Archive for the ‘Health Care’ Category

Oregon is in recession, but the state budget is booming

Tuesday, November 17th, 2009

Oregon Legislatively Approved Budgets - Economics International Corp.

Oregon’s legislators are quick to complain that they had to find $2 billion in state budget cuts in the last legislative session. These  complaints are a bit disingenuous when, in fact, as the figure above shows, the legislatively approved budget has increased by $7.6 billion since the last budget.

Whenever one writes about state budgets, the more wonkish among us will argue that “total” state spending is the wrong number to look at. They argue that much of the funding and spending sits in dedicated accounts and that the Legislature has no discretion over much of the state’s spending.

This is what is known as the “colors of money” argument: Every dollar has a color—blue dollars can only be spent on roads, red dollars can only be spent on health services, green dollars are in the general fund, and so on. It is said that the colors cannot be mixed and the rules cannot be changed. But they can and the Legislature can change them.

Oregon Legislatively Approved DHS Budget - Economics International Corp.

An example of this this “colors of money” fallacy is the massive expansion of Oregon’s state-provided and state-subsidized health insurance. The expansion was championed by the Governor and approved by the Legislature. The expansion was entirely within discretion of Oregon’s elected officials.

Over the next four years, the program will impose $1.2 billion in new and increased taxes on hospitals and health insurance—taxes that will be passed down to taxpayer/consumers. Oregon hopes that the Federal government will match Oregon’s increased spending so that new and expanded programs would spend at least $2.8 billion over the next four years. [This is what is known as the "Coupon Fallacy," which is a topic for a future post.]

The Legislature, however, has painted all this money with its own color. In this way, politicians can complain about spending fewer green dollars while spending more red dollars and increasing total state spending.

Hoodwinking our way out of recession: Oregon DHS uses economic sleight of hand to sell a billion dollars of new taxes

Wednesday, November 11th, 2009

Oregon's New Taxes - Economics International Corp.

Over the next four years, Oregonians will face $2.4 billion in new taxes.

In January 2010, Oregonians will vote on ballot measures that will raise personal income taxes by $847 million and raise corporate income taxes by $530 million over the next four years. The campaigns for and against these new taxes ensure that nearly every Oregonian will know about them by Christmas.

$1 Billion in Taxes on Health Insurance and Hospital Care

Less well known are the massive tax increases—$1.0 billion—affecting health insurance and hospital care provided in Oregon. These new taxes are set in stone. There will be no vote and they go into effect soon.

Oregon HB 2116 (PDF) raises taxes through a tax on hospitals and a tax on health insurance providers. The figure above shows that the hospital tax is projected to raise $307 million in 2009-11 and the health insurer tax will raise $105 million in 2009-11. In 2011-13, the increased hospital taxes will amount to $450 million and the health insurance tax will amount to $154 million.

State Agency Fudges Employment Impacts—Again

Such huge tax increases in the middle of one of the worst recessions in memory will slow Oregon’s recovery from the current recession and damage employment growth in the state.

That is why it is so surprising that Oregon’s Department of Human Services (DHS) has reported to Oregon Business magazine that the tax increases will boost employment in the state by 3,600 jobs.

In response to a public records request, DHS has provided documents describing how the agency came up with results that are contrary to fundamental economic analysis.

As it turns out, the agency employed the Broken Window Fallacy to its benefit. The agency counted only the estimated additional money that would flow into the state from Federal sources, such as matching funds.  The agency did not account for the tax money that will be extracted from taxpayers by the State of Oregon. Thus, the agency considered only the benefits of the program, but did not consider the costs.

This is not the first time that state agencies have cooked to books to fudge the economic and fiscal impacts of its tax policies.

The Bend Bulletin (registration required) has picked up these stories and provides a summary of the recent rounds of economic sleight of hand.

Note: This post has been revised since it was originally published.

More shaking, less salt? Do the number of salt shaker holes really matter?

Friday, July 11th, 2008

In a widely repeated story, the Daily Mail reports that, in an effort to reduce salt consumption, several city councils in the U.K. have ordered 5-hole salt shakers and begun giving them away to chip shops and carry-outs.  The 5-hole shakers are to replace 17-hole shakers.  The councils hope that fewer holes will result in lower salt consumption.  According to the story, one council spent two weeks studying the issue before declaring that 5-hole shakers would solve the city’s sodium related health concerns.

Steve Buckstein has stirred up a lively debate on the role of government in guiding individuals’ health and lifestyles.  However, something that has been missing from the discussion is whether the number of holes actually affects salt consumption.

There has been very little research on the topic.  The only known academic study reports the following:

  1. The total area of the shaker holes are more important than the number of holes.  More area, more salt is shaken.
  2. For a given area, multi-holed shakers are associated with lower salt use than single-holed shakers.

Therefore, the study suggests that reducing the number of shaker holes will reduce salt consumption only if it also reduces the total amount of hole area.

Using some basic probability theory to estimate sexual activity among teenage females

Tuesday, March 18th, 2008

A widely reported study found that more than one-quarter of 14-19 year old females had a sexually transmitted infection. Curiously, almost one in eight of the survey participants who did not report ever having had sex were found to have had a sexually transmitted infection. This suggests that some survey participants underreported their sexual activity.

A working paper by Dr. Eric Fruits uses the prevalence of sexually transmitted infections to estimate the incidence of sexual activity among survey participants. In contrast to the self reported incidence of sex, Dr. Fruits finds that almost two-thirds of survey participants engaged in some form of sexual activity. In other words, approximately one in four survey participants who did not report any sexual experience are likely underreporting their activities.

Our latest health care “crisis”

Sunday, January 20th, 2008

For almost 50 years, health care expert have diagnosed a “crisis” of high and rising health care costs. It is easy to fall into the trap of thinking that all of today’s crises are new. In fact, high and rising health care costs are not a new problem.

Eric Fruits writes in Oregon Business that one part of the crisis has been the rising cost of health care and health insurance. For years, the cost of health care has outpaced inflation. In turn, the costs of health insurance have risen rapidly, taking a toll on businesses and their employees. Another part of the crisis is the number of uninsured. Last year, Oregon’s governor tried to sell voters a huge tobacco tax increase by pointing to an estimated 117,000 uninsured children in Oregon. These parts of the crisis are related and were born out of the growth of the third-party payer system of covering health and medical costs.