Report explores funding for state retiree health care benefits

Source: American City and County Local Government Update, Vol. 8 No. 29, July 7, 2008

A new report from the Washington-based Center for State and Local Government Excellence explores some of the ways states are moving from a pay-as-you-go approach to funding future retiree health care benefits to one that addresses unfunded liabilities and rising health care costs. The center prepared the report, “Balancing Dollars and Health Sense: A Framework for Decision Making on Funding State Retiree Health Care Benefits,” in response to a request from the Michigan House of Representatives for research on retiree healthcare funding options in light of the state’s $22.7 billion in unfunded retiree health care obligations.

Private Equity and Employment

Source: Steven J. Davis, John Haltiwanger, Ron S. Jarmin, Josh Lerner, Javier Miranda, US Census Bureau Center for Economic Studies, Paper No. CES-WP-08-07, March 1, 2008

The impact of private equity on employment arouses considerable controversy. Labor groups concerned about the fortunes of workers employed at buyout firms contend private equity firms destroy jobs. By contrast private equity associations and other groups have released a number of recent studies that claim positive effects of private equity on employment following the takeover. In this paper we conduct a comprehensive examination of the impact of private equity buyouts on the employment outcomes of firms that are taken over by these investment firms. We focus the analysis on two different dimensions. First, what are the employment outcomes of workers employed at establishments existing at the time of the buyout? Second, what is growth performance of the firm following the buyout? We conduct the analysis using a unique linked dataset covering the universe of US firms and information regarding US buyout operations between 1980 and 2005. We find targeted establishments exhibit net employment contraction, higher job destruction and establishment exit relative to controls. However, targeted firms exhibit higher greenfield entry and more acquisition and divestiture.

Americans’ Access to Medical Care Deteriorates Between 2003 and 2007

Source: Peter J. Cunningham, Laurie E. Felland, Center for Studying Health System Change, Tracking Report no. 19, June 2008

From the press release:
More than 20 percent of the U.S. population in 2007–one in five people–reported not getting or delaying needed medical care in the previous 12 months, up significantly from 14 percent–one in seven people–in 2003, according to a national study released today by the Center for Studying Health System Change (HSC).

In 2007, more than 23 million people reported going without needed care and approximately 36 million people delayed care, for a total of about 59 million people reporting access problems, according to findings from HSC’s 2007 Health Tracking Household Survey, a nationally representative survey containing information on 18,000 people; the survey had a 43 percent response rate. HSC has conducted the survey five times since 1997 as part of the Community Tracking Study, and the 2007 survey shows the sharpest increase in access problems in a decade, particularly among insured Americans.

The proportion of Americans reporting an unmet medical need between 2003 and 2007 increased by 2.8 percentage points to 8 percent–the equivalent of about 9.5 million more people going without medical care, the study found. During the same period, the proportion of Americans delaying needed care increased by 3.9 percentage points to 12.3 percent, or about 13.5 million more people postponing care. The 59 million people reporting access problems increasingly cited cost as an obstacle to needed care, along with rising rates of health plan and health system barriers, the study found.

Transportation Security Administration’s Efforts to Proactively Address Employee Concerns

Source: U.S. Department of Homeland Security, Office of Inspector General, OIG 08-62, May 2008

The Transportation Security Administration reports that a stable, mature, and experienced workforce is the most effective tool it has to meet its mission. Despite the value placed on the workforce, employees have expressed their concerns about how the agency operates by historically filing formal complaints at rates higher than other federal agencies of comparable size.

Additionally, Transportation Security Administration employees at some airports have contacted the Congress, the Department of Homeland Security’s Office of Inspector General, and the media to report their frustrations with local management’s lack of resolution of ongoing workplace problems. The Transportation Security Administration has taken proactive steps by establishing the Office of the Ombudsman, the Integrated Conflict Management System, and the National Advisory Council to help identify and address its employees’ workplace concerns. Our overall audit objective was to evaluate the effectiveness of these initiatives. Despite the positive steps taken, the Transportation Security Administration could improve its initiatives by establishing more effective internal systems, processes, and controls. Specifically, the agency has not provided sufficient tools and guidance regarding the structures, authorities, and oversight responsibilities of each initiative, and has faced challenges in communicating the details of each to its workforce.

Low employee morale continues to be an issue at some airports, contributing to the Transportation Security Administration’s 17% voluntary attrition rate. More than half of the employees we interviewed described the agency’s efforts to educate them on the various initiatives available to address their workplace concerns as “inadequate.” Accordingly, we are making six recommendations to the Assistant Secretary of the Transportation Security Administration to provide employees with sufficient tools, including clear guidance and better communication, on the structures, authorities, and oversight responsibilities of the initiatives we reviewed. The agency fully or partly concurred with five of the recommendations and has taken action to resolve four, which will remain open until implementation is completed. The agency did not provide sufficient information on its actions reported for one recommendation and did not concur with another. As such, both recommendations remain open and unresolved.
See also:
The Transportation Security Administration’s National Deployment Force

Financing the U.S. Health System: Issues and Options for Change

Source: Meena Seshamani, Jeanne Lambrew, Joseph Antos, Bipartisan Policy Center, June 2008

Health reform proposals across the spectrum have included changes in how the U.S. health system is financed. The goals of such changes range from using financial incentives to promote system goals, and replacing insufficient financing mechanisms with more sustainable ones, to increasing federal subsidies for a reformed health system. Irrespective of their specific design and independent of the delivery system changes they support, these options have policy implications that have received little public attention. This paper examines the implications of different options for financing the health system. Specifically, it describes recently proposed policies including continuing current financing and redirecting health spending to more effective uses, rolling back high-income tax cuts, modifying the current tax exclusion for health benefits, a play-or-pay model, and a value-added tax. Their effects on individuals, employers, and the health system are explored.

Treasury Department Releases New Guidance on Health Savings Accounts

Source: U.S. Department of the Treasury, Notice 2008-59, June 2008

From the press release:
The Treasury Department and the Internal Revenue Service today released Notice 2008-59, which provides employers and employees with a new set of formal questions and answers on Health Savings Accounts (HSAs).

Since HSAs were created as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Treasury and the IRS have issued a large number of formal guidance items containing questions and answers on HSAs. Notice 2008-59 contains over 40 new frequently asked questions and answers that cover a wide range of topics, including:
• Who is an Eligible Individual;
• Issues related to High Deductible Health Plans;
• Contributions to HSAs;
• Distributions from HSAs; and
• Establishing an HSA.

American Time Use Survey — 2007 Results

Source: Bureau of Labor Statistics, Press release, USDL 08-0859, June 25, 2008

The Bureau of Labor Statistics (BLS) of the U.S. Department of Labor reported today that in 2007:
• Twenty percent of employed persons did some or all of their work at home on days that they worked, and 87 percent did some or all of their work at their workplace.
• On an average day (which includes all 7 days of the week), 83 percent of women and 66 percent of men spent some time doing household activities, such as housework, cooking, lawn care, or financial and other household management.
• Watching TV was the leisure activity that occupied the most time, accounting for about half of leisure time, on average, for both men and women.

New Report Finds Regional, State Differences in Health Insurance Coverage

Source: Robin A. Cohen, Diane M. Makuc, National Health Statistics Reports, No. 1, June 19, 2008

From the press release:
New England had the lowest percentage of uninsured individuals under age 65 in 2004-2006 and the Southwest had the highest, according to a report from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Overall, 91.1 percent of New Englanders had some kind of health insurance in 2004-2006. The Southwest had the greatest proportion of uninsured — 18.2 percent of children and nearly 30 percent of adults.

The report is based on data collected from 240,000 people under age 65 as part of the 2004-2006 National Health Interview Survey.
See also:
Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2007