provide a clear test of the predictions of the standard economic model of insurance choice in the absence of choice frictions because plans were priced so that nearly every plan with a lower deductible was financially dominated by an otherwise identical plan with a high deductible. We document that the majority of employees chose dominated plans, which resulted in excess spending equivalent to 24% of chosen plan premiums. Low-income employees were significantly more likely to choose dominated plans, and most employees did not switch into more financially efficient plans in the subsequent year. We show that the choice of dominated plans cannot be rationalized by standard risk preference or any expectations about health risk. Testing alternative explanations with a series of hypothetical-choice experiments, we find that the popularity of dominated plans was not primarily driven by the size and complexity of the plan menu, nor informed preferences for avoiding high deductibles, but by employees’ lack of understanding of health insurance. Our findings challenge the standard practice of inferring risk preferences from insurance choices and raise doubts about the welfare benefits of health reforms that expand consumer choice.
Poll: Large Majorities, Including Republicans, Oppose Discrimination Against Lesbian, Gay, Bisexual and Transgender People by Employers and Health Care Providers | KFF
Large majorities of Americans think it should be illegal for either employers or health care providers to discriminate against people because they are lesbian, gay or bisexual, or transgender, a new KFF poll finds. This includes large majorities of Republicans, independents and Democrats across a range of questions about such discrimination.
Creating Caring Institutions: Politics, Plurality, and Purpose
How do we know which institutions provide good care? Some scholars argue that the best way to think about care institutions is to model them upon the family or the market. This paper argues, on the...
US Domestic Policy Dashboard - Impact Counter | Impact Counter
Explore US domestic policies and their impact on public health across all branches of government.
U.S. Demands to Access Africans’ Data Raise Privacy, Sovereignty Concerns — ProPublica
The United States is requiring access to health data as part of lifesaving aid deals with African countries. The U.S. says the data will be aggregated and anonymized, but privacy experts fear the information could be misused or exploited.
Public Opinion on Abortion
Abortion has long been a contentious issue in the United States, and it is one that sharply divides Americans along partisan, ideological and religious lines.
Americans Turning to AI to Supplement Healthcare Visits
One in four Americans use AI for health information. Most do so to supplement care, but some are using AI in place of a provider visit when barriers arise.
The Paradox of Redistribution and Strategies of Equality: Welfare State Institutions, Inequality, and Poverty in the Western Countries
Debates on how to reduce poverty and inequality have focused on two controversial questions: Should social policies be targeted to low-income groups or be universal? Should benefits be equal for all or earnings-related? Traditional arguments in favor of targeting and flat-rate benefits, focusing on the distribution of the money actually transferred, neglect three policy-relevant considerations: (1) The size of redistributive budgets is not fixed but reflects the structure of welfare state institutions. (2) A trade-off exists between the degree of low-income targeting and the size of redistributive budgets. (3) Outcomes of market-based distribution are often more unequal than those of earnings-related social insurance programs. We argue that social insurance institutions are of central importance for redistributive outcomes. Using new data, our comparative analyses of the effects of different institutional types of welfare states on poverty and inequality indicate that institutional differences lead to unexpected outcomes and generate the paradox of redistribution: The more we target benefits at the poor and the more concerned we are with creating equality via equal public transfers to all, the less likely we are to reduce poverty and inequality.
Opinion | Treat Medicines Like Netflix Treats Shows (Published 2019)
Australia seems to have found a way to entice Big Pharma into making essential new medicines affordable. Why can’t the United States?
