U.S. Government Manual, 2007-2008 Edition

Source: Office of the Federal Register and the National Archives and Records Administration, Revised June 1, 2007

As the official handbook of the Federal Government, the United States Government Manual provides comprehensive information on the agencies of the legislative, judicial, and executive branches. It also includes information on quasi-official agencies, international organizations in which the United States participates, and boards, commissions, and committees. The Manual begins with reprints of the Declaration of Independence and the U.S. Constitution. The new edition of the Manual is available annually in late summer.

U.S.: Household Income Rises, Poverty Rate Declines, Number of Uninsured Up

Source: U.S. Census Bureau, CB07-120, August 28, 2007

From the news release:
Real median household income in the United States climbed between 2005 and 2006, reaching $48,200, according to a report released today by the U.S. Census Bureau. This is the second consecutive year that income has risen. Meanwhile, the nation’s official poverty rate declined for the first time this decade, from 12.6 percent in 2005 to 12.3 percent in 2006. There were 36.5 million people in poverty in 2006, not statistically different from 2005. The number of people without health insurance coverage rose from 44.8 million (15.3 percent) in 2005 to 47 million (15.8 percent) in 2006. These findings are contained in the Income, Poverty, and Health Insurance Coverage in the United States: 2006 report. The data were compiled from information collected in the 2007 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC). Much more summary material in this news release.

Related from the Census Bureau:
• Numerous Documents and Tables Can Be Accessed Here
Income, Earnings and Poverty in the United States: 2006

Other related items:
Number And Percentage Of Americans Who Are Uninsured Climbs Again: Poverty Edges Down But Remains Higher, And Median Income For Working-Age Households Remains Lower, Than When Recession Hit Bottom In 2001
Source: Center on Budget and Policy Priorities, August 28, 2007
More Americans, Including More Children, Now Lack Health Insurance
Source: Center on Budget and Policy Priorities, August 28, 2007
U.S. Uninsured Rate Climbs Again
Source: Daniel C. Vock, Stateline.org, August 29, 2007
Number of Uninsured U.S. Residents Increases by 2.2M to 47M in 2006
Source: Kaiser Daily Health Policy Report, August 29, 2007

Workers’ Compensation: Benefits, Coverage, and Costs, 2005

Source: Ishita Sengupta, Virginia Renor and John F. Burton Jr., National Academy of Social Insurance, August 2007

From press release:
U.S. workers’ compensation payments for medical care and cash benefits for workers disabled by workplace injuries or diseases declined in 2005, according to a study released today by the National Academy of Social Insurance (NASI). The drop in payments in 2005 (the most recent year with data) reflects large declines in California payments, as reforms enacted in 2003 and 2004 took effect.

Nationally, workers’ compensation payments for injured workers fell by 1.4 percent to $55.3 billion in 2005. The payments include $26.2 billion to providers of medical care and $29.1 billion in cash wage replacement benefits for injured workers.

California payments fell by 12.2 percent; a change made up of a 16.0 percent decline in medical payments and an 8.6 percent decline in cash payments. “The reduced spending for benefits and medical care reflects the initial stages of cost containment measures that were put in place in 2003 and 2004 reforms to the California system,” according to NASI member Christine Baker, who directs the California Commission on Health and Safety and Workers’ Compensation, a nonpartisan labor-management group that advises state policymakers.

Because it is a large state – accounting for nearly 20 percent of national benefit payments in 2005 -California altered national trends. Outside California, total workers’ compensation payments rose by 1.7 percent, an increase driven by a 4.1 percent increase in payments to medical providers. Cash payments to injured workers outside California showed a small decline (0.3 percent).

Healing Our Sicko Health Care System

Source: Jacob S. Hacker, New England Journal of Medicine, Vol. 357 no. 8, August 23, 2007

It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore’s indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 — most of them insured — say they are “somewhat” or “completely” unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year — perhaps as many as half — are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing — yes, “dating back to the 1980s” — and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.

Small Steps to Big Reform

Source: Merrill Matthews and Victoria C. Bunce, Council for Affordable Health Insurance, Issues and Answers, no. 146, August 2007

From press release:
As the country enters a national debate over health care reform, we need to remember that the U.S. health care system works well for the vast majority of people. Nevertheless, there are several problem areas, including the high cost of care and a large number of uninsured, that impede the ability of some people to get access to affordable health insurance and quality care. The public policy question is whether those problems can be adequately addressed by limited and targeted reforms, or does the country need to embark on a massive restructuring of the health care system?

Today, the Council for Affordable Health Insurance (CAHI) is releasing “Small Steps to Big Reform,” which argues that there are several targeted legislative changes, at both the state and federal levels, that would address the vast majority of the current problems and would go a long way in expanding health insurance coverage.

CMS Announces Payment Changes for Medicare Home Health Services

Source: Centers for Medicare & Medicaid Services (CMS), 42 CFR Part 484, [CMS-1541-FC], RIN 0938-AO32, 2007

From press release:
The Centers for Medicare & Medicaid Services (CMS) today issued a final rule to refine and update the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2008. This final rule reflects the ongoing efforts of CMS to support beneficiary access to home health services and improve the quality and efficiency of care provided to Medicare beneficiaries through more accurate payments for services rendered. Refinements to the Medicare HH PPS as well as the annual update to the Medicare payment rates for home health services will disburse an estimated additional $20 million in payments to home health agencies in CY 2008.
Home Health Prospective Payment System Refinement and Rate Update for Calendar Year 2008; Final Rule with comment period on display in the Federal Register on August 22, 2007
Fact Sheet

Occupational Licensing: Ranking the States and Exploring Alternatives

Source: Adam B. Summers, Reason Foundation, Policy Study 361, August 2007

From press release:
Do you want to be a fortune teller in Maryland? Your future better include a license from the state. How about being a hair braider in Mississippi? You’ll need 300 to 1,500 hours of training and government permission. Want to sell flowers in Louisiana? Only licensed florists can do that. And almost every state requires certification if you want to move furniture and hang art while calling yourself an interior designer.

In California, there are a total of 177 different jobs that require a special license or credential, the most in the country, according to a new Reason Foundation study examining occupational licensing trends.

Northeastern states aren’t much better. Connecticut, Maine and New Hampshire all require job seekers to obtain a license before performing more than 130 jobs. In stark contrast, you can do most of those very same jobs – without a license – in Missouri, where just 41 careers require certification.

Press Release with Complete Rankings
Policy Summary
State-by-State Occupational Licensing List

University of Michigan Study Tracks Growing Income Gap Among American Families

Source: University of Michigan, Press release, August 7, 2007

The rich really are getting richer and the poor are getting poorer, a new University of Michigan study shows. The study–the most recent available analysis of long-term wealth trends among U.S. households is based on data from the Panel Study of Income Dynamics, conducted by the U-M Institute for Social Research (ISR) since 1968. Over the last 20 years, the net worth of the top two percentile of American families nearly doubled, from $1,071,000 in 1984 to $2,100,500 in 2005. But the poorest quarter of American families lost ground over the same period, with their 2005 net worth below their 1984 net worth, measured in constant 2005 dollars.
Data and Documentation

The Labor Market Effects of Rising Health Insurance Premiums

Source: Katherine Baicker and Amitabh Chandra, California Center for Population Research, On-Line Working Paper Series, Paper CCPR-038-06, January 1, 2006

From abstract:
We use variation in medical malpractice payments driven by the recent “medical malpractice crisis” to identify the causal effect of rising health insurance premiums on wages, employment and the distribution of part-time and full-time work. We estimate that a 10 percent increase in health insurance premiums reduces the aggregate probability of being employed by 1.2 percentage points, reduces hours worked by 2.4 percent, and increases the likelihood that a worker is employed only part-time by 1.9 percentage points. For workers covered by employer provided health insurance, a 10 percent increase in premiums results in an offsetting decrease in wages of 2.3 percent. Thus, rising health insurance premiums may both increase the ranks of the unemployed and place an increasing burden on workers through decreased wages for those with employer health insurance and decreased hours for those who may be moved from full time jobs with benefits to part time jobs without.

Emergency Response Planning in Hospitals, United States: 2003-2004

Source: Richard W. Niska, and Catharine W. Burt, Division of Health Care Statistics, Centers for Disease Control and Prevention, Advance Data From Vital and Health Statistics, Number 391, August 20, 2007

Objective–This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units.

Methods–Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals.

Results–About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.