01/11/2017

How Accessible Is Health Care In Your State? Here’s The Ranking.

Mercatus Center

There is broad agreement in the United States that it would be desirable to lower the cost and improve the quality of health care and broaden health insurance coverage. There is much disagreement about how this trio of goals is to be accomplished. The years-long political struggle over the Affordable Care Act (ACA, commonly known as Obamacare) is the most visible manifestation of this divergence of views. The ACA represents one approach to tackling the three goals. Many on the political Left argue for still-more-centralized public-sector control over health care and particularly for a federal single-payer insurance system. Policymakers and commentators on the Right have offered a variety of proposals that, generally speaking, would shift more power to private-sector entities and to states. All these proposals have one thing in common: they assume the key to lower costs and better care lies in reconfiguring the insurance system.

We believe the three goals of healthcare reform cannot be attained by fixating solely, or even primarily, on health insurance reform. States have (and should have) substantial control over the delivery of health care—and not solely or principally in the area of insurance reform. To make maximum use of state powers in improving care, it is vital to have a basis for comparison—to see what works in other states. The Healthcare Openness and Access Project (HOAP) is a set of tools providing state-by-state measures of the flexibility and discretion that patients and providers have in managing health and health care. In other words, how open are each state’s laws and regulations to institutional variation in the delivery of care, and how much access to varying modes of care does this confer on the state’s patients and providers?

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Thanks to "bracket creep," the inflation of the 1970s pushed millions of taxpayers into higher tax brackets even though their inflation-adjusted incomes were not rising. To help offset this tax increase and also to improve incentives to work, save, and invest, President Reagan proposed sweeping tax rate reductions during the 1980s. What happened? Total tax revenues climbed by 99.4 percent during the 1980s, and the results are even more impressive when looking at what happened to personal income tax revenues. Once the economy received an unambiguous tax cut in January 1983, income tax revenues climbed dramatically, increasing by more than 54 percent by 1989 (28 percent after adjusting for inflation).

 

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