Health Care

Health Care

Research

Christopher Koopman, Thomas Stratmann, Mohamad Elbarasse | May 19, 2015
Thirty-six states and the District of Columbia currently limit entry or expansion of health care facilities through certificate-of-need (CON) programs. These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators. Since 1972, Michigan has been among the states that restrict the supply of health care in this way, with 18 devices and services—including acute hospital beds, magnetic resonance imaging (MRI) and positron emission tomography (PET) scanners—requiring a certificate of need from the state before the device may be purchased or the service offered.
Adam C. Smith | May 19, 2015
In this paper I explain how the Department of Health and Human Services has taken on a powerful coordinating role in the provision of health care as a result of the Patient Protection and Affordable Care Act. This paper analyzes the unfurling of that act using the Bootlegger–Baptist model of political economy. By tracing the development of the law and its effect on how health care is delivered, the analysis shows that economic interests became coordinated through the efforts of the White House and the central “televangelist” agency, the Department of Health and Human Services. This development will inevitably result in bureaucratic decisions replacing individuals’ choices as the agency takes on an increasingly active and interventionist role in how health care is provided.
Christopher Koopman, Thomas Stratmann, Mohamad Elbarasse | Mar 31, 2015
Thirty-six states and the District of Columbia currently limit entry or expansion of health care facilities through certificate-of-need (CON) programs. These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators. Since 1979, Georgia has been among the states that restrict the supply of health care in this way, with 17 devices and services—including acute hospital beds, positron emission tomography (PET) scanners, and open heart surgery—requiring a certificate of need from the state before the device may be purchased or the service offered.
Christopher Koopman, Thomas Stratmann | Mar 03, 2015
While CON programs were intended to limit the supply of health care services within a state, proponents claim that the limits were necessary to either control costs or increase the amount of charity care being provided. However, 40 years of evidence demonstrate that these programs do not achieve their intended outcomes but rather decrease the supply and availability of health care services by limiting entry and competition. For policymakers in Florida, this situation presents an opportunity to reverse course and open the market for greater entry, more competition, and ultimately more options for those seeking care.
Christopher Koopman, Thomas Stratmann | Feb 24, 2015
While CON programs were intended to limit the supply of health care services within a state, proponents claim that the limits were necessary to either control costs or increase the amount of charity care being provided. However, 40 years of evidence demonstrate that these programs do not achieve their intended outcomes, but rather decrease the supply and availability of health care services by limiting entry and competition.
Christopher Koopman, Thomas Stratmann | Feb 12, 2015
While CON programs were intended to limit the supply of health care services within a state, proponents claim that the limits were necessary to either control costs or increase the amount of charity care being provided. However, 40 years of evidence demonstrate that these programs do not achieve their intended outcomes, but rather decrease the supply and availability of health care services by limiting entry and competition.

Testimony & Comments

Research Summaries & Toolkits

Expert Commentary

May 18, 2015

The Affordable Care Act is now in its fifth year. Many things have changed since March 23, 2010 when it was passed into law. Website rollouts, cost curves and enrollment figures have dominated the new stories. What we speak so little of, however, is how health care has actually been reformed and how this in turn defined what health care reform means to us today.
Apr 30, 2015

For a detailed perspective on the latest case, OUTLOOK turned to health care policy expert Robert Graboyes, a scholar at the Mercatus Center at George Mason University in Arlington, Virginia.
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Apr 13, 2015

The case has the potential to invalidate substantial subsidies now being provided by federal taxpayers to millions of Americans using federal exchanges in 37 different states. Given the uncertainty created by the pending case, legislators on both sides of the aisle are considering how to react to various possible scenarios arising from a court decision.
Mar 23, 2015

Medicare is contributing to a potential shortage of 90,000 doctors by 2025. Two Medicare issues, if left unresolved, would limit the future supply of doctors and reduce the ability to find a doctor during retirement: Physician payments under the Sustainable Growth Rate (SGR) and financing of Graduate Medical Education (GME).
Mar 18, 2015

The Supreme Court recently heard oral arguments in King v. Burwell, another case involving the Affordable Care Act (a.k.a. "Obamacare"). If the Court decides that the law's words mean what they say, then federal subsidies for individuals will be available only in states that have established insurance exchanges. For those who live in the 36+ states that have chosen not to set up their own exchanges, this presents a problem.
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Mar 16, 2015

The Congressional Budget Office’s new report shows updated cost projections for the insurance coverage expansion in the Affordable Care Act. The following explains what CBO has actually projected: basically that the ACA will do less to expand coverage than previously estimated.

Charts

The existence of a CON program is detrimental to the welfare of the residents of the state, regardless of the number of restrictions. Even for states with only a few restrictions, Stratmann and Russ find that the presence of a CON program in a state is associated with fewer hospital beds, Computed Tomography (CT) scanners, and MRI machines.

Experts

Charles Blahous is the director of the Spending and Budget Initiative, a senior research fellow at the Mercatus Center at George Mason University and a public trustee for Social Security and Medicare. He specializes in domestic economic policy and retirement security (with an emphasis on Social Security), as well as federal fiscal policy, entitlements, demographic change, and health-care reform.
Robert Graboyes is a senior research fellow for the Mercatus Center at George Mason University.
Christopher J. Conover is an affiliated senior scholar at the Mercatus Center at George Mason University and a research scholar at the Center for Health Policy & Inequalities Research at Duke University.
Jerry Ellig is a senior research fellow at the Mercatus Center at George Mason University and a former assistant professor of economics at George Mason University. He specializes in the federal regulatory process, economic regulation, and telecommunications regulation.
Michael L. Marlow is an affiliated senior scholar at the Mercatus Center at George Mason University and professor of economics and distinguished scholar at California Polytechnic State University, San Luis Obispo.

Podcasts

Robert Graboyes | March 24, 2015
For the 5th anniversary of the passing of the Affordable Care Act, Mercatus Center health policy scholar Robert Graboyes analyzes the impact of this legislation. He argues that partisan fighting over health insurance fails to address the real need in America’s healthcare system: providing lower-cost healthcare for more people sustainably.

Recent Events

Please join us for lunch with Mercatus Center Senior Research Fellow Jason Fichtner to discuss pro-growth policy options. He’ll also address the research and ideas Mercatus shares with policymakers in order to advance the debate on economic issues.

Books

Media Clippings

Casey B. Mulligan | Oct 09, 2014
This excerpt originally appeared in The Washington Times.
Robert Graboyes | Sep 25, 2014
This excerpt originally appeared in Reuters.
Charles Blahous | Jun 04, 2014
This excerpt originally appeared in CQ and also appeared Roll Call.
Robert Graboyes | Jan 29, 2014
Robert Graboyes cited at Star-Telegram.
Tyler Cowen | Oct 30, 2013
Tyler Cowen cited at The Washington Post.
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