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The Goodman Institute Health Blog

Tuesday Links

Posted on May 22, 2023May 22, 2023 by John C. Goodman

Around 50% of patents linked to drugs approved by the FDA directly cite NIH-funded research. 

The case for work requirements included in the GOP’s Debt limit bill.

Gramm and Solon: the case for the Republican Debt-Ceiling bill is strong.

Big Brother strikes again. CMS: no more mail delivery for cancer drugs. (InsideHealthPolicy – gated)

Is ChatGPT nicer than your doctor? Is the information better?

 

1 thought on “Tuesday Links”

  1. Bob Hertz says:
    May 24, 2023 at 4:45 pm

    I am not an expert on work requirements. However I am obliged to say that there are some strong objections to this policy, and not just bleeding-heart fluff.

    Here are some points from the Georgetown University Health Policy Center and a Leonardo Cuello:

    …”work requirements are also a waste of time and resources because the majority of Medicaid enrollees are already in working households. The data also shows that the minority that are not working usually have a good reason—such as they’re in school or caring for family.

    ….. there is a simple reason work requirements don’t increase work: they don’t actually do anything to address the reasons people don’t work. You know, in reality. Evidence shows the reasons people don’t work are things like lack of child and family care, transportation, access to jobs, and job training, as well as disabling health conditions and (particularly in some rural areas) a history of opioid use or other SUD. Work requirements don’t help any of these people work—they just punish these families further.

    ….. work requirements are also anti-family. Parents may be denied or have their coverage terminated because they are taking care of children—often because there is no available or affordable child care option. Some states may claim to offer an “exception” for such parents, but will fail to identify many parents providing child care and terminate them anyways. Georgia, which is about to implement a work requirement in July, hasn’t even bothered to offer a caregiving exception; presumably suggesting that parents should choose between health insurance or taking care of their kids? Parents in non-expansion states with a work requirement would also risk termination if they did try to add work hours.

    …work requirements are also destined to fail because they require the state to have two-way communication with all or a large part of the Medicaid population every month. As communication failures in Arkansas and New Hampshire demonstrated, the Medicaid population includes people with unstable housing or experiencing homelessness, inconsistent access to cell phones and the internet, and informal employment arrangements that change monthly. If you think monthly data matching and reporting in this context is possible, please email me about a fantastic bridge I have for sale.”

    One aspect of this complex issue I do know about is medical debt. When Medicaid is limited or just unavailable, more individuals fall into medical debt. This hurts them as well as the medical institutions that care for them. The persons who are kicked off Medicaid and enter the job market do not, as a rule, obtain jobs that include health insurance.

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