Found 25 article(s) for author 'David Cutler'

Reducing Administrative Costs in U.S. Health Care

Reducing Administrative Costs in U.S. Health Care. David Cutler, March 2020, Paper, “This policy proposal is a proposal from the author(s). As emphasized in The Hamilton Project’s original strategy paper, the Project was designed in part to provide a forum for leading thinkers across the nation to put forward innovative and potentially important economic policy ideas that share the Project’s broad goals of promoting economic growth, broad-based participation in growth, and economic security. The author(s) are invited to express their own ideas in policy papers, whether or not the Project’s staff or advisory council agrees with the specific proposals. This policy paper is offered in that spirit.Link

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Are Pharmaceutical Companies Earning Too Much?

Are Pharmaceutical Companies Earning Too Much? David Cutler, March 3, 2020, Paper, “Some of the most valuable innovations known to medicine have come from the pharmaceutical industry. Yet, the cost of those innovations places new drugs out of reach for many patients and significantly burdens others. Are pharmaceutical companies earning too much? Deciding whether pharmaceutical companies earn too much money is complicated.  In this issue of JAMA, 2 reports take different approaches to the question. In one article, Ledley et al1 compare the profitability of pharmaceutical companies with that of other large companies. The authors used data from 2000 to 2018 on public companies for which information on sales and input costs could be obtained. The sample included companies in the S&P 500 Index, a group of the largest US companies, and comprised 35 pharmaceutical companies, 357 non–health care companies, and 52 nonpharmaceutical health care companies. Three measures of profits were examined: gross profits (revenue minus the costs of goods sold); earnings before income, taxes, depreciation, and amortization; and net income, also referred to as earnings. Net income is typically what is used to measure corporate profitability and makes the most compelling conclusion, although the results did not differ greatly across the measures. Ledley et al1 showed that from 2000 to 2018, the median net income margin in the pharmaceutical industry was 13.8% annually, compared with 7.7% in the S&P 500 sample. This difference was statistically significant, even with controls, although earnings seemed to be declining over time.Link

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Attributing Medical Spending to Conditions: A Comparison of Methods

Attributing Medical Spending to Conditions: A Comparison of Methods. David Cutler, November 2018, Paper, “Partitioning medical spending into conditions is essential to understanding the cost burden of medical care. Two broad strategies have been used to measure disease-specific spending. The first attributes each medical claim to the condition listed as its cause. The second decomposes total spending for a person over a year to the cumulative set of conditions they have. Traditionally, this has been done through regression analysis. This paper makes two contributions. First, we develop a new method to attribute spending to conditions using propensity score models. Second, we compare the claims attribution approach to the regression approach and our propensity score stratification method in a common set of beneficiaries age 65 and over drawn from the 2009 Medicare Current Beneficiary Survey. Our estimates show that the three methods have important differences in spending allocation and that the propensity score model likely offers the best theoretical and empirical combination.Link

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A Breath of Bad Air: Cost of the Trump Environmental Agenda May Lead to 80 000 Extra Deaths per Decade

A Breath of Bad Air: Cost of the Trump Environmental Agenda May Lead to 80 000 Extra Deaths per Decade. David Cutler, Francesca Dominici, June 12, 2018, Paper, “President Donald Trump and Environmental Protection Agency (EPA) Administrator Scott Pruitt have pledged to reexamine landmark environmental policies and to repeal regulations. In their view, excessive regulations are harming US industry, and thus reducing regulation will be good for business. As Donald Trump has said, seemingly without irony, “We are going to get rid of the regulations that are just destroying us. You can’t breathe—you cannot breathe.”” Link

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The Good and Bad News of Health Care Employment

The Good and Bad News of Health Care Employment. David Cutler, February 27, 2018, Paper, “Health care has long been one of the bright spots in the US employment situation. As people have moved out of manufacturing, health care has been a prominent landing place. Just this year, health care passed retail trade to become the largest employer in the economy. Furthermore, health care is a relatively stable industry. Because demand for care remains relatively constant across recessions and expansions, health care employment declines less in recessions than does employment in other industries.Link

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What Is The US Health Spending Problem?

What Is The US Health Spending Problem? David Cutler, February 14, 2018, Paper, “Is increased spending on medical care harmful to the US economy? The overall share of the gross domestic product spent on medical care is not a problem, provided that the services bought are worth more than their cost. However, high and rising costs expose two often-overlooked problems. First, spending is too high because many dollars are wasted. Estimates suggest that unnecessary medical spending costs the typical American family thousands of dollars each year.Link

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Rising Medical Costs Mean More Rough Times Ahead

Rising Medical Costs Mean More Rough Times Ahead. David Cutler, August 8, 2017, Opinion, “Medical costs are rising again, after recent years of historic lows. As the figure shows, growth rates of real per person medical spending in the past 3 years have averaged 3.4% annually, up from 0.9% in 2011 to 2013. Although the current growth rate is low in a historical context, it exceeds the economy’s growth as a whole. Thus, health costs are expected to reappear on the radar screen of governments, businesses, and households.Link

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Health and Taxes

Health and Taxes. David Cutler, October 25, 2016, Paper, “Viewing health care through the lens of a social issue prompts such questions as: What policies would best improve the population’s health? How can report cards be used to improve the quality of surgery? Where are there opportunities for additional disease prevention? The questions here are intricate and detailed. Some of the issues are clinical, and advice from physicians is actively sought and welcomed. For example, no one would develop a pay-for-performance system for surgeons without extensive involvement of the relevant surgical societies.Link

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