Further time and study are needed to learn whether these evolutionary changes will achieve their goals without harming the doctor-patient relationship. In response, many hospitals and physicians are forming closer and larger affiliations. Nevertheless, it has set into motion market dynamics that are affecting medical practice, such as limiting insurance networks to fewer providers and requiring patients to pay for more treatment costs out of pocket.
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The act expands several ongoing pilot programs in Medicare that reform how doctors and hospitals are paid, but it does not directly change how private insurers pay healthcare providers. Market reforms have not hurt the insurance industry’s profitability, prices for individual insurance have been lower than expected, and government costs so far have been less than initially projected. Although the act falls short of achieving truly universal coverage, nine million uninsured people have received coverage so far. The act allows most people to keep the same kind of insurance that they currently have, and it does not change how private insurance pays physicians and hospitals. The act also increases coverage by allowing states to expand Medicaid (the social healthcare program for families and people with low income and resources) to cover everyone near the poverty line, and by subsidizing private insurance for people who are not poor but who do not have workplace coverage. But this paper is one more reason to worry about the long-term economic consequences.The Affordable Care Act’s core achievement is to make all Americans insurable, by requiring insurers to accept all applicants at rates based on population averages regardless of health status. Of wealthy areas, who benefit, at least in the short term, from restrictions on the supply of new housing.
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Those policies are generally embraced by the residents High housing prices are the result of public policies that discourage new development. The third shows the increase in land-use regulations in rich states.Īnd here’s the crucial point: It doesn’t have to be this way. The second shows the pattern of migration, which has changed significantly over the last The first shows that average incomes by state converged between 18 as low-skilled workers moved to wealthier states. The trends are beautifully illustrated by three time-lapse graphics. But for low-skill workers, the high price of housing means the cost of living in those places often exceeds the benefits of It also slows the pace of economic growth.īasically, the economy works best when people can move where their skills are most valued. And the result isn’t just second-best for them They are moving because they can’t afford to live in Boston. In this account, people aren’t moving to the Sun Belt because they want to live there. “Now low-skilled workers can no longer afford to move to the high-wage places.” “The best places for low- and high-skilled workers used to be the same places: California, Maryland, New York,” said Peter Ganong, a doctoral student in economics, who wrote the paper with Daniel Shoag,Ī professor of public policy. Has forced low-wage workers to migrate instead to areas with inferior opportunities.
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As my colleague Annie Lowrey writes, there is growing evidence that income inequalityĪnd one interesting explanation boils down to the high price of housing.Ī recent paper by researchers at Harvard University argues that the prohibitive cost of living in the areas with the greatest economic opportunities Why is the gap between rich and poor in America yawning ever wider?