Reflex: September 8, 2011

America’s broken health system: number of underinsured up and health costs consuming nearly all income gains.  Rich Daly (Modern Healthcare) reports that a new study in Health Affairs found that nearly all the gains from 1999-2009 in average income by an American family of four were consumed by higher health care costs. Meanwhile, Mary Mahon and Bethanne Fox (Commonwealth Fund) describe another new Health Affairs study that reveals that the number of underinsured adults increased 80 percent between 2003-2010. Austin’s comment: This is all bad news. It is somewhat encouraging that if policymakers continue to support implementation of the ACA, it is expected to bring some relief to many of the underinsured in 2014. (That’s a big “if.”) As for medical inflation, it is not at all clear the ACA will be of much help in the commercial market, an argument for more reforms.

Tax reform may be too big a task for the Super Committee, writes Jeanne Sahadi. Reducing exclusions, exemptions and deductions and lowering marginal rates is a way to increase tax receipts and make the tax code fairer. Don’s commenttax reform seems to be an area of general consensus as an approach, and may be the only way tax receipts can increase politically. If tax reform is not included in the Super Committee deliberations, it is hard to see how any revenue increases will be included and that puts us on the route to the sequester. The table in this post shows the relationship between marginal rates, number of brackets and removal of exemptions, deductions and exclusions.

Strict hand hygiene and other practices shortened stays and cut costs and mortality in a pediatric intensive care unit, reports a study in Health Affairs. “Should future efforts to improve quality replicate on a larger scale the results we have reported here, it would be possible to reduce critically ill patients’ average length-of-stay by 21 percent. In terms of cost savings alone, that change would certainly improve our national well-being.” Aaron’s Comment: Unfortunately, there’s still a lot of work to be done in this area, as I discussed last week.

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