The Uninsured: A Primer is structured in two parts. The first presents basic information about health coverage and the uninsured population leading up to and after the implementation of the Affordable Care Act, who the uninsured are and why they do not have health coverage. The second presents information on the impact lack of insurance can have on health outcomes and personal finances, and provides an understanding of the difference health insurance makes in people’s lives.
The Uninsured: A Primer – Key Facts About Health Insurance and the Uninsured in America | The Henry J. Kaiser Family FoundationDecember 7, 2014
According to the World Economic Forum’s 2014-15 Global Competitiveness Report, the United States has the third most competitive economy in the world. The U.S. ranked fifth in 2013-14. Switzerland has the most competitive economy. Global competitiveness is “defined as the set of institutions, policies and factors that determine the level of productivity.”
From the report itself regarding U.S.: “some weaknesses in particular areas remain to be addressed. The business community continues to be rather critical, with trust in politicians still somewhat weak (48th), concerns about favoritism of government officials (47th), and a general perception that the government spends its resources relatively wastefully (73rd). The macroeconomic environment remains the country’s greatest area of weakness (113th), although the fiscal deficit continues to narrow and public debt is slightly lower for the first time since the crisis.”
Every so often in punditry land there appears a column so egregiously flawed that it makes a perfect platform for a homework assignment in undergraduate health-economics courses. With a straight face and little commentary, one mandates students to fact-check the piece and to examine its inherent logic. Students relish taking apart in this way the scribblings of seasoned adults.
So we must thank Sally Pipes for contributing to pedagogy a veritable jewel along these lines in her July 28 Forbes article, entitled “Employer Health Insurance: A Bargain Compared to Government-Sponsored Coverage.”
We find that in recent years, when fiscal conditions have been tight, health insurance premiums for state workers have grown materially less rapidly than premiums for comparable private- sector employers; this slower premium growth for state workers reflects, for example, changes from traditional comprehensive plans to networked plans, increases in deductibles, and/or non-transparent reductions in access due to reductions in payments to providers. Interestingly, the share of the premium paid by state workers has tended to rise in states with high rates of public-sector unionization, where the employee share started at a low base, while the share has fallen elsewhere.
The results in this presentation expand on those published in Congressional Budget Office, Options for Reducing the Deficit: 2014 to 2023 (November 2013) using the most recent CBO baseline. The analysis provides estimates of the impact on coverage of 3 alternative policy options:
- Totally eliminate the tax exclusion for federal income tax and payroll tax purposes;
- Eliminate the tax exclusion for federal income tax but not for payroll tax purposes;
- Cap income and payroll tax exclusions at the median premium for employment-based plans
Revelations of chronic delays at Veterans Administration VA hospitals and inexcusable fraud in record keeping have spurred calls for reform of the VA system. Politicians have been eager to jump in front of cameras to declare their support for veterans. But House and Senate VA reform bills represent only tentative first steps towards empowering veterans to take ownership over their health care and hold the VA accountable.
The bigger problem is the absence of a coherent co-payment system to incentivize veterans to think through their health care decisions. Contrary to conventional wisdom, VA health care is free only to veterans with severe, service-related conditions. A byzantine co-insurance system exists in which the cost of care is linked to the severity of a veteran’s condition and the degree to which the condition is service-related. Veterans additionally receive a monthly tax-free cash payment based on the severity of their service-related health condition. The result is that veterans face perverse incentives to let their health deteriorate to the point where they can avoid copayments and receive higher monthly financial support. Reform should focus on redesigning VA co-insurance to give veterans incentives to embrace preventive care and take greater ownership over their health care decisions.
Thursday, July 17, 2014 | 10:00 a.m. – 11:30 a.m.
AEI, Twelfth Floor 1150 Seventeenth Street, NW Washington, DC 20036
About This Event: Recent scandals at medical centers for veterans have trained a spotlight on longstanding inefficiencies within the US Department of Veterans Affairs VA. In the case of the VA’s disability system, a nearly century-old approach to wounded veterans still prevails. The widespread consensus is that the problem goes much deeper than falsified waiting lists and delayed access to care, and necessitates a global overhaul. What would a renewed vision of veteran care look like, and how should we clarify the objectives of the VA’s disability system? In the interim, what short-term reforms are practical?
Please join AEI as former VA Assistant Deputy Secretary for Policy Michael H. McLendon presents a blueprint for reform, followed by a discussion with experts in health care, disability, and public administration.