Start at birth, coordinate services into comprehensive early childhood programs and achieve greater economic and social gains. Professor Heckman’s latest research, “The Lifecycle Benefits of an Influential Early Childhood Program,” shows that high quality birth-to-five programs for disadvantaged children can deliver a 13% per year return on investment—a rate substantially higher than the 7-10% return previously established for preschool programs serving 3- to 4-year-olds. Heckman, his University of Chicago colleague Jorge Luis García, Duncan Ermini Leaf of the Leonard D. Schaeffer Center for Health Policy and Economics at University of Southern California, and María José Prados of the Dornsife Center for Economic and Social Research at University of Southern California, find that significant gains are realized through better outcomes in education, health, social behaviors and employment.
Now, new data from the Centers for Disease Control and Prevention shows that a U.S. life expectancy dropped in 2015 – a year after the major provisions of the ACA went into effect – and for the first time since 1993, when according to NPR, the drop was attributed to the AIDS epidemic, a flu outbreak, and an spike in homicide rates. While the relationship between health insurance and mortality might still be debated – and it is certainly too early to suggest, as NPR’s analysis implies, that the ACA is as bad as the AIDS epidemic – one thing is clear: There is no evidence that the ACA is, on net, saving lives.
A study on mortality rates released on Thursday by the National Center for Health Statistics showed that Americans could expect to live for 78.8 years in 2015, a decrease of 0.1 from the year before. The overall death rate increased 1.2 percent — that’s about 86,212 more deaths than those recorded in 2014.
Dr. Peter Muennig, a professor of health policy and management at Columbia University’s Mailman School of Public Health, said in an interview that the decline was a “uniquely American phenomenon” in comparison with other developed countries, like Japan or Sweden.“A 0.1 decrease is huge,” Dr. Muennig said. “Life expectancy increases, and that’s very consistent and predictable, so to see it decrease, that’s very alarming.”
What’s causing the decline? For researchers, the numbers reflect a culmination of problems: eight of the top 10 causes of death showed an increase in death rates, including those from heart disease, diabetes and kidney disease. Deaths from Alzheimer’s rose 15.7 percent, unintentional injuries rose 6.7 percent and suicide rose 2.3 percent.The infant mortality rate, often the marker researchers use to gauge the health of a population, rose slightly, but Dr. Jiaquan Xu, one of the authors of the study, said that the rise was not considered significant.Dr. Muennig said that popular theories for the cause of the decline, including an increase in obesity rates and an opiod epidemic, fail to explain a problem that feels broader.“If you actually dissect the data neither of those arguments hold,” he said. “This report slams it home that this is really a mystery.”Is there any positive news?Dr. Xu said that the study’s lone bright spot showed a decline in deaths from cancer, by 1.7 percent.“That’s the only part that’s good news,” he said.How does race play a factor in my life span?The study is further confirmation of a decline in health in different racial populations. Death rates among non-Hispanic black males rose 0.9, and 1 percent among non-Hispanic white males. Rates for non-Hispanic white females rose 1.6 percent.Rates for non-Hispanic black females, Hispanic males, and Hispanic females held steady from 2014 to 2015.Dr. Muennig said that a decline in the health of working class whites was a major contributor to the latest survey results. Life expectancy for whites has stagnated or dipped in recent years, fueled by vulnerability to drug and alcohol abuse, suicide and economic distress.“It’s not happening to black people,” Dr. Muennig said. “That group used to have a huge and growing disparity with whites, but that gap has radically narrowed.”AdvertisementContinue reading the main storyIn 2014, the life expectancy gap between black and white people closed to 3.4 years, the smallest on record.What about income?Thursday’s survey did not break people down by income or education level, but past research has shown that as the gap between the rich and poor in America widens, people of different income levels can expect to live for different lengths of time.In February, researchers at the Brookings Institution analyzed life expectancies for men who were among the top 10 percent of earners, and those who were among the bottom 10 percent. For men born in 1950, life expectancy was 14 years shorter than for those among the rich.Dr. Muennig said that researchers suspect that the strain of income inequality in the United States — and the stress that this causes — could be a major contributing factor to the uptick, but it has been hard to prove beyond one thread of research that studies how earned-income tax credits can help improve the health of people with low incomes.Does sex play a factor?Yes. According to the data, life expectancy for females remains consistently higher than it for males. In 2015, the difference in life expectancy between females and males increased to 4.9 years in 2015, up from 4.8 years in 2014.What do these numbers mean for the future?Dr. Xu said in an interview that the decline doesn’t necessarily show a trend, but that the numbers are cause for concern.“If a year from now if this situation continues,” Dr. Xu said, “it’s definitely a problem for public health.”Continue reading the main storyRELATED COVERAGEOpinion David LeonhardtThe American Dream, Quantified at Last DEC. 8, 2016White Americans Are Dying Younger as Drug and Alcohol Abuse Rises APRIL 20, 2016Black Americans See Gains in Life Expectancy MAY 8, 2016TRENDINGJohn Glenn, American Hero of the Space Age, Dies at 95‘They Are Slaughtering Us Like Animals’Trump’s Labor Pick, Andrew Puzder, Is Critic of Minimum Wage IncreasesOn Campus, Trump Fans Say They Need ‘Safe Spaces’Contributing Op-Ed Writer: Trump Voters Are Feeling ItSouth Korea’s President Awaits Her Fate, Dejected, Sleepless and AloneOp-Ed Columnist: Trump: Madman of the YearThe Best Movies of 2016Trilobites: That Thing With Feathers Trapped in Amber? It Was a Dinosaur TailOp-Ed Columnist: The American Dream, Quantified at LastView More Trending Stories »What’s NextLoadi
Hundreds on Medicaid waiting list in Illinois die while waiting for care | Illinois Policy | Illinois’ comeback story starts hereNovember 25, 2016
The state’s most recent enrollment reports show more than 650,000 able-bodied adults have enrolled in Medicaid since the Obamacare expansion, and this enrollment shows no sign of slowing down. This is nearly twice as many adults as the state said would ever enroll and more than the state said would ever even be eligible.
Expansion costs are also significantly over projections. Despite promises from the administration of former Gov. Pat Quinn that total expansion costs would “only” hit $2.7 billion in the first two years, costs actually came in at $4.7 billion – 70 percent higher than promised.
Calorie Overestimation Bias and Fast Food Products: The Effects of Calorie Labels on Perceived Healthiness and Intent to Purchase by Simon Hedlin :: SSRNOctober 29, 2016
In 2014, the United States Food and Drug Administration announced that chain restaurants with 20 or more locations would be required to put calorie labels on the menu. The merits of the policy depend in large part on three empirical issues: 1) if calorie labels help correct calorie under- or overestimation biases; 2) if the labels lead to changes in consumer behavior, which may improve physical health; and 3) if they have an impact on psychological health. This paper presents data from an online experiment (N = 1,323) in which participants were randomly presented with pictures of food and drink items from major fast-food companies either with or without calorie labels. The following findings are reported. First, there was calorie overestimation bias among participants, and the respondents thought, on average, that products contained more calories than was actually the case. Second, calorie labels both made participants perceive the products as healthier, and made them more likely to intend to purchase said items. Third, calorie labels did not have any discernible effects either on the expected utility from consuming the products, or on the participants’ experienced well-being. Thus, while calorie labels did not appear to have any negative effects on psychological health, they did seem to correct a calorie overestimation bias, which may inadvertently improve the perceived healthiness of foods and beverages high in calories, and could also potentially lead consumers to buy more, rather than fewer, such products.
Patient Cost Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design by Hsing-Wen Han, Hsien‐Ming Lien, Tzu-Ting Yang :: SSRNOctober 29, 2016
This paper exploits longitudinal insurance claims data and a cost-sharing subsidy that has exempted co-payment and coinsurance of healthcare services for children under the age of 3 in Taiwan. We use a regression discontinuity design to estimate its effect on children’s healthcare utilization. Our results show that cost-sharing subsidy significantly increases the utilization of outpatient care, especially low-value care at high-cost hospitals. In contrast, the utilization of inpatient care is price insensitive. Finally, we find that a lower level of cost-sharing has little impact on children’s health.
As a strategy to improve Americans’ health status and reduce healthcare costs, the Affordable Care Act (ACA) allows employers to place up to 30% of total health insurance spending “at risk” for employees. Employees can keep/earn that share by participating in programs to reduce chronic disease risk factors and/or by controlling their cholesterol, blood pressure, and body mass indexes (BMI). Partly as a result of this provision, chronic disease risk factors have become a primary focus of many if not most major employers in America. Whether these wellness programs have worked is beyond the scope of this posting, but is unresolved. In 2010 Health Affairs published an oft-cited (albeit challenged and undefended) meta-analysis finding savings with these programs. This conclusion was directionally confirmed (except for randomized control trials, which showed a negative return on investment) by a 2014 meta-analysis in a wellness trade journal. Conversely, the Incidental Economist published several pieces on the questionable finances and other concerns raised by these programs. The Bloomberg BNA Healthcare Policy Report published a concise summary of the “con” argument. A 2014 RAND study of PepsiCo found no savings.