John R. Graham Archive

John R. Graham is a Senior Fellow at The Independent Institute.
Full biography and recent publications

New Evidence that Obamacare Is Working?



Obamacare supporters are excited by a research article suggesting Obamacare is working to increase access to care. In an article published in JAMA: The Journal of the American Medical Association, researchers followed up respondents to the Gallup-Healthways Well-Being Index (which I’ve discussed previously). Yes, in an absolute sense, their access to care improved. According...
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Health Spending Growth Moderate in Second Quarter (Maybe)



A recent report by actuaries working for the Centers for Medicare & Medicaid Services estimates that the rate of growth of health spending, subdued for many years, is picking up again: “The health share of US gross domestic product is projected to rise from 17.4 percent in 2013 to 19.6 percent in 2024.” Readers of this...
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Medicaid’s Poverty Trap Illustrated



The tragic story of a disabled woman trapped in poverty by the hodge-podge of ways the U.S. finances health care illustrates why we need to sweep the whole thing away and give everyone a universal, refundable tax credit: On a crisp California morning in February 2012, my sister-in-law, Marcella Wagner, was driving down the interstate...
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Will 11 Million Pay Obamacare’s Mandate Penalty?



I recently took issue with lack of clarity in media coverage of a report by the IRS Taxpayer Advocate, which claimed that 6.6 million people paid Obamacare’s individual-mandate penalty last year. I figured the total must be significantly higher, because each tax return would cover more than one individual. In an e-mail to me...
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Obamacare Exchange Plans Have 34 Percent Fewer Providers than Non-Exchange Plans



Avalere Health has quantified how narrow networks are in Obamacare exchange plans, as shown in the figure below. According to Avalere CEO President Dan Mendelson: “Plans continue to test new benefit designs in the exchange market. Given the new requirements put in place by the ACA, network design is one way plans can drive...
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Did 15 Million—Not 6.6 Million—Pay Obamacare’s Mandate Penalty?



The media have reported that 6.6 million “taxpayers” paid the Obamacare penalty (tax) for not obeying the individual mandate to buy federally qualified health insurance in 2014. However, the actual figure must be much larger. The report by the Taxpayer Advocate discusses “returns,” although not individual taxpayers. It reports that 2.6 million 2014 returns...
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Let’s Hope Arizona’s New Health Law Is Contagious



Last April, Arizona governor Doug Ducey signed a law that allows patients to order lab tests directly from a lab, without physician intermediation. The tests will be self-paid: No government nor private health plan has to pay for them. The legislation was backed by one of the most exciting diagnostic companies in the market: Theranos, founded by an...
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Ten States Join Interstate Medical Licensure Compact



Iowa has become the tenth state to enact the Interstate Medical Licensure Compact. This is a great achievement for the medical profession and state sovereignty. For almost a year now, I have been supporting this effort, and I am glad to see it succeeding. Licensure itself is problematic, because it confers monopoly power on...
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Zeke Emanuel Hammers Obamacare Again



Obamacare’s best frenemy, Dr. Ezekiel Emanuel, and his colleagues at the Center for American Progress, gave up on Obamacare last year. In yesterday’s Wall Street Journal, he and Topher Spiro emphasize that Accountable Care Organizations, which Obamacare established to co-ordinate care and lower costs in Medicare, are failing to achieve either goal: The Obama...
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Health Jobs Outpace Soft Employment Report



Health jobs keep growing faster than other civilian, nonfarm jobs. Health care added 40,000 jobs in June, almost one in five of the 223,000 jobs added. At a seasonally adjusted growth rate of 0.27 percent, health jobs continue to grow significantly faster than other jobs, which grew at 0.14 percent (see Table I). Although...
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