The fabric of our society is changing. In 1980, approximately 78 percent of families with children were headed by married parents. In 2012, married parents headed only 66 percent of families with children. In a new report, Bradford Wilcox and Robert Lerman explore the role of family structure with new data and analysis, and document how this retreat from marriage is not simply a social and cultural phenomenon. It has important economic implications for, amongst others, men’s labor force participation rates, children’s high school dropout rates and teen pregnancy rates. Since these factors are highly correlated with economic opportunity and the ability to move up the income ladder, this suggests that income inequality and economic mobility across generations are critically influenced by people’s decisions and attitudes towards marriage. Understanding the role of family structure is therefore key to understanding the big economic challenges of our time.
New CBO study shows that ‘the rich’ don’t just pay their ‘fair share,’ they pay almost everybody’s share » AEINovember 19, 2014
But the major finding of the CBO report is that the households in the top income quintile are the real “net payers” of the US economy. The average household in the top one-fifth of American households by income paid $57,500 in federal taxes in 2011, received $11,000 in government transfers, and therefore made a net positive contribution of $46,500. The second-highest income quintile basically just barely covers its transfer payments, so it’s really the top 20% of “net payer” households that are financing transfer payments to the entire bottom 60% AND financing the non-financed operations of the entire federal government.
The Sheiner study is similar to an earlier study by Andrew Rettenmaier and Thomas Saving a former trustee of Medicare. That study found that 80 percent of the variation in Medicare spending per enrollee could be explained by demographics age, race, sex, etc., income, and the uninsured rate. After making adjustments for these variables, the study asked how much money Medicare could save if every state matched the performance of the five lowest-spending states? The answer: about 10 percent. For all health care spending, how much could be saved if every state matched the performance of the five lowest-spending states? Answer: about 5 percent.
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.
An Estimated $84.9 Billion In Uncompensated Care Was Provided In 2013; ACA Payment Cuts Could Challenge ProvidersMay 5, 2014
Millions of uninsured people use health care services every year. We estimated providers’ uncompensated care costs in 2013 to be between $74.9 billion and $84.9 billion. We calculated that in the aggregate, at least 65 percent of providers’ uncompensated care costs were offset by government payments designed to cover the costs. Medicaid and Medicare were the largest sources of such government payments, providing $13.5 billion and $8.0 billion, respectively. Anticipating fewer uninsured people and lower levels of uncompensated care, the Affordable Care Act reduces certain Medicare and Medicaid payments. Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.
This article presents estimates of personal health care spending by age and gender in selected years during the period 2002–10 and an analysis of the variation in spending among children, working-age adults, and the elderly. Our research found that in this period, aggregate spending on children’s health care increased at the slowest rate. However, per capita spending for children grew more rapidly than that for working-age adults and the elderly. Per capita spending for the elderly remained about five times higher than spending for children. Overall, females spent more per capita than males, but the gap had decreased by 2010. The implementation of Medicare Part D, the effects of the recent recession, and the aging of the baby boomers affected the spending trends and distributions during the period of this study.
For Kids’ Sake: State-Level Trends in Children’s Health Insurance A State-by-State Analysis. SHADAC, April 2014.