• On The Record (with daily recap)

    • GAO: The Federal Government’s Long-Term Fiscal Outlook: Fall 2011 Update
    • GAO: Health Care Price Transparency: Meaningful Price Information Is Difficult for Consumers to Obtain
    • CBO: Trends in the distribution of income

    Today in TIE: Reflex, Austin provides macro health care chart dump, and is hitting the road, Don compares Heritage ideas for LTC to CLASS, Aaron looks at the cost of drinking

    • http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2011.01276.x/full

      New paper on Medicare spending and outcomes.

      “Conclusions. On average, greater medical spending is associated with better health status of Medicare beneficiaries, implying that across-the-board reductions in Medicare spending may result in poorer health for some beneficiaries.”

      Would love to hear Austin’s take on the significance of the methodological differences with Dartmouth and their significance. (1. IV analysis vs averages for geographic spending quintiles 2. Incorporating metrics for prior health. 3. Measuring spending over a much longer time)

    • Another key point from the discussion:

      “Conversely, as noted above, even if our primary result is accurate on average, it does not imply that all medical spending for all medical conditions and situations necessarily has the same positive effects on health. For example, Kaestner and Silber (2010) found significant variations in the magnitudes of the estimated positive effect of spending on health across several medical conditions. These results suggest that the search for inefficiencies in Medicare spending needs to be conducted on a more disaggregated basis, focusing on the effectiveness of specific treatments and care patterns for particular conditions and combinations of conditions”


    • I am surprised that the GAO’s report on price transparency doesn’t mention Arrow’s paper (which I only discovered a few years ago) on healthcare markets. If appropriate, it would provide an important historical perspective: we have tried for almost 50 years to make healthcare markets work.