AFSCME Information Highway

Source: Sherry Glied, and Bisundev Mahato, Commonwealth Fund, Volume 37, May 2, 2008

From the overview:
Employer-sponsored insurance coverage forms the backbone of the U.S. health insurance system, yet there are crucial weaknesses that have contributed to a growing number of uninsured Americans. Ultimately, the lack of employer-based coverage generates public costs in the form of taxpayer bills to fund public insurance or uncompensated care programs for care that would otherwise be paid for through insurance. This report quantifies those costs, using data from the Medical Expenditure Panel Surveys to estimate public program spending and uncompensated care costs for uninsured workers and their dependents. In 2004, uninsured and publicly insured workers and their dependents accounted for $45 billion in public costs. This includes $33 billion associated with public program insurance costs and $12 billion in uncompensated care costs. Public costs associated with uninsured and publicly insured workers and their dependents were 45 percent greater in 2004 than in 1999. All costs are reported in 2004 dollars.

See also:

The Widening Health Care Gap Between High- and Low-Wage Workers

Congressional Testimony--Widening Gaps in Health Insurance Coverage in the United States: The Need for Universal Coverage

Posted by Info Center at 5:34 PM in Health Care | Permalink

Source: American Lung Association/Robert Wood Johnson Foundation

The annual update of State Legislated Actions on Tobacco Issues--SLATI, for short--is now in its 20th year of publication.

Published by the American Lung Association with support from RWJF, the report tracked the passage of legislation and other state policies related to tobacco control and prevention, including tobacco taxes, youth access and funding for tobacco control programs during 2007.

SLATI 2007 showed an increasing number of states taking strong action against tobacco during the year--including five states which took steps to counter the harmful effects of secondhand smoke.

Indeed, eight states passed increases in their tobacco taxes in 2007, bringing the average state cigarette tax up to $1.11 a pack--a dramatic increase from the beginning of 2002. Back then, the average tax was only 44.6 cents per pack.

Full Report (PDF; 3.7 MB)

Posted by William at 8:14 AM in Health Care | Taxation | Permalink

Source: State Health Access Data Assistance Center, University of Minnesota, April 2008

From the summary:
This article reveals how the cost of family health insurance nationwide is increasing dramatically for employees without anywhere near an equivalent increase in family income. If this trend continues, more workers are likely to become uninsured because of the expense.

Key Findings:

• The amount workers pay for family coverage nationwide has increased by 30 percent from $8,281 in 2001 to $10,728 in 2005.
• Employee income has increased by only 3 percent in the same time period.
• The average cost employers pay for their share of family coverage has increased by 28 percent from $6,360 to $8,143.

Seventy-six percent of insured individuals in the United States receive health insurance from their own or a family member's employer. It follows that the more employees and employers have to pay for that insurance, the more likely workers are to join the ranks of the uninsured. Risa Lavizzo-Mourey, M.D., M.B.A, president and CEO of the Robert Wood Johnson Foundation stated in a press release, "This study makes plain what every working parent knows--that providing insurance coverage takes a bigger bite from the family budget every year."

Posted by Info Center at 3:42 PM in Benefits | Compensation | Health Care | Permalink

Source: U.S. Governmental Accountability Office

The number of individuals participating in HSA-eligible health plans and HSAs increased significantly between 2004 and 2007; however, in all years, many HSA-eligible plan enrollees did not open an HSA. The number of individuals covered by HSA-eligible plans increased significantly between September 2004 and January 2007--from about 438,000 to approximately 4.5 million, according to industry estimates. Despite the growth, these plans represented a small share of individuals with private health coverage--about 2 percent in 2006. The number of tax filers reporting HSA activity also increased, nearly tripling between 2004 and 2005, from about 120,000 to about 355,000. Industry estimates suggest continued growth in HSA participation in 2006 and 2007. Despite the growth in HSA participation, nationally representative survey estimates from 2005, 2006, and 2007 found that more than 40 percent of HSA-eligible health plan enrollees did not open an HSA.

Tax filers who reported HSA activity in 2005 had higher incomes on average than other tax filers. Among tax filers between the ages of 19 and 64, the average AGI for filers reporting HSA activity was about $139,000 compared with about $57,000 for all other filers. The income differences existed across all age groups.

Full report

Posted by William at 10:11 AM in Benefits | Health Care | Permalink

Source: Genworth Financial

From press release:
Not only has the cost of long term care in U.S. nursing homes, assisted living facilities and in the home increased for the fifth consecutive year, but the nation faces an impending shortage of direct-care workers, further driving up long term care costs. Those are two of the key conclusions drawn from cost of care research by Genworth Financial.

Each year Genworth surveys the cost of care in more than 10,000 nursing homes, assisted living facilities and home care providers in all 50 states and 90 geographic regions including the District of Columbia. This year the survey adds adult day health care findings. The most comprehensive cost analysis in the industry, it surveys three times the number of providers and offers more regional detail than similar studies, and is the only survey that provides comparative data for the past five years.

This year, Genworth's study found the price of most long term care services are rising faster than inflation, and by 2050, the nation's bill for providing long term care services is expected to top $379 billion. In 2008, the average annual price of a private nursing home room reached $76,460 nationally - more than one and a half times the average annual household income in the U.S. of $48,2011. The most preferred form of care is in the home, and the cost of home care performed by a non-skilled home health aide remained flat in most regions of the country.

This year's Cost of Care Survey is complemented by additional research released today by Genworth entitled "A Workforce to Care for Our Aging." This study identifies an imminent shortage of caregivers as the driver of increasing long term care costs. By 2030, the number of Americans 65 years and older will double. The U.S. will need to recruit 200,000 new direct-care workers each year to meet future demand among our aging population.

Cost of Care Survey (PDF; 1.2 MB)
2008 Cost of Care Map (interactive)
Survey Trends and Findings
Methodology

Posted by William at 9:52 AM in Health Care | Permalink

Source: Center for State and Local Government Excellence

A new Center for Excellence poll finds that most Americans are unaware that state and local public health departments are facing a serious shortage of skilled professionals that could put the health and lives of citizens at risk.

Most Americans don't see it as a problem. As many as 45 percent of public health workers are expected to retire within the next five years. But the poll of 1,200 adults, which was conducted for the Center by by Princeton Survey Research Associates International, finds that only one in three Americans see this as a major problem for state governments, and only one in four see it as a problem for local government.

"We count on public health professionals to prevent the spread of disease, protect us from bioterrorist threats, make sure our food is safe to eat, and our air is safe to breathe," said Elizabeth Kellar, executive director of the Center for State and Local Government Excellence.

"Those closest to the public health infrastructure know that the safety net is fragile. The public sector workforce is older than the private sector's, and state and local governments are facing their greatest turnover ever. Public health is an area that already faces critical shortages, so there is no time to lose."

Full report

Posted by William at 10:30 AM in Health Care | Workforce | Permalink

Source: Frank Sloan and Lindsey Chepke, Issues in Science and Technology, Spring 2008

A properly designed malpractice insurance system could actually decrease the prevalence of errors and enhance the overall level of care.

Every decade or so, the United States is seized with a fervor to reform medical malpractice. Unfortunately, this zest is typically motivated by circumstances that have little to do with the fundamental problems of medical malpractice, and the proposed changes to the system do not address the true flaws. A well-functioning malpractice system should focus not only on how to compensate patients for medical errors but also on how to prevent these errors from occurring in the first place.

Full article

Posted by William at 10:09 AM in Health Care | Permalink

Source: Peter Orszag, Issues in Science and Technology, Spring 2008

Popular discussions of the long-term fiscal challenges confronting the United States usually misdiagnose the problem. They typically focus on the government expenses related to the aging of the baby boomers, with lower fertility rates and longer life expectancy causing most of the long-term budget problem. In fact, most of the long-term problem will be driven by excess health care cost growth; that is, the rate at which health care costs grow compared to income per capita. In other words, it is the rising cost per beneficiary rather than the number of beneficiaries that explains the bulk of the nation's long-term fiscal problem.

Full article

Posted by William at 9:58 AM in Health Care | Permalink

Source: Josh Goodman, Governing, April 2008

Woody Allen once described death as "a very effective way of cutting down on your expenses." In the past decade, states all over the country have gone to great lengths to prove that the comedian was not only morbid but wrong. They have embraced the idea that keeping people healthy is both humane and fiscally smart; if the public is healthier, public spending will decrease. And they seem to agree that the way to keep people healthy is to prevent them from getting sick in the first place. They are investing in healthy-diet promotion and anti-smoking campaigns even as they cope with symptoms of diabetes and other chronic illnesses. "We're trying to drive people to understand that health status is the goal," says Marcia Nielsen, of the Kansas Health Policy Authority. "You don't want more medical care and you don't want more medical insurance, unless they're a means to an end."

To some hardheaded scholars and calculating critics, the problem is that, discouraging as it might seem, Woody Allen had a point. A large body of research suggests that preventive care may help people live longer, healthier lives (no small achievement) but doesn't actually save money. As a result, governments may be forced to come to grips with the notion that, when it comes to health policy, the right thing to do and the thrifty thing to do are very different.

Full article

Posted by William at 9:55 AM in Benefits | Health Care | Permalink

Source: Institute of Medicine (National Academies)

From news release:
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care work force that is too small and woefully unprepared to meet their specific health needs, says a new report from the Institute of Medicine. The report, Retooling for an Aging America: Building the Health Care Workforce, calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. Medicare, Medicaid, and other health plans should pay higher rates to boost recruitment and retention of geriatric specialists and care aides, said the committee that wrote the report.

The committee set a target date of 2030 -- the year by which all baby boomers will have turned 65 or older -- for the necessary reforms to take place.

Full Report (Read for free online.)
Project website

Posted by William at 10:32 AM in Health Care | Health Care Workers | Permalink

Source: American Hospital Association

From press release:
As more Americans worry about a slowing economy, a new study highlights the important role hospitals play in supporting a strong and stable economy. Hospitals employ more than five million people and rank second as a source of private sector jobs, according to a report released today at the American Hospital Association's (AHA) annual meeting in Washington. But hospitals and hospital employees also purchase goods and services from other businesses supporting additional jobs and economic activity in their community and across the country.

Today's TrendWatch report, which was prepared by Avalere Health, LLC, found that hospitals:
• Employ over five million people;
• Directly or indirectly support one of every ten jobs in the U.S.;
• Remain a stable source of employment, even during times of economic stress; and
• Support nearly $1.9 trillion of economic activity.
• Also included is a detailed state-by-state analysis of the economic contributions hospitals make to the communities they serve.

Full Report (PDF; 452 KB)

Posted by William at 10:26 AM in Health Care | Permalink

Source: Congressional Budget Office

SCHIP has significantly reduced the number of low-income children who lack health insurance. According to the Congressional Budget Office's (CBO's) estimates, the portion of children in families with income between 100 percent and 200 percent of the poverty level who were uninsured fell by about 25 percent between 1996 (the year before SCHIP was enacted) and 2006. In contrast, the uninsurance rate among higher-income children remained relatively stable during that period. The difference probably reflects the impact of the SCHIP program.

The states' outreach efforts and simplified enrollment processes for SCHIP appear to have also increased the share of eligible children who participate in Medicaid--and contributed to a decline in the percentage of children below the poverty level who are uninsured.

The enrollment of children in public coverage as a result of SCHIP has not led to a one-for-one reduction in the number of low-income children who are uninsured, however. Almost any increase in government spending or tax expenditures intended to expand health insurance coverage will displace private coverage to some degree. In the specific case of SCHIP, the program provides a source of coverage that is less expensive to enrollees and often provides a broader range of benefits than alternative coverage. As a result, the program displaces--or "crowds out"--private coverage to some extent. On the basis of a review of the research literature, CBO has concluded that for every 100 children who gain public coverage as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.

CBO's analysis of the Children's Health Insurance Reauthorization Act of 2007, as passed by the House of Representatives, suggested that the legislation would result in 5.8 million children gaining coverage under Medicaid or SCHIP in 2012. Of that increase, CBO estimated, 3.8 million children would otherwise have been uninsured, and 2.0 million children would otherwise have had private coverage. In other words, about one-third of the children who would be newly covered under SCHIP and Medicaid would otherwise have had private coverage. That crowd-out rate is probably about as low as feasible for a voluntary program to increase coverage among children, given the size of the proposed expansion. (Policies to reduce the rate below that level would most likely also reduce the number of children enrolled in the program who would otherwise be uninsured.)

On August 17, 2007, the Administration issued a directive to state health officials that imposes certain minimum requirements on states seeking to enroll children in SCHIP whose families have income above 250 percent of the poverty level. CBO's analysis suggests that the directive's impact on enrollment is likely to be modest under current law, given the way the Administration appears to be implementing it and, more important, given the funding levels assumed in the baseline. The directive could have a substantially larger impact on enrollment in SCHIP if the Congress expanded the program significantly.

Full-text

Posted by William at 10:19 AM in Children | Health Care | Permalink

Source: Centers for Medicare and Medicaid Services

The Medicare Program is the second-largest social insurance program in the U.S., with 44.1 million beneficiaries and total expenditures of $432 billion in 2007. The Boards of Trustees for Medicare report annually to the Congress on the financial operations and actuarial status of the program. Beginning in 2002, there is one combined report discussing both the Hospital Insurance program (Medicare Part A) and the Supplementary Medical Insurance program (Medicare Part B and Prescription Drug Coverage). The Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) prepares the report under the direction of the Boards. The Boards of Trustees issued their most recent report on March 25, 2008.

2008 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Supplementary Medical Insurance Trust Funds (242 pages, PDF).

Posted by Info Center at 9:14 AM in Health Care | Permalink

Source: Center for Studying Health System Change

From press release (Robert Wood Johnson Foundation):

As the nation's hospitals face increasing demands to participate in a wide range of quality improvement activities, the role and influence of nurses in these efforts is also increasing, according to a new study by the Center for Studying Health System Change (HSC). Hospital organizational cultures set the stage for quality improvement and nurses' roles in those activities. Hospitals with supportive leadership, a philosophy of quality as everyone's responsibility, individual accountability, physician and nurse champions, and effective feedback reportedly offer greater promise for successful staff engagement in improvement activities.

Yet hospitals confront challenges with regard to nursing involvement, including: scarcity of nursing resources; difficulty engaging nurses at all levels--from bedside to management; growing demands to participate in more, often duplicative, quality improvement activities; the burdensome nature of data collection and reporting; and shortcomings of traditional nursing education in preparing nurses for their evolving role in today's contemporary hospital setting. Because nurses are the key caregivers in hospitals, they can significantly influence the quality of care provided and, ultimately, treatment and patient outcomes. Consequently, hospitals' pursuit of high-quality patient care is dependent, at least in part, on their ability to engage and use nursing resources effectively, which will likely become more challenging as these resources become increasingly limited.

Full text

Posted by Info Center at 8:49 AM in Health Care | Health Care Workers | Permalink

Source: Harvard School of Public Health

A recent survey by the Harvard School of Public Health (HSPH) and Harris Interactive, as part of their ongoing series, Debating Health: Election 2008, finds that Americans are generally split on the issue of whether the United States has the best health care system in the world (45% believe the U.S. has the best system; 39% believe other countries have better systems; 15% don't know or refused to answer) and that there is a significant divide along party lines. Nearly seven-in-ten Republicans (68%) believe the U.S. health care system is the best in the world, compared to just three in ten (32%) Democrats and four in ten (40%) Independents who feel the same way.

This poll was conducted during a period of debate over the comparative merits of the U.S. health care system and the health care systems in other countries. President Bush and other prominent political figures have claimed that the U.S. has the best system in the world. At the same time, the World Health Organization and other organizations have ranked the U.S. below many other countries in their comparisons, while Michael Moore presented a similarly negative assessment of the U.S. health system in a popular format with his film Sicko.

So how might this issue impact how Americans vote in the upcoming presidential election? When asked if they would be more likely to support or oppose a presidential candidate who advocates making the U.S. health care system more like health systems in other countries, specifically Canada, France, and Great Britain, only one in five (19%) Republicans say they would be more likely to support such a candidate. This is compared to more than half (56%) of Democrats and more than a third of Independents (37%) who say they would be more likely to support such a candidate.

Americans' views on the U.S. health care system (Word; 340 KB)

Posted by Info Center at 8:43 AM in Health Care | Health Reform | Permalink

Source: PENNumbra

You won't hear many health experts claim that the American healthcare system is functioning perfectly in terms of core considerations such as cost, access, and quality. The question that arises with the advent of any new policy approach seeking to improve the system is obvious: Does the change represent a step forward or backward? Professors Kristin Madison, of Penn, and Peter Jacobson, of the University of Michigan, take up this question in regard to the latest innovation in health care policy--consumer-directed healthcare (CDHC).

Professor Madison argues that while CDHC is not a panacea, "[e]ven if its shortcomings prevent its full diffusion through the American health care system, CDHC will still . . . help[] to establish a foundation for future reforms in health care finance and delivery, [and] has the potential to improve the health care system in the long run." Professor Jacobson's response? "CDHC is a direct attack on the idea that health care differs from other market commodities because of its moral aspirations . . . . For those who believe that equity should be a fundamental attribute of health care delivery, CDHC represents a huge step backwards." Nonetheless, Professor Madison is convinced that CDHC will be a lightning rod that stirs the American health care system out of its complacency and "forces us to confront the tradeoffs inherent in any health care system in a resource-constrained world." Professor Jacobson is not content to wait and see how the American public reacts to CDHC: "If the policy focus is on CDHC, equity will be subordinated. If universal coverage dominates, CDHC proponents are probably right that cost and quality issues will be subordinate. For me, it's an easy choice--helping those without insurance to have a minimal acceptable level of care."

Full Debate (PDF; 118 KB)

Posted by Info Center at 8:37 AM in Benefits | Health Care | Permalink

Source: Treatment Advocacy Center

Since the 1960s there has been a mass exodus of patients from public psychiatric hospitals. Data are available on the number of patients in such hospitals in 1955 and in 2004-2005. The data show that:
• In 2005 there were 17 public psychiatric beds available per 100,000 population compared to 340 per 100,000 in 1955. Thus, 95 percent of the beds available in 1955 were no longer available in 2005.
• The states with the fewest beds were Nevada (5.1 per 100,000), Arizona (5.9), Arkansas (6.7), Iowa (8.1), Vermont (8.9), and Michigan (9.9). The states with the most beds were South Dakota (40.3) and Mississippi (49.7).
• A consensus of experts polled for this report suggests that 50 public psychiatric beds per 100,000 population is a minimum number. Thus, 42 of the 50 states had less than half the minimum number needed, and Mississippi was the only state to achieve this goal.
• The total estimated shortfall of public psychiatric beds needed to achieve a minimum level of psychiatric care is 95,820 beds.
• The consequences of the severe shortage of public psychiatric beds include increased homelessness; the incarceration of mentally ill individuals in jails and prisons; emergency rooms being overrun with patients waiting for a psychiatric bed; and an increase in violent behavior, including homicides, in communities across the nation.
• The consequences of the severe shortage in public psychiatric beds could be improved with the widespread utilization of PACT (Program of Assertive Community Treatment) programs and assisted outpatient treatment (AOT), both of which have been proven to decrease hospitalization. It could also be improved with greater flexibility in federal and state regulations allowing for the development of alternatives to hospitalization.

Full report (PDF; 59 KB)

Posted by Info Center at 8:26 AM in Health Care | Mental Health | Permalink

Source: U.S. House of Representatives, Committee on Oversight and Government Reform, March 2008

From the press release:
Although Medicaid is the largest health care program operated by the states, the Administration has failed to provide any estimates of the state-specific impacts of its regulations. After several unsuccessful attempts by the Committee to obtain these important state estimates from CMS, the Committee requested an analysis from Medicaid State Directors on the impact of the CMS regulations on their state.

The report finds that the state estimates of the fiscal impact of the CMS regulations are significantly higher than the $15 billion impact projected by the Administration for next five years. States estimated that the regulations would reduce federal payments to them by nearly $50 billion over the next five years, more than three times the Administration's estimate.

The large discrepancy between the state estimates and the CMS estimates is evidence that the regulations are likely to have a much larger fiscal and programmatic impact on state Medicaid programs and state budgets than people realize.

▪ Summaries of State Responses
▪ Interactive Map
▪ Response from Center for Medicaid and State Operations

Posted by Info Center at 2:34 PM in Health Care | Health Reform | State & Local Finance | Permalink

Source: U.S. Department of Justice, Office of Inspector General, Audit Division, February 2008

The Federal Bureau of Prisons (BOP) is responsible for confining federal offenders in prisons that are safe, humane, cost-efficient, and secure. As part of these duties, the BOP is responsible for delivering medically necessary health care to inmates in accordance with applicable standards of care.

As of November 29, 2007, the BOP housed 166,794 inmates in 114 BOP institutions at 93 locations.1 During FY 2007, the BOP obligated about $736 million for inmate health care. The BOP provides health care services to inmates primarily through: (1) in-house medical providers employed by the BOP or assigned to the BOP from the Public Health Service, and (2) contracted medical providers who provide either comprehensive care or individual services.

To control the rising cost of health care, since the early 1990s the BOP has implemented initiatives aimed at providing more efficient and effective inmate health care. The BOP's on-going initiatives include assigning most inmates to institutions based on the care level required by the inmate, installing an electronic medical records system that connects institutions, implementing tele-health to provide health care services through video conferencing, and implementing a bill adjudication process to avoid costly errors when validating health care-related invoices. We include a discussion of these cost-cutting initiatives and the effect the initiatives have had on controlling inmate health care costs in the Findings and Recommendations section of this report.

Posted by Info Center at 2:00 PM in Corrections | Health Care | Permalink

Source: Congressional Budget Office, February 24, 2008

PDF of PowerPoint slides -- Presentation to the National Governors Association's Health and Human Services Committee

Posted by Info Center at 3:13 PM in Health Care | Statistics | Permalink

Source: John E. McDonough, Michael Miller and Christine Barber, Health Affairs, Web Exclusive, Vol. 27 no. 2, 2008
(subscription required)

Enactment of ambitious health reform laws in Massachusetts and Vermont in 2006 helped instigate a wave of state legislative activities to expand coverage to uninsured people. We identify thirty-nine states that have enacted laws in at least one access category since 2006. At least thirteen states have begun processes to enact comprehensive reforms to cover at least half of their uninsured residents. Key activities involve coverage expansions for uninsured children and for uninsured adults; regulatory changes in small-group and individual insurance markets; and individual and employer mandates. The future extent and durability of this wave are uncertain.

Posted by Info Center at 4:37 PM in Health Care | Permalink

Source: Centers for Disease Control and Prevention, Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER), February 2008

From the summary:
CDC's Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER) has released its inaugural report on public health emergency preparedness. The report, Public Health Preparedness: Mobilizing State by State, highlights the progress that has been made in state and local preparedness and response, identifies preparedness challenges facing public health departments, and outlines CDC's efforts to address those challenges. Designed to increase accountability regarding the country's investment in preparedness activities, the report presents national data as well as state-specific snapshots for all 50 states and four directly funded localities: Chicago; Los Angeles County; New York City; and Washington, DC.
▪ Key Findings

Posted by Info Center at 12:31 PM in Emergency Management | Health Care | Permalink

Source: Lisa Clemans-Cope, Bowen Garrett, Urban Institute, February 26, 2008

From the abstract:
This issue brief focuses on how employer-sponsored insurance (ESI) coverage has changed among employees. It begins with a brief description of major forces driving ESI: changes in the workforce and the rising costs of health insurance over the four year period. Next, it examines the decline in ESI among employees and the underlying reasons determining whether an employee has ESI, specifically: employer sponsorship of ESI, employee eligibility, employee participation, and employee participation in ESI available through another family member's job. The issue brief concludes by examining how the reasons for the decline in ESI varied across different groups of employees.

Posted by Info Center at 1:06 PM in Benefits | Health Care | Permalink

Source: Sean Keehan, Andrea Sisko, Christopher Truffer, Sheila Smith, Cathy Cowan, John Poisal, M. Kent Clemens, Health Affairs Web Exclusive, February 26, 2008

From the abstract:
The outlook for national health spending calls for continued steady growth. Spending growth is projected to be 6.7 percent in 2007, similar to its rate in 2006. Average annual growth over the projection period is expected to be 6.7 percent. Slower growth in private spending toward the end of the period is expected to be offset by stronger growth in public spending. The health share of gross domestic product (GDP) is expected to increase to 16.3 percent in 2007 and then rise throughout the projection period, reaching 19.5 percent of GDP by 2017.

Posted by Info Center at 12:55 PM in Health Care | Permalink

Source: John Holahan and Allison Cook, Health Affairs, Web Exclusives, Vol. 27 no. 2, published online February 20, 2008
(subscription required)

From the abstract:
The number of uninsured Americans increased by 3.4 million between 2004 and 2006, despite improving economic conditions. In the first four years of the decade, during a period of economic recession, the number increased by 6.0 million. The dominant factor in both periods was a decline in employer-sponsored insurance coverage. Although the recent decline was less than that experienced from 2000 to 2004, growth in public coverage was small, and the number of uninsured people increased by 1.0 million children and 2.4 million adults. Employer coverage declined most for self-employed or small-firm workers, in the South, and among noncitizens.
See also:
• Cost Impact Analysis for the "Health Care for America" Proposal
• Lewin Group Cost Impact Analysis: Executive Summary
• Costs and Savings: Breakdown of Lewin Group Cost Analysis
• Two Approaches to U.S. Health Care Reform: Shared Responsibility vs. 'You're On Your Own'
• Lewin Cost Analysis: Coverage Fact Sheet

Posted by Info Center at 11:42 AM in Economy | Health Care | Permalink

Source: Leslie A. Grant, Commonwealth Fund, Volume 85, February 13, 2008

Beverly Healthcare--one of the nation's largest nursing home chains--launched a culture change initiative in 2002, called resident-centered care (RCC). This report presents findings from a 12-month evaluation of that initiative. While most prior culture change models had been implemented by nonprofit organizations in a small number of facilities, this project marked a major departure for the culture change movement because it was the first time that a large national for-profit chain implemented culture change. The RCC initiative was successful in that it introduced new organizational practices, made improvements in resident quality of life (e.g., in choice and autonomy), and created better work environments for staff. The RCC initiative did not achieve short-term financial gains. The business case for culture change, however, should be based on long-term goals to reposition the nursing home within an evolving continuum of care.

Posted by Info Center at 5:08 PM in Health Care | Permalink

Source: Harvard School of Public Health, Press release, February 14, 2008

During the course of the presidential nomination campaign, some candidates' health care plans have been described as 'socialized medicine'. Historically, the phrase socialized medicine has been used to attack health reform proposals in the U.S. However, a new poll by the Harvard Opinion Research Program at the Harvard School of Public Health (HSPH) and Harris Interactive finds that Americans are split on whether a socialized medical system would be better or worse than the current system. Among those who say they have at least some understanding of the phrase (82%), a plurality (45%) says such a system would be better while 39 percent say it would be worse. Twelve percent say they do not know and four percent say about the same.

The poll shows striking differences by party identification. Seventy percent of Republicans say that socialized medicine would be worse than our current system. The same percentage of Democrats (70%) say that a socialized medical system would be better than our current system. Independents are more evenly split with 43% saying socialized medicine would be better and 38% worse.
▪ Americans' Views on Socialized Medicine

Posted by Info Center at 1:14 PM in Health Care | Health Reform | Permalink

Source: Kaiser Family Foundation, February 2008

This new analysis examines changes in wages and benefits over time, finding that health benefit costs paid by employers have increased from 0.6 percent of GDP in 1960 to 4.1 percent in 2006 as wages have fallen as a share of employee compensation. It is part of Kaiser's online series Snapshots: Health Care Costs.

Posted by Info Center at 10:32 AM in Health Care | Permalink

Source: Allison Orris and Judith Solomon, Center on Budget and Policy Priorities, February 13, 2008

Over the last year, the Department of Health and Human Services (HHS) has issued a series of Medicaid regulations that could significantly affect health care at the state and local level. These regulations, most of which alter longstanding Medicaid policies, do not require congressional approval. In fact, in some cases Congress has expressly declined to enact the very same changes that HHS is now making through administrative action.

In addition, in December the Administration issued an interim final rule to implement a provision of the 2006 Deficit Reduction Act. The new rule goes well beyond Congress's intent in that legislation, and does so in ways that will jeopardize access to essential health services.

Taken together, these regulatory changes will reduce federal Medicaid spending by close to $15 billion over the next five years. Most of these costs will simply be shifted to state and local governments, at a time when states have less capacity to absorb added costs given the economic slowdown and their weakening fiscal conditions.

Posted by Info Center at 1:19 PM in Health Care | State & Local Finance | Permalink

Source: Victoria C. Bunce, J.P. Wieske, and Lawrence J. Siedlick, Council for Affordable Health Insurance, 2008

From press release:
Today the Council for Affordable Health Insurance (CAHI) released the 2008 edition of "Health Insurance Mandates in the States." According to the study, the number of state mandated benefits continues to grow -- to 1,961 nationwide, up from 1,901 last year.

"Policymakers are increasingly focusing on how to reduce the number of uninsured Americans," stated CAHI Director Dr. Merrill Matthews. "Ironically, these same policymakers continue to pass laws that drive up the cost of coverage and make policies unaffordable for millions of Americans."

A health insurance mandate is a requirement that an insurance company cover specific health care providers, benefits or patient populations. While mandates make health insurance more comprehensive, they also make it more expensive because mandates require insurers to pay for care consumers previously funded out of their own pockets. Based on our analysis, mandated benefits currently increase the cost of basic health coverage from a little less than 20% to more than 50%, depending on the state and the specific legislative language.

The study's authors, CAHI Research and Policy Director Victoria C. Bunce, State Affairs Director J.P. Wieske and Government Affairs Assistant Lawrence J. Siedlick, track hundreds of mandate bills and identify those that actually pass. The study also includes an estimate, provided by a team of health actuaries, of how much each mandate adds to the cost of a health insurance policy.

Posted by Info Center at 12:25 PM in Health Care | Permalink

Source: Congressional Budget Office, Publication number 2764, January 2008

Health care costs in the United States have grown substantially for decades and are expected to continue to grow in the future. For the federal government, rising health care costs constitute the principal challenge of fiscal policy-no other single factor will exert more influence over the long-term balance of the federal budget. The effects of rising health care costs are not limited to public programs, however. Private payers have experienced similar growth in costs.

This Congressional Budget Office (CBO) paper-written at the request of the Chairman of the Senate Committee on the Budget-describes the historical growth in spending on health care in the United States. It examines the factors that determine health care spending and how they have contributed to spending growth over time. Special emphasis is given to the largest single factor driving spending growth-the greatly expanded capabilities of medicine brought about by technological advances in medical science over the past several decades. Finally, the paper discusses the implications of continued technological change for future growth of health care spending.
● Charts
● Testimony on Growth in Health Care Costs

Posted by Info Center at 11:16 AM in Health Care | Permalink

Source: Edwin Park, Center on Budget and Policy Priorities, February 7, 2008

December 2007, Congress extended the expiring State Children's Health Insurance Program through March 2009. As part of his fiscal year 2009 budget, the President proposes to reauthorize SCHIP through the end of fiscal year 2013. The budget proposal would provide an additional $19.7 billion to states for their SCHIP programs, above the $5 billion-a-year funding level assumed in the budget baseline.

The proposed funding increase has been portrayed in some media reports as a significant expansion of SCHIP to cover more children. Yet while the $19.7 billion amount does substantially exceed the amount proposed for SCHIP in the budget the President submitted a year ago, it would not provide sufficient funding for states to significantly expand their SCHIP programs and cover many more uninsured low-income children. In fact, the amount that the President's new budget proposes for SCHIP likely would not even be sufficient to enable states simply to maintain their current SCHIP programs.

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Bush Budget Gives States Little to Cheer About
Source: Daniel C. Vock and Pamela M. Prah, Stateline.org, February 5, 2008

Posted by Info Center at 4:32 PM in Budget – United States | Health Care | Permalink

Source: Genevieve M. Kenney, Jamie Rubenstein, Anna S. Sommers, Stephen Zuckerman, Fredric Blavin, Urban Institute, February 1, 2008

This article examines experiences under Medicaid and the State Children's Health Insurance Program (SCHIP), drawing on surveys of over 3,000 enrollees in California and North Carolina in 2002. In both States, Medicaid enrollees were less likely than SCHIP enrollees to have parents who were covered by employer-sponsored insurance (ESI). With the exception of dental care and provider perceptions, access experiences were fairly comparable across the two programs, despite differences in the characteristics of the children served by the two programs. Relative to being uninsured, Medicaid enrollment was found to improve access to care along a number of different dimensions, controlling for other factors. Furthermore, this study emphasizes the need for continued evaluation of access to care for both programs.

Posted by Info Center at 10:55 AM in Health Care | Permalink

Source: Kaiser Family Foundation Commission on Medicaid and the Uninsured, January 28, 2008

From press release:
New reports released today by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) describe aggressive efforts by states in the past year and a half to expand coverage to low-income children and their families, but the actions may be curtailed as a deteriorating economic climate and new limits on federal assistance take effect.

A downturn in the economy, the federal failure to reauthorize the State Children's Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility all suggest that the recent period of aggressive expansion of coverage by states may be over. This is the conclusion based on a series of new studies by the KCMU, including a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and recent studies of enrollment in Medicaid and SCHIP.

● Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles
● Current Issues in Medicaid: A Mid-FY2008 Update Based on a Discussion with Leading Medicaid Directors
● SCHIP Enrollment in June 2007: An Update on Current Enrollment and SCHIP Policy Directions
● Medicaid Enrollment in 50 States: December 2006 Update
● State Children's Health Insurance Program (SCHIP): Reauthorization History

Posted by Info Center at 5:07 PM in Health Care | Health Reform | Permalink

Source: Kaiser Family Foundation

Health insurance is a key element in ensuring access to health care for women, as women with coverage are more likely to obtain preventive, primary, and specialty care services. However, many women face barriers to obtaining coverage because they have limited access to private insurance or do not qualify for public programs. Kaiser has released two updated fact sheets that provide the most current information and data on health insurance coverage for women ages 18-64. The fact sheet, "Women's Health Insurance Coverage," provides new statistics on health coverage and describes the major sources of health insurance for non-elderly adult women, including employer-sponsored coverage, Medicaid, individually purchased insurance, and Medicare. It also summarizes the major policy challenges facing women in obtaining health coverage, and provides data on the more than 17 million women who are uninsured.

The second fact sheet, "Health Insurance Coverage of Women by State," provides state-by-state data on the uninsured rate, as well as rates of private insurance and Medicaid coverage.

Posted by Info Center at 10:07 AM in Health Care | Permalink

Source: Centers for Medicare & Medicaid Services (HHS)

Health care spending growth in the United States accelerated slightly in 2006, increasing 6.7 percent compared to 6.5 percent in 2005, which was the slowest rate of growth since 1999. Health care spending, however, continues to outpace overall economic growth and general inflation, which grew 6.1 percent and 3.2 percent, respectively, in 2006.

In 2006, health care spending reached a total of $2.1 trillion, or $7,026 per person, up from $6,649 per person in 2005, according to a report by the Centers for Medicare & Medicaid Services (CMS). The health spending share of the nation's Gross Domestic Product (GDP) remained relatively stable in 2006 at 16.0 percent, up by only 0.1 percentage point from 2005.

Health care spending data

Posted by Info Center at 9:32 AM in Health Care | Permalink