“A full-throated defense of economic dynamism.” - The Wall Street Journal
“…reminds us that inequality sends a signal of what society lacks most, in America’s case, entrepreneurship and risk taking.” - Lawrence Lindsey, CEO, The Lindsey Group, former Director of the National Economic Council
“…a must-read for serious students of economic policy.” - Glenn Hubbard, Dean, Columbia Business School, and former Chairman of the Council of Economic Advisers
“…a fresh argument for the productive value of inequality.” - David Autor, Professor of Economics, Massachusetts Institute of Technology
“…a very valuable contribution.” - Larry Summers, former Secretary of the Treasury and director of the National Economic Council, president emeritus, Harvard University
“Unintended Consequences provides a provocative interpretation of the causes of the global financial crisis and the policies needed to return to rapid growth. Whether you agree or not, this analysis is well worth reading.” - Nouriel Roubini, New York University; Chairman, Roubini Global Economics
“Unintended Consequences represents the most cogent and persuasive analysis of the Financial Crisis to date.” - Andrei Shleifer, 1999 John Bates Clark Medal Winner
“…challenges misconceptions that distort our economic debates.” - Arthur Brooks, President of the American Enterprise Institute
“…a very valuable contribution.” - Larry Summers, former Secretary of the Treasury and director of the National Economic Council, president emeritus, Harvard University
“…a must-read for serious students of economic policy.” - Glenn Hubbard, Dean, Columbia Business School, and former Chairman of the Council of Economic Advisers
“Unintended Consequences is far smarter and more thought-provoking than most economics written for the general public” - Greg Mankiw, Harvard University, Former Chairman of the Council of Economic Advisors
“…serious thinking for serious thinkers. …a thought-provoking blueprint for growing middle- and working-class incomes.” - Mitt Romney, former Governor of Massachusetts

For whatever topics you select (currently: Healthcare/Seniors):

Include articles that mention this topic 42

Only articles primarily about this topic 12

Doctor’s Office Care at Hospital Prices

Bobby Jindal and Charlie Katebi Wall Street Journal

Date Posted:: July 28, 2023
Is Database:: Database

.@BobbyJindal argues that simple reforms in Medicare billing could save patients and taxpayers somewhere between $346B and $672B over the next 10 years.

Currently, Medicare pays hospital-owned facilities two to three times as much as independent physician offices for the same service, according to the Alliance for Site Neutral Payment Reform. This creates an enormous incentive for large hospital chains to acquire outpatient practices. A report by the Physician Advocacy Institute found that the share of hospital-owned physician practices more than doubled, from 14% to 31%, between 2012 and 2018. By 2020 more than half of physicians worked directly for a hospital or at a physician practice owned by a hospital, according to the American Medical Association. Removing these perverse incentives could save patients and taxpayers between $346 billion and $672 billion over the next decade.

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Medicare pays hospital-owned facilities two to three times as much as independent physician offices for the same service, according to the Alliance for Site Neutral Payment Reform, creating an incentive for large hospital chains to acquire outpatient practices.
The share of hospital-owned physician practices more than doubled, from 14% to 31%, between 2012 and 2018, according to a Physician Advocacy Institute report, and by 2020 more than half of physicians worked for a hospital or hospital-owned practice, according to the American Medical Association.
Removing Medicare's site-based payment differences could save patients and taxpayers between $346 billion and $672 billion over the next decade.

Obamacare Dealt Yet Another Blow as Premiums Jump Again

Reed Abelson and Margot Sanger-Katz New York Times

Date Posted:: November 2, 2026
Is Database:: Database

According to a KFF analysis, the average benchmark health care premium on the Obamacare insurance marketplaces will increase 13% in 2027, compared to 10% for private insurance. This follows a 26% increase last year.

Obamacare premiums will rise an average of 13% in 2027, following a 26% increase in 2026. Much of the increase reflects rising medical costs, with employer-plan premiums also expected to climb about 10%. But the expiration of enhanced federal subsidies has left some Obamacare customers particularly exposed. Remaining income-based subsidies will shield most enrollees from next year’s premium increases by shifting the additional expense to taxpayers. Those ineligible for assistance—including many self-employed workers and early retirees—must absorb the full increase, sometimes after already paying over $1,000 more per month in 2026.Many customers have responded by buying cheaper coverage with higher deductibles, pushing the average deductible to nearly $4,000 this year. Having already traded down, they have less room to offset further increases. KFF estimates suggest enrollment had fallen by nearly five million by June, while a Commonwealth Fund survey indicates that the uninsured rate among working-age adults has risen.

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Average premiums in the Obamacare marketplaces will rise 13% in 2027, according to an analysis by KFF that combined newly published federal prices for 30 states with state-level figures.
Reports by several consulting firms project that 2027 premiums for employer plans, which cover around 150 million people, could rise by about 10%, below the 13% marketplace increase.
Premiums for federal workers are increasing by more than 10%.

Will Medical Care Strangle or Save the Federal Budget?

David Cutler National Bureau of Economic Research

Date Posted:: October 26, 2026
Is Database:: Database

From 1970 to 2010, growth in US medical spending outpaced GDP growth by ~2.4pp annually. From 2010 to 2024, that growth differential fell to just 0.3pp. If it persists, medical spending reaches only 19% of GDP by 2040; if excess spending growth reverts to 2.4pp, it reaches 26%.

Figure 1 shows that in 1970, medical care was 6.9% of GDP. In 2024, it was 18%. From 1970 through around 2010; mean medical spending growth exceeded GDP growth by 2.4 pp annually. Since 2010, the growth of medical spending has exceeded the growth of GDP by only 0.3 pp annually. There is no comparable time period with anything like the sustained slowdown in spending growth since 2010. Patient cost-sharing has increased enormously [indirectly reducing overall expenditure via incentives] as shown in Figure 5. An additional role [was] played by the diffusion of cost-reducing technologies. Because they are often less invasive, second-round therapies typically have lower unit prices. [mechanism in Fgure 6]. Finally, there [are] fewer expensive new innovations than in the past. [However], recent data show an uptick in spending growth in 2024, which continued in 2025. Some of this is a result of new technologies— prime examples are GLP-1 medications and new drugs for cancer that are taken on an ongoing basis. To consider a scenario with [a reversion to] more rapid spending increases, I assume that the growth of medical spending above GDP growth after 2024 returns to the average rate realized between 1970 and 2010. This scenario is shown as the High-spending scenario in figure 1, in which medical care in 2040 rises to 26% of GDP.

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David Cutler projects U.S. medical spending reaching 26%, 22.3%, or 19% of GDP by 2040 under high, benchmark, and low scenarios, versus 18% in 2024 and 6.9% in 1970.
Federal medical spending consumed 45% of “discretionary revenue”—total federal revenue less Social Security contributions—in 2024, up from 13% in 1987, and Cutler projects 61% by 2040 under the high-spending scenario.
Cutler states that only the low-spending scenario is consistent with current tax levels and non-medical spending commitments, attributing the post-2010 slowdown to high-deductible plans, prior authorization, cost-reducing technology, and reduced administrative friction.

The Sweet Life: The Long-Term Effects of a Sugar-Rich Early Childhood

Paul Gertler and Tadeja Gračner Working Paper

Date Posted:: May 12, 2026
Is Database:: Database

Using a regression discontinuity design exploiting the end of sugar rationing in September 1953, Gertler and Gračner find that birth cohorts post-dating the policy change experience worse lifetime outcomes in many health measures as well as economic success.

We study the long-term effects of exposure to a sugar-rich diet in early childhood on health and economic well-being in later adulthood, and identify diet as a possible pathway. We exploit the end of sugar and sweets rationing in 1953 in the UK as a natural experiment inducing variation in exposure to a sugar-rich diet in early childhood. We find that the end of rationing increased the adult prevalence of chronic inflammation, an important marker of chronic disease. We also find increases in poor metabolic health; particularly diabetes, cholesterol and arthritis. Finally, we find that excessive intake of sugar also results in worse economic outcomes; specifically, in reduced human capital accumulation, a lower likelihood of having a skilled occupation, and a lower accumulation of wealth. While the effects of a sugar-rich diet early in life may have affected these outcomes directly via physiological programming, we find that a sugar-rich diet early in life elevated free sugar consumption across lifespan, consistent with evidence that life-long dietary preferences and habits form early, and that sugar may be addictive.

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Using the end of UK sugar and sweets rationing in 1953 as a natural experiment, the authors find that early-childhood exposure to a sugar-rich diet increased adult chronic inflammation, a marker of chronic disease.
The authors find that early-childhood exposure to a sugar-rich diet raised the prevalence of poor metabolic health in later adulthood, particularly diabetes, cholesterol and arthritis.
Early exposure to a sugar-rich diet is associated with worse economic outcomes — reduced human capital accumulation, a lower likelihood of holding a skilled occupation, and lower wealth accumulation — and with elevated free sugar consumption across the lifespan.

Nursing Is the Surefire New Path to American Prosperity

Jeanne Whalen Wall Street Journal

Date Posted:: April 2, 2026
Is Database:: Database

The median annual wage for a nurse in 2024 was $93,600; those with an advanced degree earned $132,050. The Labor Department forecasts that employment of nurses with advanced degrees will increase 35% btw 2024 and 2034 relative to job growth of 3%.

The median annual wage for registered nurses in the U.S. is $93,600, compared with $49,500 for all occupations, according to the Labor Department. For nurse practitioners and others with advanced degrees, it is $132,050. The Labor Department projects that employment of advanced-degree nurses will increase by 35% from 2024 to 2034, eclipsing the expected 3% growth across all occupations. Registered-nurse employment is projected to rise 5% over that period.

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The median annual wage for U.S. registered nurses is $93,600, compared with $49,500 across all occupations, according to the Labor Department.
Nurse practitioners and other nurses with advanced degrees have a median annual wage of $132,050, according to the Labor Department.
The Labor Department projects employment of advanced-degree nurses will rise 35% from 2024 to 2034, against 5% for registered nurses and 3% across all occupations.

Case for Mask Mandate Rests on Bad Data

Phillip Magness Wall Street Journal

Date Posted:: November 12, 2020
Is Database:: Database

The IHME model’s failure to update for behavioral changes led to flawed projections, undermining the case for a mask mandate.

The IHME [Institute for Health Metrics and Evaluation] model's failure to update for behavioral changes led to flawed projections, undermining the case for a mask mandate. The model erroneously assumed a U.S. mask-adoption rate of 49% as of late September, suggesting significant potential for increase to 95% or 85%. However, more recent surveys indicate that the mask-adoption rate has been around 80% since the summer. This discrepancy highlights the importance of using current data in economic modeling and policy-making, as outdated assumptions can lead to misguided decisions with significant economic implications. Accurate data is crucial for effective policy interventions, especially in public health, where behavioral changes can rapidly alter the landscape.

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The IHME model assumed a U.S. mask-adoption rate of 49% as of late September, implying large room for gains toward 85–95%, while more recent surveys indicate adoption has been around 80% since the summer.
The IHME model's failure to update for behavioral changes produced flawed projections that undermine the case for a mask mandate.
Outdated assumptions in modeling rapidly changing behavior can lead to misguided policy decisions with significant economic implications, making current data essential to public health interventions.

IHME failed to update their model for behavioral changes"...Unfortunately, the IHME modelers’ findings contained an error that even minimal scrutiny should have caught. The projected number of lives saved, and the implied case for a mask mandate, are based on a faulty statistic. Using a months-old survey, IHME modelers assumed erroneously that the U.S. mask-adoption rate stood at only 49% as of late September, and therefore had plenty of room to increase to “universal adoption,” defined as 95%, or to a more plausible 85%. According to more recent survey findings, however, America’s mask-adoption rate has hovered around 80% since the summer...."

Phillip Magness, "Case for Mask Mandate Rests on Bad Data,"Wall Street Journal, November 11, 2020, https://www.wsj.com/articles/case-for-mask-mandate-rests-on-bad-data-11605113310

CBO presents options for covering the uninsured

James Capretta American Enterprise Institute

Date Posted:: October 9, 2020
Is Database:: Database

@JamesCapretta 30mm Americans under 65 were uninsured in 2019, 20m eligible for subsidized coverage but unenrolled, 9.8mm ineligible for subsidies. Addressing gaps is crucial for near-universal coverage, as highlighted by the CBO’s analysis.

As of 2019, 30m Americans under 65 were uninsured, representing 12% of that demographic. Notably, 20m of these individuals are eligible for subsidized coverage but remain unenrolled, often due to perceived cost or enrollment complexities. Of the uninsured, 17% qualify for Medicaid or CHIP, 19% for ACA marketplace subsidies, and 31% have employer coverage access. Only 9.8m uninsured individuals are ineligible for subsidies, with 4m being noncitizens without lawful status and 5.8m falling through coverage gaps. Addressing these gaps is crucial for achieving near-universal coverage, as highlighted by the CBO's analysis.

Takeaways by Macro Roundup^® AI

As of 2019, 30m Americans under 65 were uninsured, or 12% of that age group, according to CBO.
CBO finds 20m of the uninsured are eligible for subsidized coverage but not enrolled, often because of perceived cost or enrollment complexity, with 17% eligible for Medicaid or CHIP, 19% for ACA marketplace subsidies, and 31% having access to employer coverage.
CBO reports that 9.8m uninsured people are ineligible for subsidies, including 4m noncitizens without lawful status and 5.8m who fall into coverage gaps.

James Capretta, "CBO presents options for covering the uninsured," American Enterprise Institute, October 5, 2020, https://www.aei.org/articles/cbo-presents-options-for-covering-the-uninsured/

Allison Percy and Karen Stockley, “Who Went Without Health Insurance In 2019, and Why?” Congressional Budget Office, September 2020, https://www.cbo.gov/system/files/2020-09/56504-Health-Insurance.pdf

Jared Maeda and Karen Stockley, “Policies to Achieve Near-Universal Health Insurance Coverage,” Congressional Budget Office, October 2020, https://www.cbo.gov/system/files/2020-10/56620-near-universal-coverage.pdf

Capretta here makes no sense according to CBO“…0 million people are uninsured because they are residing in the U.S. without proper legal status; as such, they are ineligible for subsidized coverage.6 million people are ineligible for employer coverage but have incomes too high to qualify for subsidized premiums through the ACA exchanges; they could enroll in plans offered in the nongroup market but would be required to pay the full premiums themselves. Finally, there are 3.2 million people who have incomes below the federal poverty line and live in states that did not expand Medicaid as allowed by the ACA.This group falls into a “coverage gap” in current law; their incomes are too low to qualify for subsidized premiums in the ACA exchanges and yet too high to qualify for Medicaid. The first priority of any future effort to cover the uninsured should be to ensure this population can enroll in either Medicaid or another alternative that requires no premium payment….”

And only 1/3 of persons not insured not eligible for subsidized coverage“…In 2019, an estimated 30 million people under the age of 65, or 12 percent of that population, were uninsured. One reason for the lack of insurance coverage was a lack of subsidized options. About one-third of uninsured people under the age of 65 did not have access to coverage that was subsidized by the government or an employer: 13 percent were noncitizens who were not lawfully present in this country; 11 percent had income that was less than 100 percent of the FPL and lived in a state that did not expand Medicaid; and 9 percent had income that was too high to qualify for marketplace subsidies(see Figure 1)…”

“…About two-thirds of the 30 million uninsured people under the age of 65 had access to some form of subsidized coverage but were not enrolled, although those options were subsidized to different degrees: 17 percent were eligible for Medicaid or CHIP; 19 percent were eligible for subsidized coverage through the marketplaces established under the ACA; and 31 percent had access to coverage through an employer. Most of those people could have purchased health insurance that cost less than 10 percent of their income, but fewer people had an option that cost less than 5 percent of their income. Those people lacked health insurance coverage because they did not consider it to be worth the cost or because of the complexities of the enrollment process, among other reasons….”

But bottom line according toCBO only 9.8mm people who are currently uninsured are not eligible for subsidized coverage under the current systems, and 4mm are not lawfully present in the country, so only5.8mm peoplearen’t being captured by the current system. The other 20mm people don’t have health insurance because to quote CBO “…Those people lacked health insurance coverage because they did not consider it to be worth the cost or because of the complexities of the enrollment process, among other reasons…”

Ed Comment:The numbers in this article don't seem to add up. It says 30 mm are uninsured. Then it details 10 million and seems to call it 2/3s. Then it has a category zero million.

Ed Comment:Hard to see that 100mm people are at risk of losing coverage and/or can't get HC. 20 mm are subsidized and don't take it. 2.6 can afford it and don't take it. Half of the remainder are illegals. Many people won't be very sympathetic to them and we still give them some/essential HC so it looks like 3 of the 30 might want it but can't get it. The rest are all covered. That said, I still don't know how many people with pre existing conditions significant enough to truly prevent them from being covered are being "saved" by obamacare. (The ones with employer coverage would get it). So it looks like the true number is at risk is much smaller than 100mm Can you please take all your entries and sort everyone into buckets including the elderly. One bucket would be resting conditions covered by employers. It would be great to see those who were eligible for Medicaid and chips without Obama care and those who were added to it because of Obama care. A clear top down picture would be useful/enlightening.

Jim Capretta Comment:"Thank you for pointing this out (not sure why no one else did). Some numbers got lopped off in the translation from what I submitted to what got posted. Here are the correct numbers in order of the first bulleted points: 5.1 million people 5.5 million 9.4 million Then in the next bullets it should be: 4.0 million 2.6 million I hope this is clear enough.”

Ed you were right, 30mm persons < 65are currently uninsured, but I can’t line his numbers with the reports, according to theCBO(See Figure 1, 67% of uninsured persons are currently eligible for subsidized coverage) Before I sent you a note that it was wrong I wanted to confirm with him, he said it was a typo on AEI’s part.

Capretta, "...In 2019, 12 percent of the nonelderly population — or about 30 million people — went without health insurance..."

Kevin McNellis, Carolyn Ugolino and Emily Vreeland, “Federal Subsidies for Health Insurance Coverage For People Under 65: 2020 to 2030,” Congressional Budget Office, September 2020, https://www.cbo.gov/publication/56650

Steve Comment:I’m still working on thenumber of individuals with pre-existing conditions who currently get coverage through employment and the number who are buying it on the exchanges due to the ACA. This is proving a little hard.But I wanted to show you a topdown snapshot of the <65 population,90% are covered if you exclude illegal immigrants. (According to theKaiser Family Foundationanother67.7mm >65 individuals are enrolled in Medicare in 2020.)According to CBO 155mm (57%) of the 272mm individuals < 65are covered by employment based coverage this year. But in terms of the number of people < 65 “saved” by Obamacare in 2020 CBO estimates13mm(so 5% of <65) individualswere added to Medicaid due to the ACA.See table A-1. In total70mm (28%)individuals <65 are covered by Medicaid. Note one thing from footnotes as this caught me up “The components do not sum to the total population because some people report multiple sources of coverage. CBO and JCT estimate that in every year of the projection period, between 12 million and 14 million people (about 5 percent of the insured population) have multiple sources of coverage, such as employment-based coverage and Medicaid”

.@BobbyJindal argues that simple reforms in Medicare billing could save patients and taxpayers somewhere between $346B and $672B over the next 10 years.

How much would paying the same rate regardless of ownership save?

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According to a KFF analysis, the average benchmark health care premium on the Obamacare insurance marketplaces will increase 13% in 2027, compared to 10% for private insurance. This follows a 26% increase last year.

Are marketplace health premiums rising faster than employer plan premiums?

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Related Articles:

From 1970 to 2010, growth in US medical spending outpaced GDP growth by ~2.4pp annually. From 2010 to 2024, that growth differential fell to just 0.3pp. If it persists, medical spending reaches only 19% of GDP by 2040; if excess spending growth reverts to 2.4pp, it reaches 26%.

How much federal revenue will medical spending consume by 2040?

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Related Articles:

Using a regression discontinuity design exploiting the end of sugar rationing in September 1953, Gertler and Gračner find that birth cohorts post-dating the policy change experience worse lifetime outcomes in many health measures as well as economic success.

Does a sugar-rich early childhood diet worsen adult health and wealth?

Takeaways by Macro Roundup® AI

Related Articles:

The median annual wage for a nurse in 2024 was $93,600; those with an advanced degree earned $132,050. The Labor Department forecasts that employment of nurses with advanced degrees will increase 35% btw 2024 and 2034 relative to job growth of 3%.

Is nursing one of the highest-paying, fastest-growing career paths?

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Related Articles:

The IHME model’s failure to update for behavioral changes led to flawed projections, undermining the case for a mask mandate.

Do outdated modeling assumptions overstate the benefits of mask mandates?

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@JamesCapretta 30mm Americans under 65 were uninsured in 2019, 20m eligible for subsidized coverage but unenrolled, 9.8mm ineligible for subsidies. Addressing gaps is crucial for near-universal coverage, as highlighted by the CBO’s analysis.

Are most uninsured Americans already eligible for subsidized coverage?

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