Why Are People Waiting So Long For Medical Care?

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?.


The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions

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.


More evidence that giving poor people money is a great cure for poverty – Vox

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.


Kids who get health insurance are more likely to finish high school and college – 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.


Population Health | John Goodman’s Health Policy Blog | NCPA.org

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.


The Golden Age Is Now by Yevgeniy Feyman, City Journal 23 May 2014

May 24, 2014

The doubling of human life expectancy is one of the most remarkable achievements of the past century. Consider, Lomborg writes, that “the twentieth century saw life expectancy rise by about 3 months for every calendar year.” The average child in 1900 could expect to live to just 32 years old; now that same child should make it to 70. This increase came during a century when worldwide economic output, driven by the spread of capitalism and freedom, grew by more than 4,000 percent. These gains occurred in developed and developing countries alike; among men and women; and even in a sense among children, as child mortality plummeted.

Why are we living so much longer? Massive improvements in public health certainly played an important role. The World Health Organization’s global vaccination efforts essentially eradicated smallpox. But this would have been impossible without the innovative methods of vaccine preservation developed in the private sector by British scientist Leslie Collier. Oral rehydration therapies and antibiotics have also been instrumental in reducing child mortality. Simply put, technological progress is the key to these gains—and market economies have liberated, and rewarded, technological innovation.

via The Golden Age Is Now by Yevgeniy Feyman, City Journal 23 May 2014.


Jobless contend with weight gain as they search for work – The Washington Post

May 15, 2014

A subject long ignored by policymakers, and one that unemployment counselors are too sheepish to raise with job seekers, the link between bulging waistlines and joblessness is now of intense interest to researchers studying the long-term effects of the country’s economic malaise.

Recent studies and surveys have shown a distinct relationship between unemployment and obesity, particularly for lower-skilled workers who struggle to find work — a search made more challenging by their weight.

via Jobless contend with weight gain as they search for work – The Washington Post.


County Health Rankings Show People Living in Least Healthy Counties Twice as Likely to Have Shorter Lives than People Living in Healthiest Counties – Robert Wood Johnson Foundation

March 28, 2014

The fifth edition of the County Health Rankings released today continues to show us that where we live matters to our health. Large gaps remain between the least healthy counties and healthiest counties. For instance, the least healthy counties have twice the death rates and twice as many children living in poverty and teen births as the nation’s healthiest counties.

A collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute (UWPHI), the County Health Rankings allow each state to see how its counties compare on 29 factors that impact health, including smoking, high school graduation rates, unemployment, physical inactivity, and access to healthy foods. The Rankings are available at http://www.countyhealthrankings.org.

via County Health Rankings Show People Living in Least Healthy Counties Twice as Likely to Have Shorter Lives than People Living in Healthiest Counties – Robert Wood Johnson Foundation.


Heckman | Impact of Early Childhood Education on Adult Health

March 27, 2014

Published on March 27, 2014, in Science, research by Professor Heckman and colleagues at the University of Chicago, University College London, and Frank Porter Graham Child Development Institute at the University of North Carolina shows the potential of quality early child programs that incorporate health and nutrition to prevent disease and promote adult health.

via HEALTH RESEARCH | Heckman.


Pitfalls Seen in a Turn to Privately Run Long-Term Care – NYTimes.com

March 7, 2014

Even as public attention is focused on the Affordable Care Act, another health care overhaul is underway in many states: an ambitious effort to restrain the ballooning Medicaid cost of long-term care as people live longer and survive more disabling conditions.

At least 26 states, including California, Florida, Illinois and New York, are rolling out mandatory programs that put billions of public dollars into privately managed long-term care plans, in hopes of keeping people in their homes longer, and expanding alternatives to nursing homes.

via Pitfalls Seen in a Turn to Privately Run Long-Term Care – NYTimes.com.


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