Source: Physicians for a National Health Plan
A study published online today finds that the private insurance companies that participate in Medicare under the Medicare Advantage program and its predecessors have cost the publicly funded program for the elderly and disabled an extra $282.6 billion since 1985, most of it over the past eight years. In 2012 alone, private insurers were overpaid $34.1 billion.
That’s wasted money that should have been spent on improving patient care, shoring up Medicare’s trust fund or reducing the federal deficit, the researchers say.
Medicare has contracted with private insurance plans – previously referred to as Medicare HMOs and now called Medicare Advantage plans – since 1985. Such plans, most of them for-profit, currently cover about 27 percent of Medicare enrollees and have been growing at a fast clip. UnitedHealth and Humana are among the largest players in this market, and together operate about one-third of such plans.
Medicare pays these privately run plans a set "premium" per enrollee for hospital and physician services (averaging $10,123 in 2012) based on a prediction of how costly the enrollee’s care will be.
The authors find that private insurers have four strategies that make them more costly than the traditional Medicare program.
1. Private plans cherry-pick healthier beneficiaries who cost less to care for, guaranteeing large profits. Although private plans must accept all seniors who choose to enroll, they cherry-pick by selectively recruiting the healthiest seniors through advertising, office location, etc. They also induce sicker ones to disenroll by making expensive care inconvenient.
2. They recruit otherwise healthy seniors with very mild (and inexpensive) cases of sometimes serious conditions – automatically triggering higher premiums for these beneficiaries from the risk-adjustment scheme implemented in 2004, but escaping payments for expensive care. For instance, many seniors have very mild cases of arthritis, heart failure and bronchitis that require little or no treatment.
3. They enroll patients who get most of their care free at the Veteran’s Administration.
4. They heavily lobby Congress to raise their reimbursement. The insurance industry successfully induced Congress and the Bush administration to add bonus payments to Medicare Advantage premiums beginning in 2003.
Source: Smart Growth America
Local governments across the country have compared development strategies to understand their impact on municipal finances. These studies generally compare two or more different development scenarios, and help local leaders make informed decisions about new development based on the costs or revenues associated with them.
Many municipalities have found that a smart growth approach would improve their financial bottom line. Whether by saving money on upfront infrastructure; reducing the cost of ongoing services like fire, police and ambulance; or by generating greater tax revenues in years to come, community after community has found that smart growth development would benefit their overall financial health. Many of these findings have been made publicly available.
No national survey has examined these savings as a whole until now. This report is the first to aggregate those comparisons and determine a national average of how much other communities can expect to save by using smart growth strategies.
Number of U.S. Companies that Reach $100-Million in Annual Revenues Remarkably Stable Over Past 20 Years, According to Kauffman Paper
Source: Kauffman Foundation
The pace at which the United States produces $100-million companies has been stable over the last 20 years despite changes in the economy. However, according to a new Kauffman paper released today, the locations and sectors in which those companies are created are changing.
In the paper, "The Constant: Companies that Matter," Kauffman Foundation Senior Fellow Paul Kedrosky explores the rate and founding locations of companies in the United States that "matter" from 1980 to present.
Kedrosky uses three criteria to define companies that matter: They must be scalable, quickly reaching $100 million or more in revenues; they must be able to generate jobs quickly and broadly; and, they must be disproportionate creators of wealth, both directly through profits and salaries and indirectly through equity.
"Companies unable to reach $100 million in revenues are still relevant to the economy," Kedrosky says. "But the $100-million firms meet an entirely different threshold that gives cities, states and countries an even greater economic advantage."
Anywhere from 125 to 250 companies per year (out of roughly 552,000 new employer firms) are founded in the United States that reach $100 million in revenues. The largest contributors, in percentage terms, are from the consumer discretionary and industrials sectors. Taking into account sectoral contribution to U.S. GDP, the information technology sector produces more $100-million companies than might be expected.
Geographically, the most productive region in terms of $100-million company production is the U.S. southeast (Georgia, Florida, Kentucky, Louisiana) with the Pacific region (California, Oregon, Washington, Hawaii) coming in second. Following closely behind are the Mid-Atlantic and Central regions. Most regions are balanced with regard to sector, except for the Pacific region, which produces only slightly fewer $100-million information technology companies than the rest of the country combined, most of which are in California.
Sequestering Meals on Wheels Could Cost the Nation $489 Million per Year
Source: Center for Effective Government
Sequestering Meals on Wheels funds could cost taxpayers far more than it saves. While across-the-board spending cuts that began March 1, called sequestration, are expected to reduce spending on Meals on Wheels programs this year by an estimated $10 million, these savings will be dwarfed by at least $489 million per year in increased spending on Medicaid, both this year and in each subsequent year that sequestration remains in place.
Outside of Washington, waiting lists for Meals on Wheels enrollees have received media attention, but the expected savings have remained largely unquestioned. In reality, cutting Meals on Wheels will very likely increase the federal deficit by increasing the overall cost burden and shifting it to Medicaid, local charities, and other programs.
Overall, Meals on Wheels saves the federal taxpayers money by helping participants live at home instead of living in comparatively expensive nursing homes. The average cost to Medicaid of nursing home care per patient is approximately $57,878 annually.
By contrast, the cost to Medicaid of home care is much lower, approximately $15,371 annually, or $42,507 less than nursing home care. Nationally, according to a survey by the Administration on Aging, as many as "92% [of enrollees] say Meals on Wheels means they can continue to live in their own home."
Based on these estimates, our analysis suggests that sequestering Meals on Wheels funds will actually cost the U.S. taxpayer $479 million dollars over the seven months it will be implemented during this federal fiscal year, which ends September 30 (see the appendix for details of this estimate). Moreover, because sequestration-related cuts are expected to increase in FY 2014 and beyond, if sequestration is not reversed, Medicaid-related costs will increase even more in those years.
Recent analysis indicates cell phone distracted driving crashes vastly under-reported
Source: National Safety Council
Today, the National Safety Council released findings from a recent analysis of national statistics on fatal motor vehicle crashes, in a report entitled, “Crashes Involving Cell Phones: Challenges of Collecting and Reporting Reliable Crash Data,” funded in part by Nationwide Mutual Insurance Company. The report reviewed 180 fatal crashes from 2009 to 2011, where evidence indicated driver cell phone use. Of these fatal crashes, in 2011 only 52% were coded in the national data as involving cell phone use.
Even when drivers admitted cell phone use during a fatal crash, the Council’s analysis found that in about one-half of these cases, the crash was not coded in Federal data (the National Highway Traffic Safety Administration’s Fatal Analysis Reporting System). In addition, there are an unknown number of cases in which cell phone use involvement in crashes is impossible to determine. One example would be a driver reading an email or text message on a phone who dies in a crash without any witnesses.
The report also brings up large differences in cell phone distraction fatal crashes reported by states. For instance, in 2011, Tennessee reported 93 fatal crashes that involved cell phone use, but New York, a state with a much larger population, reported only one. Texas reported 40, but its neighboring state Louisiana reported none.
Bird-Friendly Building Design (PDF)
Source: American Bird Conservancy
A unique publication that provides planners, architects designers, bird advocates, local authorities, and the general public with a clear understanding of the nature and magnitude of the threat glass poses to birds and solutions to eliminate the threat. This edition includes a review of the science behind bird collisions, real-world examples of solutions in action, and an investigation into what information is still needed.
CREW Releases New Report Examining the Influence of High Frequency Traders in Washington
Source: Citizens for Responsibility and Ethics in Washington (CREW)
Today, Citizens for Responsibility and Ethics in Washington (CREW) released a new report, Rise of the Machines, detailing the growing political influence of high frequency traders in the nation’s capital. High frequency trading, a complicated and controversial method of securities trading, has begun drawing scrutiny from government regulators, prompting skyrocketing lobbying spending and campaign contributions by the industry.
CREW studied the lobbying and campaign contribution records of 48 companies that specialize in high frequency trading. Between the 2008 and 2012 election cycles, these firms’ campaign contributions soared by a staggering 673 percent, up from $2.1 million during the 2008 election cycle to $16.1 million during the 2012 cycle. Over this time period, these firms contributed more than $21 million to federal candidates, party committees, PACs, and super PACs.
Additionally, since 2008, these firms have spent more than $10 million lobbying Congress, the Securities and Exchange Commission, and the Commodity Futures Trading Commission. These companies’ total lobbying spending jumped 93 percent between 2008 and 2012, from $1.4 million to $2.7 million. The biggest single-year increase came between 2009 and 2010, while Congress debated heavily lobbied provisions of what would eventually become the Dodd-Frank Wall Street Reform and Consumer Protection Act.
“Swept Away” — Abuses against Sex Workers in China
Source: Human Rights Watch
This 51-page report documents abuses by the police against female sex workers in Beijing, including torture, beatings, physical assaults, arbitrary detentions, and fines, as well as a failure to investigate crimes against sex workers by clients, bosses, and state agents. The report also documents abuses by public health agencies, such as coercive HIV testing, privacy infringements, and mistreatment by health officials.
Exploring the Barriers and Opportunities for Independent Women Filmmakers (PDF)
Source: Sundance Institute
In our digital age, ideas and culture are increasingly shaped by the stories told with moving images. This context elevates film artists to an enormously influential role in determining how we see ourselves, one another, and the world around us. Yet the vast majority of films made and seen in the United States are written, directed and produced by male filmmakers whose stories tend to reflect dominant themes and reinforce the status quo. What might the future look like for both men and women given the full inclusion of a generation or two of truly empowered female perspectives in our media ecology?
There is a growing body of empirical research that documents how having a woman at the helm can affect the types of stories being told. First, female directors are more likely to feature girls and women on screen than male directors. This is true in both top-grossing films 1 and crit – ically acclaimed projects nominated for Best Picture Academy Awards over a 30-year period. 2 It is often as true for women producers as it is for women directors. Second, female producers and directors affect not only the prevalence of girls and women on screen, they also impact the very nature of a story, or the way in which a story is told. Examining more than 900 motion pictures, one study found that violence, guns/weapons, and blood/gore were less likely to be depicted when women were directing or producing, and thought-provoking topics were more likely to appear.
These patterns are not restricted to cinema. A recent content analysis 4 of war stories filed for news outlets during the first 100 days of three different international conflicts (Bosnia, Persian Gulf, Afghanistan) showed that female correspondents were more likely than their male counterparts to focus news stories on the victims of war, abuses to human rights and soldier profiles. Women put a human face on conflict reporting, just as they do in film.Together, the evidence is quite clear: gender of the storyteller matters.
Currently, the presence of women behind the camera in popular film is infrequent at best. Assessing 250 of the top-grossing U.S. movies of 2011, 5 one study found that only 5% of directors, 14% of writers, and 25% of producers were female. These statistics have fluctuated very little since 1998. This picture would seem to suggest that the traditional Hollywood economic model or power-structure is a leading impediment to access for women filmmakers.
Source: Good Jobs First
As business climatology’s sponsorship has diversified, so have its practitioners. However, its core methodological tricks have remained the same: Choose public policies that are of high concern to the corporate and/or high-wealth sponsors (e.g., unemployment insurance rates then or the estate tax today). Use self-interested respondents and/or anecdotes to ascribe otherwise unverifiable or even improbable weights to the variables. Choose variables that reduce inequality (e.g., state minimum wages) and down-rate them, in the name of jobs, of course. Or choose variables that are self-fulfilling because they are outcomes, not causes (e.g., using high-speed broadband access as a predictor rather than an indicator of growth). Or cherry-pick small, incomplete sample sets to suggest positive or negative correlations.
A recurring proof of the flawed methodologies is their lack of predictive value. It used to be Grant Thornton allowing 50 state manufacturing lobbyists to each weight their own “business climate” variables, obviously an unscientific data pollutant. Today, the same kind of idiosyncratic issues surface, as when the American Legislative Exchange Council (ALEC) inveighs against Tennessee’s estate tax. In our 2012 study focusing specifically on Rich States, Poor States: The ALECLaffer Economic Competitiveness Index, we actually found small negative correlations between some of ALEC’s favored policies and positive economic outcomes (and no statistically significant positive relationships).
Indeed, the underlying frame of these studies—that there is such a thing as a state “business climate” that can be measured and rated—is nonsensical. The needs of different businesses and facilities vary far too widely. Besides, states are not the meaningful unit of competition in economic development: metro areas are, and conditions can vary more among metro areas within a state than they do between states. Young tech start-ups need lots of engineers and venture capital. Server farms and mini-mills need cheap electricity. Warehouses need proximity to interstate highways. Headquarters need access to finance, marketing and industry-specific talent pools. Given these realities, “business climate” studies must be viewed for what they actually are: attempts by corporate sponsors to justify their demands for lower taxes and to gain public-sector help suppressing wages.
State Spending On Consumer Assistance Could Have ‘Huge Impact’ On Marketplace Enrollment
Source: Kaiser Health News
Florida is on course to spend $6 million to reach out to nearly 4 million uninsured people and help them sign up for coverage in the federal health law’s online marketplace this fall.
Maryland will spend more than four times as much, or about $24.8 million, to help about 730,000 uninsured. The District of Columbia expects to spend about $9 million assisting 42,000 uninsured.
The wide variation in spending to hire and train people to provide consumer assistance in the first year of the new marketplaces could have a major impact on how many people actually get coverage under Obamacare, experts say.
Yet states with some of the nation’s highest uninsured rates, such as Florida and Texas, are getting far less federal money per uninsured resident than states with low rates, such as Maryland, Vermont and Rhode Island, according to a Kaiser Health News analysis.
New Report: The Law That’s Saving American Fisheries
Source: Ocean Conservancy
“The Law That’s Saving American Fisheries: The Magnuson-Stevens Fishery Conservation and Management Act” is a primer and collection of stories that highlight pioneers of American fishery management as well as innovators who are opening fishing frontiers, revealing:
- How a salmon fishing pioneer’s courage in making sacrifices for long-term sustainability set the stage for Alaska’s success
- How successful fishermen from Alaska to Florida used discipline to turn around two decades of overfishing
- How West Coast fishermen found the flexibility to make a living within rebuilding programs
- How fishing entrepreneurs in Port Clyde, Maine, turned leadership into opportunity
- Why rebuilding important recreational species such as summer flounder, bluefish and lingcod provides economic as well as enjoyment payoffs
- What commercial and recreational fishermen believe we get from good stewardship
Source: Canadian Federation of Independent Business
Most Canadian small businesses pay much more than their U.S. counterparts to comply with regulatory requirements, according to CFIB’s 2013 version of Canada’s Red Tape Report.
The report coincides with the launch of Red Tape Awareness Week™, and provides a first-ever direct comparison of regulatory compliance costs in the U.S. and Canada.
The U.S. comparison was sponsored by KPMG Enterprise™.
The smallest businesses in Canada (fewer than five employees) pay 45% more per employee ($5,942) to comply with government regulation than their U.S counterparts ($4,084).
The total cost of regulation to Canadian businesses is $31 billion a year.
On both sides of the border, business owners say that regulatory costs could be reduced by about 30% while upholding the important health and safety objectives of regulation. This would mean a $9 billion yearly stimulus to the Canadian economy.
Disastrous Spending: Federal Disaster-Relief Expenditures Rise amid More Extreme Weather
Source: Center for American Progress
Superstorm Sandy devastated New Jersey, New York, and other areas along the eastern seaboard six months ago on October 29, 2012. It took at least 72 lives in the United States and caused nearly $50 billion in damages. Congress eventually provided $60 billion in disaster relief and recovery aid after weeks of deliberating and partisan bickering. These recovery efforts continue to this day.
Sandy was the worst natural disaster in the United States in terms of destruction and deaths since Hurricanes Katrina and Rita in 2005, but it wasn’t the only one. In 2011 and 2012 alone, the United States experienced 25 floods, storms, droughts, heat waves, and wildfires that each caused at least $1 billion in damages. Combined, these extreme weather events were responsible for 1,107 fatalities and up to $188 billion in economic damages.
The Center for American Progress conducted an analysis and found that the federal government—which means taxpayers—spent $136 billion total from fiscal year 2011 to fiscal year 2013 on disaster relief. This adds up to an average of nearly $400 per household per year.
Nearly all of this disaster spending was for relief and recovery from these and other smaller natural disasters. Most of these disasters are symptomatic of the man-made climate change resulting from massive amounts of carbon emissions and other pollutants in the atmosphere, which warm the oceans and the Earth. As climate change accelerates, so will federal spending on disaster relief and recovery, which will ultimately be paid for by taxpayers.
Source: Governors Highway Safety Association
In early 2013, GHSA asked its member state highway safety offices to provide their preliminary motorcyclist fatality counts for 2012, as they had done the prior three years. All 50 states and the District of Columbia supplied data. Some states suggested why their numbers had increased or decreased.
Based upon the preliminary data provided, GHSA projects that the number of motorcyclist traffic fatalities in the United States increased about 9 percent from 2011 to 2012.
The report points out that the economy is expected to contribute to more motorcyclist fatalities. With people having more disposable income, more motorcycles will be purchased. At the same time, with the relative high price of gasoline, more people will choose motorcycles to save fuel costs.
It also recommends several proven countermeasures that can help cut the number of motorcycle fatalities on our nation’s roadways.
Source: American Enterprise Institute via Robert Wood Johnson Foundation
These Robert Wood Johnson Foundation-supported reports from the American Enterprise Institute highlight market-based solutions to Medicare’s sustainability crisis and the inherent inefficiencies of the current system.
The nonpartisan Congressional Budget Office (CBO) projects the cost of providing benefits to Medicare enrollees will increase at an annual growth rate of 7 percent, reaching at least $1 trillion in fiscal year 2022.
America’s fee-for-service Medicare program represents the third-largest category of federal spending and has been under scrutiny for decades for spending more on health care benefits for enrollees than taxes can generate to pay for them. The CBO estimates that over the next 10 years, the number of Medicare enrollees will increase by one-third—approaching 67 million Americans.