Reflex: September 9, 2011

Lower income families pay a higher share of income toward national health care spending than higher-income families do, reports the Robert Wood Johnson Foundation“Specifically, we found that payments made privately, such as those for health insurance or out-of-pocket spending for care, and publicly, through taxes and tax expenditures, consumed more than 20 percent of family income for families in the lowest-income quintile but no more than 16 percent for families in any other income quintile.” Aaron’s Comment: People should consider this when arguing that Americans don’t have enough “skin in the game”, as we’ve discussed here many times.

The American Hospital Association backs raising Medicare age. Does Obama (still)? Susan Jaffe (Politico) reports that the AHA supports raising the Medicare retirement age from 65 to 67 as an alternative to (further) cutting Medicare payments to hospitals. In his speech last night, President Obama said that his plan would make “modest adjustments to health care programs like Medicare.” Austin’s comment. That the AHA backs Medicare retrenchment in this fashion makes perfect sense for them because prices paid to hospitals by private insurers are, on average, higher than Medicare’s. Earlier this year Obama also proposed raising the Medicare retirement age as one deficit cutting option. House Democrats did the same yesterday. This is a “solution” in one, narrow sense: it would reduce federal outlays by about $125 billion over 10 years, according to the CBO. However, it would not reduce overall health spending by anywhere near that amount and has many other limitations, which Aaron and I covered two weeks ago.

Minnesota is a model state for long term care provision, writes Warren Wolfe (Minneapolis Star/Tribune). They seem to provide better information about both nursing homes and home-based care options, and have a system that is better-coordinated than average. A model for reform? Don’s comment: Long term often gets less policy attention that acute care, but the movement of the baby boomers into Medicare and Medicaid will stress the system. The CLASS provisions of the ACA seem likely to be repealed, but private long term care insurance has low market share for many reasons. Proposals to federalize the Medicaid program for dual-eligibles could improve coordination but are controversial, and there are many inter-connected parts to the system. In short, there is no easy answer, but the question remains: what is the best way to insure Long Term Care? 

(H/t, Igor Volsky)

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