View Research by Author - Timothy Waidmann

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Citation URL: http://www.urban.org/TimothyWaidmann

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.

Considerable evidence suggests that disability prevalence among older Americans has fallen, but less is known about how to promote further declines. This report develops and begins to demonstrate a framework for comparing population-level effects of interventions. We reviewed the literature for seven interventions and conducted simple modeling exercises. Evidence is strongest for exercise programs that increase strength, balance, and physical activity; depression screening with referral and feedback and therapy with pharmacologic treatment; and multi-factor fall prevention programs. Little evidence exists about the long-term effects of such interventions. Both short and long-term effects are critical when evaluating the population-level impact of such interventions.

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 article examines whether race and ethnicity disparities in health account for similar disparities in employment status and other labor-related outcomes. Two population groups whose health is systematically worse than that of whites (blacks and Native Americans) are identified. We document the distribution of labor-related outcomes-employment, earnings, public transfer program participation, and household income-for these groups. Health disparities seem to contribute to the substantial difference in employment and participation in public transfer programs between whites and blacks and between whites and Native Americans. But health disparities account for a smaller portion of the substantial differences in household income and labor earnings across racial/ethnic groups. (Bound, J, Waidmann, T., Schoenbaum, M., and Bingenheimer, J. 2003. "The Labor Market Consequences of Race Differences in Health." Milbank Quarterly 81(3):441-473.)

This report details the development of a third version of MINT (Modeling Income in the Near Term), a tool for simulating the retirement incomes of members of the Baby Boom and neighboring cohorts. MINT3 can produce projections of economic and demographic characteristics in the year 2020, at the time of retirement, and for other years and ages. It can be used both to construct a baseline using alternative economic and demographic assumptions and to analyze the distributional consequences of a variety of Social Security policy changes.

During the 1990s, while overall employment rates for working-aged men and women either remained constant (men) or rose (women), employment rates for people with disabilities fell. During the same period the fraction of the working-aged population receiving Social Security Disability Insurance (DI) benefits increased dramatically. This article presents simple time series and cross-state evidence suggesting that the growth in the DI program can account for much of the decline in the relative employment position of men and women with disabilities. (Journal of Human Resources 2002 Spring; 37(2): 231-250).

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