Investment Returns: Defined Benefit vs. Defined Contribution Plans
Published: | 1:42 pm | Posted in: Private Pensions
The brief’s key findings are: The analysis compares returns by plan type from 1990-2012 using data from the U.S. Department of Labor’s Form 5500. During this period, defined benefit plans outperformed 401(k)s by an average of 0.7 percent per year, even after controlling for plan size and asset allocation. In addition, much of the money accumulated in 401(k)s […]
The Affordable Care Act, Medicare Costs, and Retirement Security
Published: | 1:38 pm | Posted in: Medicare
The brief’s key findings are: The 2010 Affordable Care Act (ACA) included roughly 165 provisions to improve Medicare’s finances. The Medicare Trustees Report, which reflects the ACA provisions, shows dramatically lower cost projections for Medicare in the future. The Medicare actuaries also produce alternative projections assuming that the legislated restraints on growth in payments to health providers are […]
Why the Surge in Income Inequality?
Published: | 6:13 pm | Posted in: Inequality
Income inequality is more severe in the United States than in any other affluent longstanding-democratic country, and it has increased sharply in the past generation. The rise in inequality is mainly a story of growing separation between households in the top 1 percent and those in the ‘‘bottom’’ 99 percent. Income inequality within the lower 99 […]
50 Years of Cognitive Aging Theory
Published: | 6:31 pm | Posted in: Alzheimer's Disease: Cure & Care
This special edition commemorates the roughly 50 years of theoretical work on cognitive aging. As an Introduction to this issue, we first briefly review cognitive aging efforts prior to the mid-1960s, then describe the mid-1960s as a pivotal point for cognitive aging theory, and finally comment on how the field has evolved since then. Cognitive Aging […]
Inequality: What Can Be Done?
Published: | 6:30 pm | Posted in: Inequality
As discussed in Inequality: What Can Be Done?, the study of income inequality was “marginalized” in mainstream economics for much of the twentieth century. The most notable exception to this generalization is the work of Anthony B. Atkinson, the British economist who is the leading authority and pioneer of the economics of inequality. He even […]
Stumbling towards Stockholm
Published: | 6:27 pm | Posted in: Inequality
Lane Kenworthy believes that within the next half-century the United States will very likely become a “modern social democracy,” using government to advance a “good society” of economic security, opportunity (at least in the Amartya Sen sense of “capabilities”), and rising living standards for all. It will do this through generous and employment-friendly social policies […]
Long-Term Services and Supports for Older Americans: Risks and Financing Research Brief
Published: | 5:55 pm | Posted in: Medicaid
Long-term care services and supports (LTSS) includes a range of services and supports individuals may need to meet their health or personal needs over a long period of time.1 Most LTSS is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called “Activities of Daily Living” (or ADLs) which […]
Severe Deprivation in America: An Introduction
Published: | 6:04 pm | Posted in: Poverty
A Life Crystal Mayberry was born prematurely on a spring day in 1990 shortly after her pregnant mother was stabbed eleven times in the back during a robbery.1 The attack induced labor. Both mother and daughter survived. It was not the first time Crystal’s mother had been stabbed. For as far back as she can […]
Medicare and the Future of Retirement Security
Published: | 3:49 pm | Posted in: Medicare
President Bush’s failed effort to privatize part of the Social Security program received a lot of attention from the media during the first half of 2005. Congressional efforts to begin privatizing the Medicare program over the last ten years have received far less attention. This absence of media attention may be one of the reasons […]
The High Stakes Struggle Over the Future of Medicare
Published: | 3:47 pm | Posted in: Medicare
Following the passage of the Medicare Modernization Act (MMA) of 2003, the future of Medicare is less clear than at any time since its inception almost 40 years ago. Medicare policy regarding financing coverage and delivery mechanisms has been the object of intermittently fierce political debate and maneuvering since 1995 when a conservative Republican majority […]
National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment
Published: | 10:08 pm | Posted in: Health Care Policy and Reform
Health spending growth in the United States for 2015–25 is projected to average 5.8 percent—1.3 percentage points faster than growth in the gross domestic product—and to represent 20.1 percent of the total economy by 2025. As the initial impacts associated with the Affordable Care Act’s coverage expansions fade, growth in health spending is expected to be influenced by […]
The 2016 Medicare Trustees Report: Is Medicare Doomed?
Published: | 8:51 pm | Posted in: Medicare
The June 22 release of the annual Medicare Trustees Report has, as usual, elicited conflicting responses. Some have focused on the positive—Medicare spending per enrollee has continued to grow at a historically slow rate—while others have emphasized the negative — the Medicare Hospital Insurance Trust Fund is now projected to run out of resources in […]
Early Performance of Accountable Care Organizations in Medicare
Published: | 8:33 pm | Posted in: Health Care Policy and Reform
BACKGROUND In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. We used quasi-experimental methods to assess the early performance of MSSP ACOs. METHODS Using Medicare claims from 2009 through 2013 and a difference-in-differences design, we compared changes in spending and in performance on quality […]
Health Spending Growth: Still Facing A Triangle Of Painful Choices
Published: | 1:21 am | Posted in: Health Care Policy and Reform, Neoliberalism
In the four years immediately following the recession (2010 through 2013), health spending grew at a historically low average annual rate of 3.6 percent, about the same as gross domestic product (GDP). This era was interrupted in 2014 with the advent of expanded coverage under the Affordable Care Act (ACA)—the newly insured used more care […]
Medicare Help At Home
Published: | 1:02 am | Posted in: Medicare
Nine million community-dwelling Medicare beneficiaries—about one-fifth of all beneficiaries—have serious physical or cognitive limitations and require long-term services and supports (LTSS) that are not covered by Medicare. Nearly all have chronic conditions that require ongoing medical attention, including three-fourths who have three or more chronic conditions and are high-need, high-risk users of Medicare covered services. […]
Twenty-First Century Medicaid: The Final Managed Care Rule
Published: | 1:00 am | Posted in: MLTC
With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid […]
Health Affairs Study On Hospital Profitability Gives Us Some Important Factors To Watch Going Forward
Published: | 12:57 am | Posted in: Health Care Policy and Reform
It is important to keep in mind that profits can be high, either because prices are high or underlying production costs are low (relative to each other). The Bai and Anderson study does not decompose profits but rather measures overall accounting profits as reported to Medicare. So, higher profits do not always indicate excess prices. […]
The U.S. Health Disadvantage And The Role Of Spending
Published: | 12:56 am | Posted in: Health Care Policy and Reform
Each week it seems, more evidence emerges regarding the poor health of Americans. We first documented a “U.S. health disadvantage” as chair and study director of the panel on understanding cross-national health differences among high-income countries at the National Academies in 2013. Our panel’s report Shorter Lives, Poorer Health showed that, as long ago as […]
Let’s Stop Making Excuses For Egregious Medical Errors
Published: | 12:52 am | Posted in: Health Care Policy and Reform
To save the life of a child, a zoo sacrifices a prized, endangered gorilla. In exchange for one nearsighted Israeli soldier captured in Gaza, Israel released 1,000 Palestinian prisoners. (This example from the Middle East may not be surprising. In Judaism, it is commanded that “to save a life is as if one saved the […]
Integrating Health Care And Housing To Promote Healthy Aging
Published: | 5:57 pm | Posted in: Archive
One of the most important public health findings over the last several decades has been that there are a number of factors, beyond medical care, which influence health status and contribute to premature mortality. Of these factors, social circumstances and the physical environment (particularly the home) especially impact an individual’s health. Housing takes on even […]
