Joseph Antos

• American Enterprise Institute

Objectives: A regulation from CMS required that, starting January 1, 2021, all US hospitals publicly display the cash price and minimum and minimum negotiated charge for 300 "shoppable services." We evaluated compliance with CMS requirements among highly respected US hospitals. Study design: We conducted a cross-sectional study of hospital websi...

Proposals to replace the existing mix of public and private health financing with a fully nationalized government system ("Medicare for All") fail to address fundamental problems of high cost, overutilization, and inefficiency. Those proposals are a reaction to the Affordable Care Act, which provided new insurance subsidies but did little to solve...

In Reply Dr Roberts and colleagues are “not convinced” that Maryland’s unique approach to paying hospitals was responsible for changes in care and cost in the state.¹ We cited the studies by Roberts and colleagues because they contributed to understanding this question. We also cited other research, including analyses with a similar methodology but...

With US health care spending projected to increase at 5.5% per year over the next decade, exceeding the projected rise in gross domestic product, there is increasing attention to the results of payment models intended to control costs, enhance quality, and improve health outcomes. With recent research again showing the United States at the top of t...

In January 2014, the State of Maryland and the Centers for Medicare and Medicaid Services (CMS) came to terms on an ambitious approach to improve care for Marylanders and to slow the growth of health care costs. The state shifted from its historic approach of limiting price growth by setting hospital rates for all payers to limiting overall hospita...

In this issue of JAMA, Emanuel and colleagues¹ propose an Affordability Index to measure the ability of the average US household to pay for its medical expenses. As the authors point out, standard economic measures used to track health spending do not adequately represent the effect of rising costs on families.

Quality measurement and performance-based payment systems are intended to promote high-value health care. Medicare is beginning to shift from process to population-based outcome measures, but the service (rather than the outcome) remains the focus under fee-for-service payment. An emerging challenge: how to mesh the differing perspectives of payers...

The Affordable Care Act expanded health insurance coverage in the United States but did little to address the structural problems that plague the U.S. health care system. Controlling cost while maintaining or improving access to quality care requires a more fundamental reform based on market principles. Such an approach means aligning the financial...

After a shockingly bad start, the Affordable Care Act (ACA) has completed its first open-enrollment season. As many as 8 million people have selected health plans through the federal and state insurance exchanges, and perhaps another 3 million have enrolled in Medicaid and the Children's Health Insurance Program. ACA supporters have breathed a sigh...

In the wake of the Supreme Court decision, states should not rush to expand eligibility for Medicaid. They cannot be certain that the federal support promised in the Patient Protection and Affordable Care Act will remain available, and a better deal might be possible after the election. Adding millions more to Medicaid rolls will exacerbate existin...

In this election year, U.S. national spending on health care will reach $2.8 trillion, or about 18% of total spending on all goods and services. This high level of spending reduces our ability to invest in other important parts of the economy and also adds to our unsustainable national debt. There is wide agreement that we must find ways to bend th...

Under the Wyden–Ryan proposal, instead of guaranteeing to pay for services as they are rendered, Medicare would give beneficiaries a subsidy to purchase coverage from one of multiple health plans, which would compete by providing necessary services cost-effectively.

Our country faces a serious fiscal crisis. According to President Obama’s National Commission on Fiscal Responsibility and Reform, the nation is on an unsustainable fiscal path, with spending well above tax revenue. The Congressional Budget Office projects that, under current policies, federal debt will soar from 62 percent of annual GDP in 2010 to...

Richard Sullivan, Jeffrey Peppercorn, Karol Sikora, John Zalcberg, Neal J Meropol, Eitan Amir, David Khayat, Peter Boyle, Philippe Autier, Ian F Tannock, Tito Fojo, Jim Siderov, Steve Williamson, Silvia Camporesi, J Gordon McVie, Arnie D Purushotham, Peter Naredi, Alexander Eggermont, Murray F Brennan, Michael L Steinberg, Mark De Ridder, Susan A M...

Health reform created the opportunity to redirect tax incentives to promote greater equity, efficiency, and choice in insurance markets. The opportunity, however, has largely been lost. First, tax credits for insurance will be available only through new health insurance exchanges, not to workers with coverage through their employers, which discrimi...

In September 2009, we released a set of concrete, feasible steps that could achieve the goal of significantly slowing spending growth while improving the quality of care. We stand by these recommendations, but they need to be updated in light of the new Patient Protection and Affordable Care Act (ACA). Reducing healthcare spending growth remains an...

The health reform plan put forth by Sen. Barack Obama (D-IL) focuses on expanding insurance coverage and provides new subsidies to individuals, small businesses, and businesses experiencing catastrophic expenses. It greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care...

central premise of Senator Barack Obama's campaign for the presidency is that Amer- ica is ready — this time — for sweeping health care reform. He has laid out a vision for reform that promises health insurance for (nearly) everyone, with cover- age as good as that enjoyed by members of Congress. According to the campaign, the Obama plan would shif...

There is a "perfect storm" brewing in the American healthcare system. Healthcare spending has grown faster than our economy for many years and is projected to double in as little as 10 years. In spite of what we spend on healthcare, research tells us that we only receive appropriate care half the time. We are simply not getting what we are paying f...

The Clinton health reform attempt in the mid-1990s and the U.S. experience since then suggest some clear lessons for the next U.S. president. Public confidence in a major reform proposal must be won, and congressional support must be garnered, even if the election is a landslide. Insisting on universal coverage as a precondition may undercut the ab...

American Health & Drug Benefits ™ has been created to act as an ideological melting pot focusing on health and drug benefit decision makers, as well as those who may affect or may be affected by those decisions. By engaging in conversations with payors, regulators, employers, and other stakeholders, our journal hopes to enable decision makers to vi...

Summary Americans are deeply concerned about paying their mounting bills for health care. This is true whether they have private insurance or public (Medicare or Medicaid)—and certainly for the 46 million with no insurance at all. The federal government's health spending, primarily for Medicare and Medicaid, is clearly unsustainable. If current com...

The exclusion of employer contributions to health premiums has skewed the development of the insurance market, resulting in generous coverage for higher-income workers but leaving millions of others uninsured and facing rapidly rising health costs. The paper considers four recent reform proposals: capping the exclusion, tax credits for insurance, t...

The long-awaited outpatient prescription drug benefit in Medicare began January 2006. Despite its importance, the drug benefit is controversial. Instead of paying directly for prescriptions, the program will operate through competing private plans. Although it is too early to assess the full impact of Part D on beneficiaries, health plans and provi...

The persistently high number of people reporting that they have no health insurance has precipitated a number of new comprehensive proposals to extend coverage to most Americans. Such proposals must find solutions to fundamental problems that have thus far eluded policymakers, including the role of government regulation, how much to spend, and who...

The persistently high number of people reporting that they have no health insurance has precipitated a number of new comprehensive proposals to extend coverage to most Americans. Such proposals must find solutions to fundamental problems that have thus far eluded policymakers, including the role of government regulation, how much to spend, and who...

Last year, representatives of five major tobacco companies and a group of state attorneys general reached an agreement that, if enacted, could dramatically change the ways in which tobacco is marketed, sold, and consumed in the United States. That settlement would impose large payments on the tobacco industry, strengthen regulatory controls, and ex...

This paper uses two new data sources, each of which combines information on worker and establishment characteristics with detailed information on the components of employee compensation, to examine union/nonunion pay differentials for white-collar workers. Estimates reveal that nonunion wages and total compensation are more responsive than union pa...

This study investigates determinants of the male-female unionization differential. Logit analysis is used to estimate three union membership equations, using data taken from the May 1976 Current Population Survey. Standard human capital measures, plus location, race, and sex, are first included as explanatory variables, and then occupational and in...

Based on the National Longitudinal Surveys of over 10,000 men and women aged eighteen to twenty-seven who were interviewed annually from 1966 through 1971, this study investigates how the youth labor market operates and identifies its manpower problems that should be addressed by policymakers. A five-part recursive model is established for the yout...

We seek to provide an answer to the question, ‘How much is required to induce white teachers to teach in black schools?’ using cross section data from the Coleman Report for 1965. The conceptual framework underlying estimation is a model of the spatial distribution of teachers based on the theory of equal advantage. School characteristics, includin...

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created a new prescription- drug benefit and opened Medicare to broader competition among health plans. While these major reforms promote market principles, they do so with heavy regulation: private plans will be given more opportunity to offer services to seniors, including...

The persistently high number of people reporting that they have no health in- surance has precipitated a number of new comprehensive proposals to extend coverage to most Americans. Such proposals must find solutions to fundamental problems that have thus far eluded policymakers, including the role of government regulation, how much to spend, and wh...