Archive for the ‘Health Care Policy’ Category


December 28, 2017 Leave a comment

I have been a professional economist for many years and one of the things I noticed early on in my career was how little impact economists have upon public discussion of economic issues. While there are undoubtedly many reasons for this, one obvious reason is the inability of professional economists, particularly academic ones, to communicate with the public in a way which the public understands. Let me illustrate this with two possible ways that we might describe the problems with guaranteed issue, a feature of Obamacare that I have written about in earlier posts which is an important reason for the collapse of the insurance exchanges. Read more…


RIP Individual Mandate

December 21, 2017 Leave a comment

The tax bill recently voted out of Congress eliminates the individual mandate which was one component of Obamacare. One politician was quoted as saying that this feature of the tax bill is the beginning of the end of Obamacare. It is reasonable to ask if this is true and, I will argue that this is true, although it may be for reasons different from the opinions of this politician.

I have written previously that one of the many flaws in the design of Obamacare is guaranteed issue, the feature which lets people sign up for Obamacare and drop it after receiving medical services. Obviously this aspect of Obamacare is incompatible with the profitability of insurance companies and it is one reason why insurance companies have left the Obamacare insurance exchanges. The elimination of the individual mandate means that fewer good risks, largely those who are young, will buy health insurance on the exchanges, which implies that the applicant pool will contain fewer good risks. That means more losses for the insurance companies selling the insurance and, as a result, higher premiums and/or fewer companies selling the insurance. In other words, the “death spiral” will accelerate to some extent which leads ultimately to the collapse of the Obamacare exchanges.

I really can’t think of a better example of the perils of central planning. And it also reveals what happens when one political party passes a new entitlement program without the support of the other political party.

Can the Rich Pay for “Bernie-Care?”

November 2, 2017 Leave a comment

In an earlier post, I reported the results of an Urban Institute study which attempted to estimate the cost of Medicare-for-All or “Bernie-Care,” the latter name given by some people to a Medicare-for-All system because Senator Bernie Sanders has advocated this plan. The Urban Institute study estimated the cost of such a plan to be between $2.0 Trillion and $2.5 Trillion. Here I ask if the rich, however defined, can pay for such a new medical insurance system.

Before going further, it should be recognized that a definition of the rich is inherently arbitrary and so the only sensible way to address this issue is to report a range of income classes and let the reader decide which one is relevant. That is what I will do in what follows below. The data comes from Table 3 of the IRS tables reporting statistics on the U.S. income tax and I will confine the results to the latest year available from the IRS, 2014. Read more…

The Cost of “Bernie Care”

September 25, 2017 1 comment

Senator Bernie Sanders has expressed support for and formally introduced a plan for a health insurance system to be run by the federal government which has been called “Bernie Care” in some media outlets.  A number of other Democratic politicians have also expressed support for this idea. This is quite likely to be the Democratic Party response to the problems with Obamacare. Indeed Barack Obama expressed his own support for this national health insurance program before his first election as President (I saw the videotape of his statements at that time) but he claimed the country was not yet ready for such a health insurance program. What would such a program cost? The Urban Institute has published a study to answer this question. Read more…

Fixing Obamacare

November 15, 2016 Leave a comment

Now that the election is over and President-Elect Trump has begun the transition to his administration, there has been some discussion of reforming the market for health insurance. I have written previously that Obamacare is in the process of collapsing because of its structural defects. For example, the Obamacare feature of guaranteed issue has caused a phenomenon known as adverse selection which is driving insurance companies out of the health insurance exchanges (links to other posts on Obamacare are given below). Here I thought it would be useful to outline some changes that seem to be sensible reforms to the currently-available flawed system.

Read more…

Obamacare Slowly Implodes (Updated)

November 30, 2015 5 comments

Readers of this blog know that I am a critic of the Affordable Care Act.  My view is that it was poorly designed and it has harmed millions of people who have lost access to their doctors and hospitals. (There are links at the end of this article to previous posts on this profoundly misguided law.) There is now accumulating evidence that the insurance exchanges are moving into what has been termed a “death” spiral, a process which can lead to the collapse of the insurance exchanges set up by the law.

This death spiral refers to a situation where insurance companies lose money selling health insurance on the exchanges and thus stop selling insurance to avoid these losses. The exchanges can collapse if all insurers withdraw from the exchanges, leaving millions of Americans without coverage. The design of the Affordable Care Act raises the possibility of this collapse because it limits the ability of insurers to charge higher prices to riskier applicants and because the law requires guaranteed issue, meaning that insurers must sell a policy to anyone who applies. Thus insurers must treat everyone as if they are bad risks and charge correspondingly higher prices for insurance but, if the applicant pool of insurance buyers is dominated by bad risks, insurance companies may lose money on their policies. This latter situation is known as “adverse selection.” There is now accumulating evidence that adverse selection has occurred in these insurance exchanges.

Read more…

Random Thoughts After a Long Hiatus

September 21, 2015 2 comments

It has been quite a while since I last posted on this blog. I finally decided to catch up by posting a series of remarks on a number of issues that are of interest to economists and (hopefully) others.

Disparate Impact Analysis

I teach in a university economics department. If you were to attend one of our faculty meetings, you would observe that nobody in the room is a seven-foot Chinese basketball player. Does that mean the faculty in my department discriminated against the seven-foot Chinese basketball players in the world who wanted to be on our staff and attend this meeting? If you were to use a nonsensical theory known as disparate impact analysis, then if seven-foot Chinese basketball players were a politically-protected group, the answer is yes and my university could be charged with discrimination in federal court.

To say the least, disparate impact analysis ignores the scientific method which most of us learned in primary school. The fact that a person has the disease known as AIDS does not imply how the person got that disease. The reason is that medical science has determined that the disease can be contracted in more than one way. Similarly, if one group of individuals makes less money than another group, there are many reasons why this may be so.  One of those reasons could be discrimination but how do we know this to be true? Put differently, there are causal relationships in an economy and there are many random events that can make a group of individuals have the demographic characteristics that they have. Read more…

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A blog by John B. Taylor

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