The Affordable Care Act is expected to add up to 16 million more Medicaid enrollees and will significantly expand eligibility for families with incomes up to 133 percent of the federal poverty level. Initially, the federal government will pay 100 percent of the cost of the newly eligible, newly enrolled populations and 95 percent...
Read More »

Senior citizens are major losers in health reform. More than half the cost of the reform will be paid for by $523 billion of cuts in Medicare spending over the next ten years.[1] Although there are some new benefits for seniors (mainly new drug coverage), the costs exceed the benefits by a factor of...
Read More »

One of the most oft-repeated arguments for health reform is to reduce costly and delayed trips to the emergency room by uninsured patients. But will that happen? The heaviest users of the ER (in proportion to their numbers) are Medicaid patients (perhaps because many doctors won’t accept them), and more than half of the...
Read More »

The most obvious way to avoid a huge imbalance between the supply and the demand for medical care (especially primary care) is to abolish the requirement that health plans provide a long list of preventive services with no co-pay or deductible. In addition, nurses, physicians’ assistants, and other paramedical personnel should have greater freedom...
Read More »

In recent blog posts I’ve discussed how the Affordable Care Act creates perverse incentives for employers and insurers. In this piece I’ll touch briefly on how it creates perverse incentives for individuals. (For more discussion, please see my Independent Institute book, Priceless: Curing the Healthcare Crisis.) One can get a glimpse of the problem...
Read More »

Under the current system virtually all employers and group insurers have perverse incentives to attract the healthy and avoid the sick. Once people have enrolled, the incentives are to overprovide to the healthy (to encourage them to stay) and underprovide to the sick (to encourage them to leave). Managed Competition in the Healthcare Exchanges...
Read More »

In my previous post I explained that the subsidies of the Patient Protection and Affordable Care Act are regressive and unfair and create high marginal tax rates. What would a better approach look like? To achieve the ideal, the federal government should offer people the same tax relief for the purchase of health insurance,...
Read More »

Quite apart from the perverse economic incentives the subsidies of the Affordable Care Act create, the subsidies are completely arbitrary and unfair. For example, a $31,200-a-year family (about 133 percent of poverty) getting health insurance at work gets less than one-fourth as much help from the government, compared to a family making nearly three...
Read More »

The Affordable Care Act offers radically different subsidies to people at the same income level, depending on where they obtain their health insurance—at work, through an exchange, or through Medicaid. These subsidies are arbitrary, unfair, and even regressive. Along with the accompanying mandates, they will cause millions of employees to lose their employer plans...
Read More »

Who should get a mammogram? At what age? How frequently? What about Pap smears and prostate cancer tests and colonoscopies? Aren’t these questions experts can decide? Unfortunately, no. Any reader of daily newspapers knows that we are forever getting conflicting advice from well-meaning people. Part of the problem is that people differ in their...
Read More »