Cancer patients on Medi-Cal fare worse than others – California Health Report

November 11, 2015

Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers.

While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC-Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.

Source: Cancer patients on Medi-Cal fare worse than others – California Health Report


The Hierarchy of Human Life – WSJ

November 5, 2015

These roots [of health inequalities] lie primarily in what Dr. Marmot identifies as the social determinants of health (SDH). These are not simply economic, although of course poverty is associated with bad health—a link established in the 19th century by Edwin Chadwick in Britain and Lemuel Shattuck in the U.S. But “poverty is not destiny,” Dr. Marmot insists. Rather, he seeks to develop a model of SDH that is intrinsically linked with human autonomy and control. Prosperity brings all sorts of empowerments, just as poverty denies them. It is the empowerment rather than the absolute poverty that he believes is most crucial.

Source: The Hierarchy of Human Life – WSJ


Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?

January 13, 2015

We examine the long-term impact of expansions to Medicaid and the State Children’s Health Insurance Program that occurred in the 1980’s and 1990’s. With administrative data from the IRS, we calculate longitudinal health insurance eligibility from birth to age 18 for children in cohorts affected by these expansions, and we observe their longitudinal outcomes as adults. Using a simulated instrument that relies on variation in eligibility by cohort and state, we find that children whose eligibility increased paid more in cumulative taxes by age 28. These children collected less in EITC payments, and the women had higher cumulative wages by age 28. Incorporating additional data from the Medicaid Statistical Information System (MSIS), we find that the government spent $872 in 2011 dollars for each additional year of Medicaid eligibility induced by the expansions. Putting this together with the estimated increase in tax payments discounted at a 3% rate, assuming that tax impacts are persistent in percentage terms, the government will recoup 56 cents of each dollar spent on childhood Medicaid by the time these children reach age 60. This return on investment does not take into account other benefits that accrue directly to the children, including estimated decreases in mortality and increases in college attendance. Moreover, using the MSIS data, we find that each additional year of Medicaid eligibility from birth to age 18 results in approximately 0.58 additional years of Medicaid receipt. Therefore, if we scale our results by the ratio of beneficiaries to eligibles, then all of our results are almost twice as large.

via Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?.


Medicaid’s return on investment | The Incidental Economist

December 5, 2014

Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?” by David Brown, Amanda Kowalski, and Ithai Lurie.

We examine the long-term impact of expansions to Medicaid and the State Children’s Health Insurance Program that occurred in the 1980’s and 1990’s. With administrative data from the IRS, we calculate longitudinal health insurance eligibility from birth to age 18 for children in cohorts affected by these expansions, and we observe their longitudinal outcomes as adults. Using a simulated instrument that relies on variation in eligibility by cohort and state, we find that children whose eligibility increased paid more in cumulative taxes by age 28. These children collected less in EITC payments, and the women had higher cumulative wages by age 28. Incorporating additional data from the Medicaid Statistical Information System (MSIS), we find that the government spent $872 in 2011 dollars for each additional year of Medicaid eligibility induced by the expansions. Putting this together with the estimated increase in tax payments discounted at a 3% rate, assuming that tax impacts are persistent in percentage terms, the government will recoup 56 cents of each dollar spent on childhood Medicaid by the time these children reach age 60. This return on investment does not take into account other benefits that accrue directly to the children, including estimated decreases in mortality and increases in college attendance. Moreover, using the MSIS data, we find that each additional year of Medicaid eligibility from birth to age 18 results in approximately 0.58 additional years of Medicaid receipt. Therefore, if we scale our results by the ratio of beneficiaries to eligibles, then all of our results are twice as large.

via Medicaid’s return on investment | The Incidental Economist.


VIDEO: The Massive Ferguson Conspiracy Just Got Blown Wide Open [WATCH]

November 18, 2014

Whittle points out that there is an epidemic of racial violence – but not the way the media spins it.

“The National Crime Victimization Survey reported approximately 13,000 black-on-white rapes and 39,000 black-on-white robberies.”

“The statistics show that the number of white-on-black rapes and violent robberies were so small that they had to be rounded to the nearest whole number – and that whole number is zero.”

Whittle blames figures like President Obama and Attorney General Holder for the racial division.“  Open racism is simply not tolerated in white America today, but black racism is the toxic glue that holds the progressive coalition together,” Whittle concludes.

via VIDEO: The Massive Ferguson Conspiracy Just Got Blown Wide Open [WATCH].


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.