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71. Massachusetts Miracle or Massachusetts Miserable: What the Failure of the "Massachusetts Model" Tells Us about Health Care Reform

Author:
Michael Tanner
Publication Date:
06-2009
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true: Although the state has reduced the number of residents without health insurance, 200,000people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate. Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average. New regulations and bureaucracy are limiting consumer choice and adding to healthcare costs. Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a “global budget” on health care spending—with its attendant rationing. A shortage of providers, combined with increased demand, is increasing waiting times to see a physician. With the “Massachusetts model” frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
Topic:
Health, Human Welfare, Markets, and Governance
Political Geography:
United States

72. How Urban Planners Caused the Housing Bubble

Author:
Randal O'Toole
Publication Date:
10-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
Everyone agrees that the recent financial crisis started with the deflation of the housing bubble. But what caused the bubble? Answering this question is important both for identifying the best short-term policies and for fixing the credit crisis, as well as for developing long-term policies aimed at preventing another crisis in the future.
Topic:
Economics, Markets, and Financial Crisis
Political Geography:
United States, California, and Georgia

73. Halfway to Where? Answering the Key Questions of Health Care Reform

Author:
Michael Tanner
Publication Date:
09-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
Although neither the House nor the Senate passed a health care bill by President Obama's August deadline, various pieces of legislation have made it through committee, and they provide a concrete basis for analyzing what the proposed health care reform would and would not do. Looking at the various bills that are moving on Capitol Hill, we can determine the following: Contrary to the Obama administration's repeated assurances, millions of Americans who are happy with their current health insurance will not be able to keep it. As many as 89.5 million people may be dumped into a government-run plan. Some Americans may find themselves forced into a new insurance plan that no longer includes their current doctor. Americans will pay more than $820 billion in additional taxes over the next 10 years, and could see their insurance premiums rise as much as 95 percent. The current health care bills will increase the budget deficit by at least $239 billion over the next 10 years, and far more in the years beyond that. If the new health care entitlement were subject to the same 75-year actuarial standards as Social Security or Medicare, its unfunded liabilities would exceed $9.2 trillion. While the bills contain no direct provisions for rationing care, they nonetheless increase the likelihood of government rationing and interference with how doctors practice medicine. Contrary to assertions of some opponents, the bills contain no provision for euthanasia or mandatory end-of-life counseling. The bills' provisions on abortion coverage are far murkier.
Topic:
Government, Health, Human Welfare, and Markets
Political Geography:
United States and America

74. Would a Stricter Fed Policy and Financial Regulation Have Averted the Financial Crisis?

Author:
Jagadeesh Gokhale and Peter Van Doren
Publication Date:
10-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
Many commentators have argued that if the Federal Reserve had followed a stricter monetary policy earlier this decade when the housing bubble was forming, and if Congress had not deregulated banking but had imposed tighter financial standards, the housing boom and bust—and the subsequent financial crisis and recession—would have been averted. In this paper, we investigate those claims and dispute them. We are skeptical that economists can detect bubbles in real time through technical means with any degree of unanimity. Even if they could, we doubt the Fed would have altered its policy in the early 21st century, and we suspect that political leaders would have exerted considerable pressure to maintain that policy. Concerning regulation, we find that the banking reform of the late 1990s had little effect on the housing boom and bust, and that the many reform ideas currently proposed would have done little or nothing to avert the crisis.
Topic:
Economics, Government, Markets, and Financial Crisis
Political Geography:
United States

75. Yes, Mr. President: A Free Market Can Fix Health Care

Author:
Michael F. Cannon
Publication Date:
10-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
In March 2009, President Barack Obama said, “If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way.” This paper explains how letting workers control their health care dollars and tearing down regulatory barriers to competition would control costs, expand choice, improve health care quality, and make health coverage more secure.
Topic:
Economics, Health, and Markets
Political Geography:
United States

76. All the President's Mandates: Compulsory Health Insurance Is a Government Takeover

Author:
Michael F. Cannon
Publication Date:
09-2009
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
The most hazardous health reform measure before Congress is not the so-called "public option," but proposals to make health insurance compulsory via an individual or employer mandate. Compulsory health insurance could require nearly 100 million Americans to switch to a more expensive health plan and would therefore violate President Barack Obama's pledge to let people keep their current health insurance. In particular, the legislation before Congress could eliminate many or all health savings account plans. Making health insurance compulsory would also spark an unnecessary fight over abortion and would enable government to ration care to those with private health insurance.
Topic:
Government, Health, and Markets
Political Geography:
United States and America

77. Three Decades of Politics and Failed Policies at HUD

Author:
Tad DeHaven
Publication Date:
11-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
The U.S. Department of Housing and Urban Development has long been plagued by scandals, mismanagement, and policy failures. Most recently, HUD's subsidies and failed oversight of Fannie Mae and Freddie Mac helped to inflate the housing bubble, which ultimately burst and cascaded into a major financial crisis.
Topic:
Development, Economics, Markets, and Financial Crisis
Political Geography:
United States

78. Bending the Productivity Curve: Why America Leads the World in Medical Innovation

Author:
Glen Whitman and Raymond Raad
Publication Date:
11-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
The health care issues commonly considered most important today — controlling costs and covering the uninsured — arguably should be regarded as secondary to innovation, inasmuch as a medical treatment must first be invented before its costs can be reduced and its use extended to everyone. To date, however, none of the most influential international comparisons have examined the contributions of various countries to the many advances that have improved the productivity of medicine over time. We hope this paper can help fill that void.
Topic:
Health, Human Welfare, and Markets
Political Geography:
America

79. Troubled Neighbor: Mexico's Drug Violence Poses a Threat to the United States

Author:
Ted Galen Carpenter
Publication Date:
02-2009
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
While U.S. leaders have focused on actual or illusory security threats in distant regions, there is a troubling security problem brewing much closer to home. Violence in Mexico, mostly related to the trade in illegal drugs, has risen sharply in recent years and shows signs of becoming even worse. That violence involves turf fights among the various drug-trafficking organizations as they seek to control access to the lucrative U.S. market. To an increasing extent, the violence also entails fighting between drug traffickers and Mexican military and police forces.
Topic:
Security and Markets
Political Geography:
United States and Mexico

80. Organ Sales and Moral Travails: Lessons from the Living Kidney Vendor Program in Iran

Author:
Benjamin E. Hippen
Publication Date:
03-2008
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
Kidney transplantation in the United States is burdened by a terrible policy failure. The cost of this failure will be paid in the currency of years of human lives unnecessarily lost, as well as a massive increase in federal expenditures over the next decade and beyond. The number of patients with end-stage renal disease (ESRD) in the United States has grown, but the supply of kidneys—for the preferred treatment for ESRD, kidney transplantation— has not kept pace with the demand. Unfortunately, the issue is not simply one of supply and demand: in the United States the supply of kidneys for transplantation is kept artificially low by a prohibition on the sale of human organs.
Topic:
Health, Human Welfare, and Markets
Political Geography:
United States, Iran, and Middle East