Research by Author & Topic

Publications by Timothy Waidmann on Health and Health Care

This analysis estimates cost burdens of racial and ethnic disparities in a select set of preventable diseases including diabetes, hypertension and stroke. Excess rates of these diseases among African Americans and Latinos relative to whites will cost the health care system $23.9 billion dollars in 2009. Medicare alone will spend an extra $15.6 billion, and private insurers will spend an extra $5.1 billion. Over the next decade, the total cost is approximately $337 billion. Left unchecked, these annual costs will more than double by 2050 as the representation of Latinos and African Americans among the elderly increases.

Emotions are flaring as constituents speak their minds to members of Congress home for August recess. That's to be expected, since health care is both a personal and public issue, but let's not forget to debate the basics:

Because a small fraction of individuals account for a large share of total health expenditures, insurers gain more by excluding high-cost people from coverage than by efficiently managing the care of enrollees. The incentives for insurers to avoid high-cost and high-risk enrollees affect not only the likelihood of health insurance coverage for the high-risk population, but also the cost and accessibility of coverage overall in the small-group and nongroup private health insurance markets. This paper identifies public policies that might address these problems in private health insurance markets more effectively and delineates the advantages and disadvantages of each.

In this paper and brief, the authors discuss alternative ways that health reform could be financed. They analyze different options including several proposals for delivery system reforms and for reduction in Medicare and Medicaid payments. They estimate the cost savings that could occur due to the introduction of a public plan option. Finally, they explore a range of revenue options. The key message of the paper is that health reform can be paid for, but it is best to obtain funds from a large number of measures to spread the burden broadly.

Although the prevalence of late-life disability has been declining, how to promote further reductions has been unclear. We developed an analytical framework that compares the effects of different interventions on the prevalence of late-life disability. We considered three potentially high-impact intervention strategies: physical activity programs, depression screening and treatment, and fall prevention. We conclude that in the short run multi-component fall-prevention efforts have the greatest impact. At present, longer-term impacts cannot be assessed based on the current literature and may differ from short-run conclusions, since increases in longevity may temper the effect intervention strategies have on prevalence of late-life disabilities. (Milbank Quarterly 84(3): 493-520, 2006.)

This article attempts to resolve previously published inconsistencies across national surveys in trends in activity limitations among the elderly. The authors prepared estimates from five national surveys from 1982-2001, and investigated sources of the inconsistencies. The panel found consistent declines of 1%-2.5% per year for two commonly used disability measures: difficulty with, and help with daily activities. Mixed evidence was found for the use of help or equipment. The panel found that the period, definition of disability, treatment of the institutionalized population, and age standardizing of results affected results. The implications of the findings for policy, national survey efforts, and further research are discussed. (Freedman, VA, E Crimmins, RF Schoeni, B Spillman, H Aykan, K Land, J Lubitz, K Manton, L Martin, D Shinberg, T Waidmann. 2004. "Resolving Discrepancies in Old-Age Disability Trends Across National Surveys: Report From a Technical Working Group." Demography 41(3):417-441.)

This paper highlights the important differences between the House and Senate Medicare bills. The differences discussed include fee-for-service changes; private plan changes; changes in beneficiary contributions, increases in the Part B premium, expansion of Specified Low Income Medicare Beneficiary protections, creation of an income-related premium, addition of a home health copayment, and increased age of eligibility. The study concludes with a brief review of other proposed changes that would also affect beneficiaries.