On March 26, an overwhelming bipartisan majority in the House of Representatives voted for the Medicare Access and CHIP Reauthorization Act (MACRA). Secretly negotiated between Republican and Democratic leaders, this bill is the so-called Medicare “doc fix,” a prize that has been chased for many years but never caught by politicians eager to break out of the fiscal discipline a previous Congress imposed on them.
The 2010 Patient Protection and Affordable Care Act (ACA) required each state to expand Medicaid eligibility to individuals and families with incomes up to 138 percent of the federal poverty level or risk losing federal funding for its entire Medicaid program. However, the U.S. Supreme Court ruled that provision of Obamacare unconstitutional.
Americans spend nearly $3 trillion annually on medical care. Nearly one-third of health care spending is on hospital care, and an additional one-fifth of health care dollars are spent on physician care. By contrast, drugs are a bargain at only about 10 percent of medical spending.
Over the next few years, the population of 85-year-olds in Wisconsin will grow more than 3 percent a year, faster than the U.S. average of around 2 percent. This means an increasing need for long-term care and future challenges in funding it.
Many state and local public employee pension funds are struggling to make up large gaps in their funding — which cratered in the aftermath of the 2008-2009 recession. The one exception is Wisconsin, which, through responsible management of Wisconsin Retirement System (WRS) finances, has successfully maintained close to full funding of its retirement system since 2001.
Patients benefit enormously from safe and effective drug therapies. However, many of the drugs Americans take are not safe when they are taken recreationally, consumed in quantities larger than prescribed or diverted for illicit sale. More than 16,000 people die annually from prescription drug overdoses, according to the Centers for Disease Control and Prevention (CDC) — double the number that die abusing either cocaine or heroin, combined.
President Barack Obama has tagged the growing inequality of income over the past three or four decades as “the defining challenge of our time,” an often-repeated claim recently echoed by economist Thomas Piketty in Capital in the Twenty-First Century. Numerous social and economic factors explain why the income and wealth gaps have grown, from the rise in family breakdown to the incentives embedded in government welfare programs.
Texas continues to grow, even in the face of a recession and the weak recovery. From 2008 to 2014, real gross domestic product per person in the United States did not grow, but in Texas, per capita GDP rose 4.7 percent. This has swelled public coffers and offers Texas the opportunity to eliminate the most counterproductive part of the tax code: the franchise tax.
Whereas large corporations typically self-insure — paying their employees’ medical bills and hiring insurers to administer health benefits — small businesses purchase group health coverage from insurers and face cost-increasing regulations as they go through the annual ritual of renewing their coverage. Over the next few years, as regulations and mandates are finally implemented, Obamacare will affect how businesses operate — including hiring, employee compensation, growth and so forth.
Patients benefit enormously from safe and effective drug therapies. Highly advanced specialty drugs and biological agents are increasingly used to treat rare diseases and disorders for which there were no treatments only a few years ago. Advanced drug therapies are very expensive, and often require special handling and extensive patient monitoring.
Both proponents and opponents of federal minimum-wage hikes are convinced that if Congress raises the minimum wage (whether to $9 or $10.10 or $15 an hour) the welfare of tens of millions of low-income workers will rise by a comparable amount. The two sides disagree over the extent of the job losses low-wage workers will suffer, but both sides acknowledge that most econometric studies over the past half-century show that a 10 percent hike in the federal minimum wage results in job losses for unskilled workers of no more than 3 percent, and potentially less than 1 percent. Most recently, the Congressional Budget Office found that if the minimum wage is hiked to $10.10, expected job losses by 2016 will amount to a scant 0.3 percent of the jobs affected.
Consumers choose plastic bags far more often than paper or reusable bags to carry their purchases. Compared to paper and reusable bags, plastic bags are lightweight, strong, flexible and moisture resistant. In addition, they are easy to store and reusable for multiple purposes. Despite these characteristics and their popularity, a growing number of municipalities and some states are enacting laws aimed at reducing the use of plastic (and sometimes paper) grocery bags. The laws range from outright bans to taxes. Advocates have given a number of justifications for placing restrictions on consumers’ use of carry-out plastic bags. These include concerns about the scarce resources used to create the bags, environmental harms when they are disposed of improperly, the visible blight of roadside litter, and the cost of disposing or recycling them.
Telecommunications, cable and wireless service consumers pay a barrage of federal, state and local taxes and fees imposed on these services and their providers. Telecom services are usually taxed like tangible goods and other intangible services, but taxes and fees vary among states and cities. California has the highest state sales tax rate (7.50 percent), while Colorado has the lowest (2.9 percent).
Nature provides a variety of services to mankind. Forests and wetlands, for example, filter pollutants, cleaning the water. Weathering, microbes, and various plants and insects create and enrich the soil. The world’s forests and oceans work as the lungs of the earth, taking in carbon dioxide and emitting oxygen. Undeveloped land provides a variety of recreational opportunities, from hiking, camping and off-road biking to hunting and fishing.
Medicaid, the federal-state health care program for the poor, was created almost as an after-thought as part of the Medicare Act of 1965. From 1975 to 2010, Medicaid costs grew 1.8 percent faster than gross domestic product (GDP), raising federal costs and putting increasing pressure on state budgets. Florida exemplifies the states’ Medicaid spending problem:
Every day, millions of American consumers go shopping. In the process, they compare the prices and quality of goods and services ranging from groceries to cellular telephone service to fast food to housing. But that daily ritual changes when it comes to comparing prices for medical care. Health care is the only major sector of our economy where consumers typically do not make decisions based on comparison shopping.
America’s well-being — our homes, workplaces, schools, hospitals and transportation systems — are all possible because of this country’s vast mineral wealth. The United States ranks as among the world’s largest minerals users and minerals producers; but we depend on foreign sources for rare earths.
In June 2012, the U.S. Supreme Court ruled as unconstitutional, those provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) denying federal matching funds to states that refuse to extend Medicaid eligibility to 138 percent of the federal poverty level (FPL). As a result, Florida and other states now have the opportunity to compare the costs and benefits of expanding Medicaid eligibility.
Drug coverage will become more prevalent as more uninsured families gain health insurance as a result of the 2010 Patient Protection and Affordable Care Act. Drug therapy is arguably the most efficient method to treat most illnesses — often substituting for more expensive hospital and surgical treatments. Broader use of prescription drugs for chronic illness could reduce medical costs by avoiding expensive emergency room visits, costly complications and hospitalizations.
The fundamental problem with Texas public schools, and nationwide, is that children are not engaged in useful learning. Far too many children are confused, overwhelmed or bored. As a result, they learn little, become discipline problems, and drop out at high rates. Though the worst problems are in the urban schools attended by the poor, the issue cannot be solely attributed to low income or an urban environment.
Medicare, the nation’s health care program for seniors, faces growing problems of cost, access and quality. The solution lies in Medicare reforms that liberate health care providers to innovate, empower patients to control some of the money spent on their health care, and allow workers to save for their retirement health care expenses.
The Supreme Court’s ruling that provisions of the Affordable Care Act that would take away all federal Medicaid funds from states that refuse to expand their Medicaid programs are unconstitutional inadvertently liberated millions of people who might have been forced into Medicaid.
Life expectancy has increased for most Americans in general over time, and life expectancy at retirement has been rising for decades. This has resulted in lengthening periods of retirement and higher associated spending on Social Security and Medicare. However, the longevity gains are significantly larger for men with relatively high lifetime earnings than those with relatively low lifetime earnings.
For several years, retirement and financial experts have bemoaned the fact that baby boomers and others who should be thinking about retirement saving are nowhere near ready to retire. One could surmise that because there has been little growth in real income recently, the average household simply does not have enough left over each month to save. But is that really the case? Or have the spending habits of middle-aged and soon-to-retire adults changed over time?
Grocers and other retailers nationwide pack consumers’ purchases in plastic bags. However, a growing number of jurisdictions — including Los Angeles county, and cities such as Austin and Seattle — have banned the use of thin-film plastic bags. Other local governments, such as the Washington, D.C., city council, have implemented a per-bag tax.