Author Archive

How Successful Has Been No-Fault Divorce?

Pro: Scott Keyes.

678No-fault divorce has been a success. A 2003 Stanford University study detailed the benefits in states that had legalized such divorces: Domestic violence dropped by a third in just 10 years, the number of husbands convicted of murdering their wives fell by 10 percent, and the number of women committing suicide declined between 11 and 19 percent. A recent report from Maria Shriver and the Center for American Progress found that only 28 percent of divorced women said they wished they’d stayed married.

Dubious: Bryan Caplan.

Apr 24, 2014 | 19 comments | by

What If Premiums in the Exchange Go Down Next Year?

Everyone’s expecting them to go up. But what if they go down? Many families could be worse off.

money-crossroadsIf a family of four headed by two adults in their mid-30s is making $59,625 per year, then the ObamaCare subsidies will make it so the second-lowest cost silver plan costs no more than 8.15 percent of its income, or $4,860.

In Marion County, the two cheapest silver plans are sold by Anthem Blue Cross and Blue Shield. The cheapest plan costs $7,700 a year and the second-cheapest costs $8,040.

To make that second-cheapest plan cost only $4,860, ObamaCare applies a tax credit of $3,180. So that is the subsidy available for any family of four making $59,625 — NO MATTER WHICH HEALTH PLAN that family purchases in the ObamaCare exchange. It can be a bronze plan or a gold plan. It can be more or less expensive. No matter, that family will receive a subsidy equal to $3,180.

But what happens if another insurer — such as UnitedHealthcare, which sat on the sidelines this year, or MDwise Inc., offers a silver plan in 2015 that’s just a little bit cheaper than the cheapest Anthem plan, say, for $7,500 per year?

Read More » »

Apr 23, 2014 | 15 comments | by

Hits and Misses

Smiling NurseThree more states — Connecticut, Nebraska and New York — are in the process of allowing nurse practitioners to work without oversight from a doctor, in an effort to alleviate physician shortages.

Tom Sargent summarizes economics in 335 words. Or is it 297 words?

eHealth, Inc., an online insurance broker, is ObamaCare’s biggest winner.

If we had a drug to delay Alzheimer’s by five years, annual treatment costs would drop by almost half a trillion dollars a year.

Apr 22, 2014 | 15 comments | by

Why Sweden is Privatizing Health Care

people-in-waiting-room…[T]he average wait time (from referral to start of treatment) for “intermediary and high risk” prostate cancer is 220 days. In the case of lung cancer, the wait between an appointment with a specialist and a treatment decision is 37 days.

Stories of people in Sweden suffering stroke, heart failure and other serious medical conditions who were denied or unable to receive urgent care are frequently reported in Swedish media. Recent examples include a one-month-old infant with cerebral hemorrhage for whom no ambulance was made available, and an 80-year-old woman with suspected stroke who had to wait four hours for an ambulance. (WSJ)

Apr 22, 2014 | 17 comments | by

How Well Do We Match Medical Student’s with Residencies?

Amy Ho at Forbes writes:

StethoscopeThis year, 5.6% of US allopathic (MD) seniors did not match, and 22.3% of U.S. osteopathic (DO) seniors did not match. On the whole, 25.0% of applicants in the NRMP Match did not match — with a 25% unemployment rate, how successful is the Match, really?

This system is highly wasteful. It incurs massive costs for hospitals and students through the interview process, precludes contract negotiations that could optimize value for both parties and results in depressed wages for young physicians. Additionally, it incurs significant opportunity cost in trading interviews for educational senior year curricula, causes undue duress for applicants and their families and contributes to decreased quality of care in physicians unsatisfied with results of the Match.

Full piece worth reading.

Apr 22, 2014 | 15 comments | by

There is More Income Mobility than You Think

It turns out that 12 percent of the population will find themselves in the top 1 percent of the income distribution for at least one year. What’s more, 39 percent of Americans will spend a year in the top 5 percent of the income distribution, 56 percent will find themselves in the top 10 percent, and a whopping 73 percent will spend a year in the top 20 percent of the income distribution…

Likewise, data analyzed by the I.R.S. showed similar findings with respect to the top 400 taxpayers between 1992 and 2009. While 73 percent of people who made the list did so once during this period, only 2 percent of them were on the list for 10 or more years. These analyses further demonstrate the sizable amount of turnover and movement within the top levels of the income distribution. (NYT)

Apr 21, 2014 | 11 comments | by

What are the Financial Risks of Being Uninsured?

Previously, Chris Conover showed that the medical risk of being uninsured is small:

…[T]he evidence that having health insurance will reduce mortality risk by any significant amount is pretty thin…even if we assume that having coverage reduces the chance of early death by 22 percent, this is comparable to a half dozen other risks that people face. For the same amount as we are spending to expand coverage under ObamaCare, we could save eight times as many lives by focusing on other causes of death such as smoking.

See also his analysis of the claim that failure to expand Medicaid kills people and Linda Gorman on the same subject at this blog.

In his latest post, Conover shows that the financial risks are small as well:

I have calculated the medical bankruptcy risk facing those with continuous coverage at 1.25 per 1,000. Eliminating this difference would evaporate the risk of medical bankruptcy for 1.89 people out of every 1,000 uninsured Americans every year.

…[I]f having coverage could reduce bankruptcy risk by 1.89/1,000, what would that mean? First, the overall difference in bankruptcy risk (inclusive of medical and non-medical causes) between those with health insurance and those without is 10.7 per 1,000, so eliminating the “excess” risk of medical bankruptcy that we are assuming can be attributed to lack of health insurance coverage would shrink this difference by less than 20%. Perhaps more astonishing, such a reduction would shrink an uninsured person’s overall bankruptcy risk by a mere 11% (from 17.9 to 16.1 per 1,000).

Apr 21, 2014 | 6 comments | by

Headlines I Wish I Hadn’t Seen

nutrition-labelAre serving sizes on food packages intentional attempts to mislead us? No, they are dictated by the government.

Medicare kept paying dozens of doctors after they were suspended or terminated from state Medicaid programs or were indicted or charged with fraud.

Terminal cancer patients in Russia are sent home to die; can’t get pain medication; some are committing suicide. (HT: Jason Shafrin)

Patients at risk: More than 100,000 doctors, nurses, medical technicians, and healthcare aides abuse prescription drugs.

Apr 21, 2014 | 14 comments | by

We’re Looking More and More like Canada

doctor-mom-and-sonPatients — and physicians — say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements. It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems.  (KHN)

Apr 21, 2014 | 13 comments | by

How Dirty Is Your Money?

money_1By analyzing genetic material on $1 bills, the NYU researchers identified 3,000 types of bacteria in all — many times more than in previous studies that examined samples under a microscope. Even so, they could identify only about 20% of the non-human DNA they found because so many microorganisms haven’t yet been cataloged in genetic data banks.

Easily the most abundant species they found is one that causes acne. Others were linked to gastric ulcers, pneumonia, food poisoning and staph infections, the scientists said. Some carried genes responsible for antibiotic resistance. (WSJ)

Apr 21, 2014 | 13 comments | by
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