US Beats UK in Lives Saved by Health Care | Foundation for Economic Education

February 19, 2017

All of which is to show that your probability of dying from a range of common conditions is much higher in the UK than here. Perhaps that’s why (with no hint of irony) The Guardian’s write-up of a Commonwealth Fund Report suggesting the UK’s health system was “the best in the world” said “the only serious black mark against the NHS was its poor record on keeping people alive.”

Source: US Beats UK in Lives Saved by Health Care | Foundation for Economic Education


Universal Healthcare for Illegals? | The Federalist Papers

February 19, 2017

While the Trump administration discusses plans to repeal and replace Obamacare, California has introduced “The Healthy California Act,” which would institute socialized healthcare covering all undocumented residents of California, including illegal immigrants.

Source: Universal Healthcare for Illegals? | The Federalist Papers


Major Blow to Obamacare Mandate: IRS Won’t Reject Tax Returns That Don’t Answer Health Insurance Question – Hit & Run : Reason.com

February 15, 2017

Earlier this month, the IRS quietly altered its rules to allow the submission of 1040s with nothing on line 61. The IRS says it still maintains the option to follow up with those who elect not to indicate their coverage status, although it’s not clear what circumstances might trigger a follow up.But what would have been a mandatory disclosure will instead be voluntary. Silent returns will no longer be automatically rejected. The change is a direct result of the executive order President Donald Trump issued in January directing the government to provide relief from Obamacare to individuals and insurers, within the boundaries of the law.

Source: Major Blow to Obamacare Mandate: IRS Won’t Reject Tax Returns That Don’t Answer Health Insurance Question – Hit & Run : Reason.com


Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers by Catherine Maclean, Ioana Popovici, Elisheva Stern :: SSRN

February 13, 2017

We examine how substance use disorder (SUD) treatment providers respond to private health insurance expansions induced by state equal coverage (‘parity’) laws for SUD treatment. We use data on the near universe of specialty SUD treatment providers in the United States between 1997 and 2010 in an event study analysis. During this period, 18 states implemented parity laws. Following the passage of a state parity law we find that providers are less likely to participate in public markets, are less likely to provide charity care, increase the quantity of healthcare provided, and become more selective of the type of patients they are willing to admit.

Source: Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers by Catherine Maclean, Ioana Popovici, Elisheva Stern :: SSRN


The Impact of the Affordable Care Act Young Adult Provision on Childbearing, Marriage, and Tax Filing Behavior: Evidence from Tax Data by Bradley Heim, Ithai Lurie, Kosali Ilayperuma Simon :: SSRN

February 13, 2017

We use panel U.S. tax data spanning 2008-2013 to study the impact of the Affordable Care Act (ACA) young adult provision on two important demographic outcomes — childbearing and marriage. The impact on childbearing is theoretically ambiguous, as gaining insurance may increase access to contraceptive services, while also reducing the out-of-pocket costs of childbirth. The impact on marriage is also ambiguous, as marriage rates may decrease when young adults have less need for dependent health insurance through a spouse, but may increase when they are now allowed to stay on their parent’s plans even if they are married. Changes in childbearing and marriage can, in turn, lead to changes in the likelihood of filing a tax return. Since W-2 forms record access to employer-provided fringe benefits, we were able to examine the impact of the coverage expansion by focusing on young adults whose parents have access to benefits. We compare those who are slightly younger than the age threshold to those who are slightly older. Our results suggest that the ACA young adult provision led to a modest decrease in childbearing and marriage rates, though the propensity to file a tax return did not change significantly.

Source: The Impact of the Affordable Care Act Young Adult Provision on Childbearing, Marriage, and Tax Filing Behavior: Evidence from Tax Data by Bradley Heim, Ithai Lurie, Kosali Ilayperuma Simon :: SSRN


Optimal Family Taxation and Income Inequality by Patricia F. Apps, Ray Rees :: SSRN

February 12, 2017

This paper presents the properties of optimal piecewise linear income tax systems for families based on joint and individual incomes respectively. It models the interaction between the wage rates of mothers as “second earners” and variation in child care prices and productivities as determinants of across-household heterogeneity in second earner labour supply. We find that individual taxation welfare dominates joint taxation not only on the well-known grounds of efficiency but also of equity. An important driver of this result is the sharp rise in wage rates in the top percentiles of the primary wage distribution. In addition to reducing the intra-household net-of-tax wage gap, individual taxation removes the opportunity for tax avoidance income splitting makes available to high wage primary earners, leading to a much fairer distribution of the tax burden.

Source: Optimal Family Taxation and Income Inequality by Patricia F. Apps, Ray Rees :: SSRN


Healthcare Spending and Utilization in Public and Private Medicare by Vilsa Curto, Liran Einav, Amy Finkelstein, Jonathan Levin, Jay Bhattacharya :: SSRN

February 12, 2017

We compare healthcare spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their healthcare spending. Healthcare spending is 25 percent lower for MA enrollees than for enrollees in traditional Medicare (TM) in the same county with the same risk score. Spending differences between MA and TM are similar across sub-populations of enrollees and sub-categories of care, with similar reductions for “high value” and “low value” care. Spending differences primarily reflect differences in healthcare utilization; spending per encounter and hospital payments per admission are very similar in MA and TM. Geographic variation in MA spending is about 20 percent higher than in TM, but geographic variation in hospital prices is about 20 percent lower. We present evidence consistent with MA plans encouraging substitution to less expensive care, such as primary rather than specialist care, and outpatient rather than inpatient surgery, and with employing various types of utilization management. Some of the overall spending differences between MA and TM may be driven by selection on unobservables, and we report a range of estimates of this selection effect using mortality outcomes to proxy for selection.

Source: Healthcare Spending and Utilization in Public and Private Medicare by Vilsa Curto, Liran Einav, Amy Finkelstein, Jonathan Levin, Jay Bhattacharya :: SSRN