December 5, 2014
Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?” by David Brown, Amanda Kowalski, and Ithai Lurie.
We examine the long-term impact of expansions to Medicaid and the State Children’s Health Insurance Program that occurred in the 1980’s and 1990’s. With administrative data from the IRS, we calculate longitudinal health insurance eligibility from birth to age 18 for children in cohorts affected by these expansions, and we observe their longitudinal outcomes as adults. Using a simulated instrument that relies on variation in eligibility by cohort and state, we find that children whose eligibility increased paid more in cumulative taxes by age 28. These children collected less in EITC payments, and the women had higher cumulative wages by age 28. Incorporating additional data from the Medicaid Statistical Information System (MSIS), we find that the government spent $872 in 2011 dollars for each additional year of Medicaid eligibility induced by the expansions. Putting this together with the estimated increase in tax payments discounted at a 3% rate, assuming that tax impacts are persistent in percentage terms, the government will recoup 56 cents of each dollar spent on childhood Medicaid by the time these children reach age 60. This return on investment does not take into account other benefits that accrue directly to the children, including estimated decreases in mortality and increases in college attendance. Moreover, using the MSIS data, we find that each additional year of Medicaid eligibility from birth to age 18 results in approximately 0.58 additional years of Medicaid receipt. Therefore, if we scale our results by the ratio of beneficiaries to eligibles, then all of our results are twice as large.
via Medicaid’s return on investment | The Incidental Economist.
November 18, 2014
Whittle points out that there is an epidemic of racial violence – but not the way the media spins it.
“The National Crime Victimization Survey reported approximately 13,000 black-on-white rapes and 39,000 black-on-white robberies.”
“The statistics show that the number of white-on-black rapes and violent robberies were so small that they had to be rounded to the nearest whole number – and that whole number is zero.”
Whittle blames figures like President Obama and Attorney General Holder for the racial division.“ Open racism is simply not tolerated in white America today, but black racism is the toxic glue that holds the progressive coalition together,” Whittle concludes.
via VIDEO: The Massive Ferguson Conspiracy Just Got Blown Wide Open [WATCH].
July 23, 2014
Rationing by waiting is having its greatest effect on those at the bottom of the income ladder. As I wrote at the Health Affairs blog:“Think metaphorically of waiting in line for care. The lowest-income families are at the end of that line. The longer the line, the longer they will have to wait. If you do something to shorten the line, you will be mainly benefiting higher-income people who are at the front.”There is another study gated with abstract that suggests that even low-income patients are more deterred by non-price barriers than by money prices.
via Why Are People Waiting So Long For Medical Care?.
June 7, 2014
Public health insurance programs comprise a large share of federal and state government expenditure, and these programs are due to be expanded as part of the 2010 Affordable Care Act. Despite a large literature on the effects of these programs on health care utilization and health outcomes, little prior work has examined the long-term effects of these programs and resultant health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public insurance expansions among children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding health insurance coverage for low-income children has large effects on high school completion, college attendance and college completion. These estimates are robust to only using federal Medicaid expansions, and they are mostly due to expansions that occur when the children are older i.e., not newborns. We present suggestive evidence that better health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translated into better teen health. Overall, our results indicate that the long-run benefits of public health insurance are substantial.
via The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions.
June 7, 2014
Now, the World Bank’s David Evans and Anna Popova are out with a new paper reviewing what evidence is out there about aid to the global poor and alcohol/tobacco consumption. They found 19 studies which attempted to measure the effect of cash transfers — both no strings attached ones and ones families receive if they fulfill certain conditions, like school attendance — on the purchase and consumption of “temptation goods”; the studies contained a total of 44 estimates of cash’s effect in various contexts. 82 percent of those estimates showed that the transfers reduced consumption of or spending on alcohol and tobacco. The vast majority of those weren’t statistically significant, so the best conclusion is that there’s no evidence transfers affect drinking or smoking behavior.
via More evidence that giving poor people money is a great cure for poverty – Vox.
June 7, 2014
We know health insurance influences health — but can it change educational outcomes, too? A new study says yes.The paper, recently published by the National Bureau of Economic Research, examined expansions of Medicaid in the 1980s and 1990s. The authors found that the expansions resulted in consistent improvements in high school and college attainment.A 10 percentage point increase in childhood Medicaid eligibility reduced the rate of high school dropouts by 5 percent and increased completion of a bachelor’s degree by 3.3 to 3.7 percent.
via Kids who get health insurance are more likely to finish high school and college – Vox.
June 4, 2014
A paper written in 2003 by David Kindig and Greg Stoddard in the American Journal of Public Health took a stab at it. They write –Although the term “population health” has been much more commonly used in Canada than in the United States, a precise definition has not been agreed upon even in Canada, where the concept it denotes has gained some prominence.They proceeded to define it as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” They go on to explain –We support the idea that a hallmark of the field of population health is significant attention to the multiple determinants of such health outcomes, however measured. These determinants include medical care, public health interventions, aspects of the social environment income, education, employment, social support, culture and of the physical environment urban design, clean air and water, genetics, and individual behavior.In other words: Everything under the sun.Such an all-inclusive definition is not very helpful, so people keep trying. Ten years later Michael Stoto gave it a shot in a paper published by Academy Health, “Population Health in the Affordable Care Act Era.” This paper spends half its space explaining some of the different definitions currently in use. The balance of the paper is suggesting to researchers how they can tailor their projects to take advantage of funding opportunities presented by ObamaCare.
via Population Health | John Goodman’s Health Policy Blog | NCPA.org.