In my early days as a health economist, it became something of a fad for health policy analysts to argue that the U.S. health care system needed more vertical integration. Basically, your doctor needed a boss, who oversaw numerous doctors coordinating your care. I recall reading numerous articles with titles like, “does your doctor need a boss?” The Cato Institute published an article on the topic in 2009, as did many others.
Tuesday Links
- Community Health Centers serve one in ten Americans.
- Even though 90 percent of US prescription drugs are generic, the number of U.S. facilities producing generic drugs has fallen by 27 percent since 2013. (NYT)
- The “worst test” in medicine is driving America’s high C-section rate. (NYT)
- Rising housing costs since 1990 are responsible for 11% fewer children, 51% of the total fertility rate decline between the 2000s and 2010s, and 7 percentage points fewer young families in the 2010s.
- CMS: “The average Marketplace premium after tax credits is projected to be $50 per month for the lowest cost plan in 2026 for eligible enrollees.”
What’s Wrong with Obamacare
In 2014, when the ACA’s key provisions took effect, individual market premiums rose nearly 50 percent.
From 2014 to 2026, premiums increased nearly twice as rapidly as employer plan premiums.
The ACA’s subsidies are ill-designed and inflationary. The enrollee’s share of the premium is capped, regardless of the total premium. Because enrollees pay only a small slice of the premium, insurers face virtually no price discipline—giving them incentives to inflate costs rather than improve value….
COVID-era subsidy boosts resulted in fully subsidized coverage and led to massive fraud.
In 2025, there are 6.4 million people enrolled in fully subsidized plans who are not eligible, costing $27 billion. In 15 states, there are more than twice as many enrollees in fully subsidized plans than are eligible.
Source: Senate Testimony of Brian Blase
Monday Links
- The VA typically pays $1,100 a month or higher for sleep apnea — a larger sum than most veterans receive for a leg amputated below the knee. (WaPo)
- Black immigrants earn about as much as native-born Black Americans. But 2nd-generation Black Americans earn about as much as White Americans.
- Social Security: “Lower-wage workers receive 90% return on their first earnings tranche, while higher earners receive only 15% on their top earnings.
- For every man older than 110, there are nine women. (Bloomberg)
- Which is better for health: walking or running? (NYT)