Posts Tagged ‘healthcare’

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Trickle-up economics, by any other name. . .

According to a new study of the distributional effects of the Republicans’ American Health Care Act (as introduced on 6 March 2017 and modified on 21 March 2017) by the Urban Institute and Brookings (pdf),

Upper-income families would receive net benefits from the tax and spending changes proposed in the AHCA, and lower-income families would experience net losses. Higher-income families benefit the most from the tax cut, with 70.6 percent of the tax reductions in 2022 received by those with incomes over $200,000 and 46.2 percent of the tax reductions received by those with incomes over $1,000,000. Reductions in federal funding for health benefits would hurt lower-income families the most; families with incomes below $30,000 would sustain more than three-quarters of the losses in benefits. Taking both tax and benefit changes into account, the largest average gains under the AHCA would go to those with the highest incomes ($5,640 on average for those with incomes over $200,000), and the largest average losses from the AHCA would go those with the lowest incomes.

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It is likely, if some version of Trump/Ryancare is approved in the United States, millions more people will not be able to purchase the insurance necessary to receive adequate healthcare.

The problem is, the United States is already an outlier when it comes to the relationship between health expenditures and health outcomes—measured in this case by life expectancy.

As Esteban Ortiz-Ospina and Max Roser explain,

all countries in this graph have followed an upward trajectory (life expectancy increased as health expenditure increased), but the U.S. stands out as an exception following a much flatter trajectory; gains in life expectancy from additional health spending in the U.S. were much smaller than in the other high-income countries, particularly since the mid-1980s.

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Even more worrisome, higher incomes in the United States are associated with greater longevity, and differences in life expectancy across income groups have increased over time.

As Raj Chetty et al. (pdf) discovered,

Higher income was associated with longer life throughout the income distribution. Men in the bottom 1% of the income distribution at the age of 40 years had an expected age of death of 72.7 years. Men in the top 1% of the income distribution had an expected age of death of 87.3 years, which is 14.6 years (95% CI, 14.4- 14.8 years) longer than those in the bottom 1%. Women in the bottom 1% of the income distribution at the age of 40 years had an expected age of death of 78.8 years. Women in the top 1% had an expected age of death of 88.9 years, which is 10.1 years (95% CI, 9.9-10.3 years) longer than those in the bottom 1%.

As a result, the average life expectancy of the lowest income classes in America is now equal to that in Sudan or Pakistan.

And, with Trump/Ryancare, that class difference in life expectancy is only going to get worse.

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