Forum for Health Economics and Policy最新文献_第6页

The Transformation of Medicare, 2015 to 2030 2015年至2030年的医疗改革

Forum for Health Economics and Policy Pub Date : 2015-12-01 DOI: 10.1515/fhep-2015-0043

H. Aaron, R. Reischauer

{"title":"The Transformation of Medicare, 2015 to 2030","authors":"H. Aaron, R. Reischauer","doi":"10.1515/fhep-2015-0043","DOIUrl":"https://doi.org/10.1515/fhep-2015-0043","url":null,"abstract":"Abstract Medicare today is a better program on almost every dimension than it was just after July 30, 1965 when Lyndon Johnson signed public law 89–97. Nonetheless, short-comings, limitations, and inadequacies remain. What should be done to make Medicare a better program? What should Medicare look like in 2030? In this paper we try to answer these questions. Three perspectives are relevant: that of beneficiaries, current and future; that of policymakers and administrators, the program’s stewards; and that of society at large. We posit certain objectives and goals that we believe – and that we think a broad swath of Americans would agree – should be pursued to improve the Medicare program. Those goals include (a) affordability for Medicare beneficiaries, (b) affordability for the working population that is paying and should continue to pay for much of the current cost of the program, (c) reduction in what we regard as needless complexity, and (d) stability and continuity in several different senses. We restrict ourselves to changes that we judge to be affordable and feasible – politically, technically, and administratively – if not today, then over the next decade or two. We believe that changes in Medicare will remain incremental, as they have been for the last 50 years. We shall assume that the ACA takes root and that the exchanges, whether managed by states or by the federal government on behalf of the states, continue to operate. We shall assume that federal and state officials eventually surmount the administrative challenges they still confront. In particular, we assume that the exchanges come to serve a growing share of the American population and that they increasingly exercise the rather considerable regulatory powers over insurance offerings that the ACA grants to them. We divide Medicare reforms into four categories: payment reform, benefit reform, quality reform and management, and the role of private insurance plans (Medicare Advantage [MA]).","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79699255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Health and Health Care of Medicare Beneficiaries in 2030. 2030年医疗保险受益人的健康和医疗保健。

Forum for Health Economics and Policy Pub Date : 2015-12-01 Epub Date: 2015-11-28 DOI: 10.1515/fhep-2015-0037

Étienne Gaudette, Bryan Tysinger, Alwyn Cassil, Dana P Goldman

{"title":"Health and Health Care of Medicare Beneficiaries in 2030.","authors":"Étienne Gaudette, Bryan Tysinger, Alwyn Cassil, Dana P Goldman","doi":"10.1515/fhep-2015-0037","DOIUrl":"https://doi.org/10.1515/fhep-2015-0037","url":null,"abstract":"On Medicare's 50th anniversary, we use the Future Elderly Model (FEM) - a microsimulation model of health and economic outcomes for older Americans - to generate a snapshot of changing Medicare demographics and spending between 2010 and 2030. During this period, the baby boomers, who began turning 65 and aging into Medicare in 2011, will drive Medicare demographic changes, swelling the estimated US population aged 65 or older from 39.7 million to 67.0 million. Among the risks for Medicare sustainability, the size of the elderly population in the future likely will have the highest impact on spending but is easiest to forecast. Population health and the proportion of the future elderly with disabilities are more uncertain, though tools such as the FEM can provide reasonable forecasts to guide policymakers. Finally, medical technology breakthroughs and their effect on longevity are most uncertain and perhaps riskiest. Policymakers will need to keep these risks in mind if Medicare is to be sustained for another 50 years. Policymakers may also want to monitor the equity of Medicare financing amid signs that the program's progressivity is declining, resulting in higher-income people benefiting relatively more from Medicare than lower-income people.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fhep-2015-0037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34502546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 40

Revamping Provider Payment in Medicare 改革医疗保险提供商支付

Forum for Health Economics and Policy Pub Date : 2015-12-01 DOI: 10.1515/fhep-2015-0044

P. Ginsburg, G. Wilensky

引用次数: 2

Trends in the Well-Being of the Aged and Their Prospects through 2030 《到2030年老年人福祉趋势及其前景》

Forum for Health Economics and Policy Pub Date : 2015-12-01 DOI: 10.1515/FHEP-2015-0039

Gary T. Burtless

{"title":"Trends in the Well-Being of the Aged and Their Prospects through 2030","authors":"Gary T. Burtless","doi":"10.1515/FHEP-2015-0039","DOIUrl":"https://doi.org/10.1515/FHEP-2015-0039","url":null,"abstract":"The US population over 65 has seen significant and sustained improvement in its absolute and relative well-being over the past half century. This paper offers a survey of trends in old-age poverty, income, inequality, labor market activity, educational attainment, insurance coverage, and health status. It concludes with a brief discussion of whether the favorable trends of the past half century can continue in the next few decades. Even though the absolute and relative positions of the nation’s aged have steadily improved over time, much of the improvement is traceable to public programs like Social Security and Medicare. These programs face gloomy financial prospects. If future voters and lawmakers scale back benefits to keep payroll taxes close to their current level, the nation’s elderly will need to rely on private resources to pay for a bigger fraction of their retirement needs. The statistics on saving and wealth accumulation suggest that relatively few working-age Americans plan to accomplish this by increasing the share of their current incomes they devote to saving. The future economic well-being of the elderly may therefore depend on their willingness to work longer and delay the age at which they rely on public programs and private savings to pay for their consumption.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86470715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Could Improving Choice and Competition in Medicare Advantage be the Future of Medicare? 改善医疗保险优势的选择和竞争能成为医疗保险的未来吗?

Forum for Health Economics and Policy Pub Date : 2015-12-01 DOI: 10.1515/fhep-2015-0046

A. Rivlin, Willemsen Daniel

引用次数: 8

Sex-selective Abortion Bans are Not Associated with Changes in Sex Ratios at Birth among Asian Populations in Illinois and Pennsylvania 性别选择性堕胎禁令与伊利诺斯州和宾夕法尼亚州亚裔人口出生性别比变化无关

Forum for Health Economics and Policy Pub Date : 2015-01-01 DOI: 10.1515/fhep-2014-0018

Arindam Nandi, Sital Kalantry, B. Citro

{"title":"Sex-selective Abortion Bans are Not Associated with Changes in Sex Ratios at Birth among Asian Populations in Illinois and Pennsylvania","authors":"Arindam Nandi, Sital Kalantry, B. Citro","doi":"10.1515/fhep-2014-0018","DOIUrl":"https://doi.org/10.1515/fhep-2014-0018","url":null,"abstract":"Abstract Legal prohibitions on sex-selective abortions are proliferating in the United States. Eight state legislatures have banned abortions sought on the basis of the sex of the fetus, 21 states have considered such laws since 2009, and a similar bill is pending in U.S. Congress. These laws have been introduced and enacted without any empirical data about their impact or effectiveness. Prior studies of U.S. Census data found sex ratios among foreign-born Chinese, Korean and Indian immigrants were skewed in favor of boys, but only in families where there were already one or two girls. Using the variation in the timing of bans in Illinois and Pennsylvania as natural experiments, we compare the pre-ban and post-ban sex ratios of certain Asian newborn children in these states over 12-year periods. We then compare these ratios with the sex ratios of Asian newborn children in neighboring states during the same period. We find that the bans in Illinois and Pennsylvania are not associated with any changes in sex ratios at birth among Asians. In Illinois and its neighboring states, the sex ratio at birth of Asian children was not male-biased during our study period. On the other hand, the sex ratio at birth among Asians in Pennsylvania and its neighboring states was skewed slightly in favor of boys, but the enactment of the ban did not normalize the sex ratio. This strongly suggests that sex-selective abortion bans have had no impact on the practice of sex selection, to the extent that it occurs, in these states. This finding is highly relevant to legislative and policy debates in the U.S. Congress and state legislatures where sex-selective abortion laws are being considered.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79408534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Long-Term Effects of Tobacco Prices Faced by Adolescents 青少年面临的烟草价格的长期影响

Forum for Health Economics and Policy Pub Date : 2015-01-01 DOI: 10.1515/fhep-2014-0005

M. Auld, M. Zarrabi

引用次数: 2

Public-Private Partnership as a Path to Affordable Healthcare in Emerging Markets 公私伙伴关系是新兴市场实现可负担医疗保健的途径

Forum for Health Economics and Policy Pub Date : 2015-01-01 DOI: 10.1515/fhep-2014-0023

J. W. Chou, D. Lakdawalla, J. Vanderpuye-Orgle

引用次数: 3

The Value of Delaying Alzheimer's Disease Onset. 延缓阿尔茨海默病发病的价值。

Forum for Health Economics and Policy Pub Date : 2014-11-01 Epub Date: 2014-11-04 DOI: 10.1515/fhep-2014-0013

Julie Zissimopoulos, Eileen Crimmins, Patricia St Clair

{"title":"The Value of Delaying Alzheimer's Disease Onset.","authors":"Julie Zissimopoulos, Eileen Crimmins, Patricia St Clair","doi":"10.1515/fhep-2014-0013","DOIUrl":"https://doi.org/10.1515/fhep-2014-0013","url":null,"abstract":"Alzheimer's disease (AD) extracts a heavy societal toll. The value of medical advances that delay onset of AD could be significant. Using data from nationally representative samples from the Health and Retirement Study (1998-2008) and Aging Demographics and Memory Study (2001-2009), we estimate the prevalence and incidence of AD and the formal and informal health care costs associated with it. We use microsimulation to project future prevalence and costs of AD under different treatment scenarios. We find from 2010 to 2050, the number of individuals ages 70+ with AD increases 153%, from 3.6 to 9.1 million, and annual costs increase from $307 billion ($181B formal, $126B informal costs) to $1.5 trillion. 2010 annual per person costs were $71,303 and double by 2050. Medicare and Medicaid are paying 75% of formal costs. Medical advances that delay onset of AD for 5 years result in 41% lower prevalence and 40% lower cost of AD in 2050. For one cohort of older individuals, who would go on to acquire AD, a 5-year delay leads to 2.7 additional life years (about 5 AD-free), slightly higher formal care costs due to longer life but lower informal care costs for a total value of $511,208 per person. We find Medical advances delaying onset of AD generate significant economic and longevity benefits. The findings inform clinicians, policymakers, businesses and the public about the value of prevention, diagnosis, and treatment of AD.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fhep-2014-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34361480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 177

Retail Tobacco Display Bans 零售烟草陈列禁令

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI: 10.1515/fhep-2013-0019

I. Irvine, V. Nguyen

引用次数: 2