Health Reform and the Plight of the Uninsured Pregnant Woman by Nicole Moody :: SSRN

May 31, 2012

America’s health and prosperity will depend on the health and prosperity of the future generation — a generation comprised of children. To ensure the health of America’s tiniest citizens and the future leaders of tomorrow, the United States must take an interest in providing adequate prenatal, natal, and postnatal care to its mothers.

Part I of this article seeks to explain the barriers preventing pregnant women from obtaining adequate and affordable health insurance coverage. I examine the three health insurance options currently available to pregnant women — employer-sponsored health insurance, individually purchased insurance, and government-funded insurance — and provide an overview of the legal history regarding the pregnant woman’s access to health care coverage. Part II provides a discussion of the Patient Protection and Affordable Care Act (ACA) and analyzes whether Obama’s 2010 health care reform made any significant progress towards improving the pregnant woman’s ability to access affordable health care coverage. Part III concludes the article with further recommendations for reforming the new health insurance system, which include (i) updating the Federal Poverty Level (FPL) standard or adopting a new measurement to more accurately reflect the poverty level and economic need of families and individuals; (ii) adopting a “fallback provision,” which extends affordable health insurance coverage to all pregnant women who do not otherwise have access to any means of affordable health insurance; and (iii) instituting more outreach, transparency, and accountability within the state health insurance systems.

via Health Reform and the Plight of the Uninsured Pregnant Woman by Nicole Moody :: SSRN.

On the Relationship between GDP and Health Care Expenditure: A New Perspective by Santiago Lago-Penas, David Cantarero, Carla Blázquez :: SSRN

May 31, 2012

In this paper we analyze the relationship between income and health expenditure in 31 OECD countries. We focus on the difference between short and long term multipliers and we also check the adjustment process of health care expenditure to changes in per capita GDP and its main components. In both cases we test if results differ in countries with a higher share of private expenditure on total health expenditure. Econometric results show that the long-run multiplier is close to unity, that health expenditure is more sensitive to per capita income cyclical movements than to trend movements, and that those countries with a higher share of private health expenditure fit faster and following a different pattern.

via On the Relationship between GDP and Health Care Expenditure: A New Perspective by Santiago Lago-Penas, David Cantarero, Carla Blázquez :: SSRN.

Henninger: Church Is Still Not State –

May 31, 2012

Some things don’t change, though, and among them is an American antipathy to being pushed too far. Americans are a tolerant people, but past some point they push back. With the HHS mandate upon them, a lot of Catholic voters are thinking resistance. It’s an old American tradition.

The Catholic lawsuits filed against the HHS mandate are based in the Constitution’s Free Exercise Clause. That’s the legal issue. But the reason so much hell broke loose after the Obama administration’s decision is that it runs afoul of the Constitution’s Establishment Clause against creating a state religion. The issue here isn’t the parsings of constitutional law but the American religious experience that led to the Establishment Clause.

via Henninger: Church Is Still Not State –

Regulatory Redistribution in the Market for Health Insurance by Jeffrey Clemens :: SSRN

May 31, 2012

In the early 1990s, several US states enacted community rating regulations to equalize the private health insurance premiums paid by the healthy and the sick. Consistent with severe adverse selection pressures, their private coverage rates fell by 8-11 percentage points more than rates in comparable markets over subsequent years. By the early 2000s, however, most of these losses had been recovered. The recoveries were coincident with substantial public insurance expansions (for unhealthy adults, pregnant women, and children) and were largest in the markets where public coverage of unhealthy adults expanded most. The analysis highlights an important linkage between the incidence of public insurance programs and redistributive regulations. When targeted at the sick, public insurance expansions can relieve the distortions associated with premium regulations, potentially crowding in private coverage. Such expansions will look particularly attractive to participants in community-rated insurance markets when a federal government shares in the cost of local public insurance programs.

via Regulatory Redistribution in the Market for Health Insurance by Jeffrey Clemens :: SSRN.

The Misguided War Against Medicines 2011 by Mark Rovere, Brett Skinner :: SSRN

May 31, 2012

Provincial health spending has grown faster on average than GDP for the last 37 years. Trends show that health spending will consume 50% of total available revenues (including federal transfers) in 6 of 10 provinces by 2017, up from roughly 25% in 1974. Some researchers blame unsustainable growth in government health spending on the cost of prescription drugs, particularly patented medicines. The evidence suggests otherwise. Prescription drugs account for a small percentage (9%) of government health spending; and patented prescription drugs are an even smaller percentage (5.2%). Excluding prescription drugs, all other non-drug categories of health expenditures (hospitals, professionals, etc.) are growing at an unsustainable pace, while accounting for 91% of government spending on health. There is no observable statistical link between the rising share of the health budget spent on drugs and variation in the growth rates in government health spending. Inflation-adjusted, post-market prices for patented drugs in Canada have been declining for 21 years, and introductory prices for patented drugs are at or below international prices.

The real cause of unsustainable growth in health spending is that government socializes too much of the private consumption costs of healthcare. Provinces subsidize 100% of the cost of medical goods and services through a redistributive, tax-funded, single-payer, government-run, insurance monopoly. Coverage is universal for hospital and physician services, but extends to drugs for only one-third of the population. Consumers are disconnected from the costs of the healthcare they personally use. As a result, the system lacks the normal economic incentives that would produce a sustainable balance between the demand for and supply of medical goods and services. Instead, governments constrain costs through central budget rationing, which creates intractable shortages because, while private insurance could cover unmet consumer demands for healthcare, governments effectively prohibit private payment for hospital and physician services.

via The Misguided War Against Medicines 2011 by Mark Rovere, Brett Skinner :: SSRN.

Medical Decision Making by and on Behalf of Adolescents: Reconsidering First Principles by Beatrice Jessie Hill :: SSRN

May 31, 2012

The school nurse cannot give your teenage daughter an aspirin for her headache without your permission, but that same daughter can get an abortion without even informing you. Or can she? The obligations on medical personnel providing care to adolescents are famously indeterminate.

Two common-law presumptions have long lurked in the background, but, far from elucidating matters, those presumptions have contributed to the state of confusion. The first presumption is that, absent any special rule, children lack the legal authority to consent to medical treatment on their own. A parallel and corresponding presumption is that parents have a legal entitlement to make medical decisions for their minor children.

This article questions whether those propositions have any force today — if, in fact, they ever did. Both as a descriptive matter and as a constitutional matter, these statements are highly questionable, particularly when adolescents are involved.

This article therefore makes the case that neither presumed truth about the American legal landscape is valid, at least with respect to older minors. It also suggests that the ultimate failure of the law to provide solid and meaningful background presumptions in the domain of minors’ medical decision-making rights has done much to aggravate, if not create, the muddle of regulation that confounds health care providers.

The constitutional doctrine pertaining to minors’ rights to bodily integrity, moreover, both highlights and founders upon the extreme lack of clarity with respect to the relevant default rules regarding older minors’ ability to consent to medical care. Increased judicial attention directed toward developing the constitutional doctrine surrounding minors‘ rights to bodily integrity would therefore be beneficial both to health care providers and to minors.

via Medical Decision Making by and on Behalf of Adolescents: Reconsidering First Principles by Beatrice Jessie Hill :: SSRN.

Bloomberg Plans a Ban on Large Sugared Drinks –

May 31, 2012

In New York City, where more than half of adults are obese or overweight, Dr. Thomas Farley, the health commissioner, blames sweetened drinks for up to half of the increase in city obesity rates over the last 30 years. About a third of New Yorkers drink one or more sugary drinks a day, according to the city. Dr. Farley said the city had seen higher obesity rates in neighborhoods where soda consumption was more common.

via Bloomberg Plans a Ban on Large Sugared Drinks –