Links of Interest

Modernizing Social Security: Caregiver Credits

Women still tend to work fewer years and earn less than men, which leads to less income in retirement. One reason is that women are often still the main family caregiver. Traditionally, Social Security has recognized this role by providing spousal and widow benefits for married women. Today, however, many women are not eligible for […]

Longevity Economics: Leveraging the Advantages of an Aging Society

An aging society is a fact for the United States, much of the developed world, and many developing countries. People are reaching traditional retirement ages with many years of expected life remaining and their functional capacity largely intact. Many of these people want to continue contributing to society through activities that are meaningful to the […]

In-Work Poverty in the United States

In-work poverty became a prominent policy issue in the United States long before the term itself acquired any meaning and relevance in other industrialized countries. With America’s embrace of an employment-centered antipoverty strategy, the working poor have become even more of an issue. This paper reviews some key trends, drivers and policy issues. How much […]

The fading American dream: Trends in absolute income mobility since 1940

One of the defining features of the “American dream” is the aspiration that children have a higher standard of living than their parents. When children are asked to assess their economic progress, they frequently compare their own standard of living to that of their parents. Such measures of “absolute income mobility”—the fraction of children earning […]

Health Care Cost Control: Where Do We Go From Here?

Medical services are expensive. There is no getting around it. The average family health insurance premium in the US is approaching $20,000. By one estimate, average family premiums could rise to 100 percent of US median household income by 2033 if trends continue. What is more troubling is that there is considerable evidence that nearly one-third of health spending is […]

Inside the nation’s largest mental health institution: a prevalence study in a state prison system

Background The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in […]

Replacement Rates for Hypothetical Retired Workers

Adequacy and equity of Social Security benefits are major policy considerations for the program. One measure of adequacy is the percentage of pre-retirement earnings that Social Security benefits replace, or the “replacement rate”. The numerator of this replacement rate is well established as the Social Security benefit. One indicator of equity is the degree of […]

The notion of precariousness among older adults living alone in the U.S.

This paper argues that older adults living alone in the U.S. face a set of unique challenges, as they are likely to experience a sense of precariousness. The term precariousness points to an intrinsic sense of instability and insecurity stemming from a lack of, or difficulty to, access essential resources. During a two-year ethnography of […]

Quality of life in the contemporary politics of healthcare: … but what is a life?

‘Quality of life’ (QoL) is a ubiquitous phrase in medicine. There is considerable literature on the meaning of ‘quality’ in ‘quality of life’, but little on the meaning of ‘life’. And yet, rooted in measurements of QoL, is a conceptualization of ‘a life’ used to judge ‘quality’. In this article I focus on ‘life’ within […]

Precarity in late life: Understanding new forms of risk and insecurity

Population aging and longevity in the context of declining social commitments, raises concerns about disadvantage and widening inequality in late life. This paper explores the concept of precarity as a means to understand new and sustained forms of risk and insecurity that affect late life. The article begins with a review of the definition and […]

Medical Marijuana Laws May Be Associated With A Decline In The Number Of Prescriptions For Medicaid Enrollees

In the past twenty years, twenty-eight states and the District of Columbia have passed some form of medical marijuana law. Using quarterly data on all fee-for-service Medicaid prescriptions in the period 2007–14, we tested the association between those laws and the average number of prescriptions filled by Medicaid beneficiaries. We found that the use of […]

After Defeat: Conservative Postenactment Opposition to the ACA in Historical-Institutional Perspective

Since the enactment of the Affordable Care Act (ACA) in 2010, conservatives have sought to undermine the law’s entrenchment. While they have failed in their ambitious quest to repeal the ACA, opponents have succeeded in overturning one major provision (the individual mandate penalty), narrowing the law’s reach, complicating its implementation, and fomenting doubts about its […]

The (Almost) Great Unraveling

As 2017 ended, Medicaid’s entitlement structure—and the funding base on which this structure rests—remained intact. During the Trump administration’s first year, this largest and most unique form of US health insurance faced an existential threat under three distinct waves of legislative attack as part of the efforts to repeal the Affordable Care Act (ACA). The […]

The Dog That Almost Barked: What the ACA Repeal Fight Says About the Resilience of the American Welfare State

The 2017 GOP drive to “repeal and replace” the Affordable Care Act (ACA) arguably constituted the most ambitious effort to dismantle a social program in American history. Certainly it was the most ambitious to come so close to enactment, falling just three votes short in the Senate. According to an extensive body of scholarship, this […]

How Growing Inequality Is Altering The Long-Term Care Policy Battlefield, While Tightening The Financing Knot

For many years, long-term care (LTC) policy makers have tended to fall into two warring camps: those favoring expanded social insurance, and those wanting tighter Medicaid eligibility criteria to incentivize people to plan for and buy LTC insurance. Both sides have warned of looming financial catastrophe as the Baby Boomers move into retirement and more […]

The Decline in Lifetime Earnings Mobility in the U.S.: Evidence from Survey-Linked Administrative Data

Abstract There is a sizable literature that examines whether intergenerational mobility has declined as inequality has increased. This literature is motivated by a desire to understand whether increasing inequality has made it more difficult to rise from humble origins. An equally important component of economic mobility is the ability to move across the earnings distribution […]

A Tale of Two Diseases: Mental Illness and HIV/AIDS

In 2011, I was speaking at an international AIDS conference where the first two speakers were from UNAIDS and Harvard. UNAIDS announced a new campaign: Getting to Zero: Zero New HIV Infections, Zero AIDS‐Related Deaths, and Zero Discrimination. (A year later, Secretary of State Hillary Clinton called for an AIDS‐Free Generation.) The Harvard researcher reported the […]

County Jail or Psychiatric Hospital? Ethical Challenges in Correctional Mental Health Care

Abstract Approximately 20% of the roughly 2.5 million individuals incarcerated in the United States have a serious mental illness (SMI). As a result of their illnesses, these individuals are often more likely to commit a crime, end up incarcerated, and languish in correctional settings without appropriate treatment. The objective of the present study was to […]