Health Economics Commons^™

A Healthier Bottom Line: Distilling Best Practices In Corporate Wellness, Mark Auriemma, Cfa, Angela Cassidy, Kelly Dougherty, Despina Garalis, Pharmd, Rph, Judith Pelletier, Jennifer Springer

Emerging Leaders Program Team Projects

The Massachusetts Business Roundtable (MBR) collaborated with a team from the Emerging Leaders Program (ELP) from the University of Massachusetts Boston to explore ways to control health care costs. One strategy being implemented by employers to control health care costs is through “wellness programs,” employer-sponsored efforts to improve the health of employees. Members of the Massachusetts Business Roundtable (MBR) and other large employers have had success in reducing their health care costs through the implementation of corporate wellness initiatives. The purpose of this paper is to define what is working in private sector wellness programs to determine whether there is …

Why Equality? How Equality?: The Desirability Of A Focus On Income Distribution, Arthur Macewan

Economics Faculty Publication Series

Much of the discussion of economic development in low and middle income countries and of poverty reduction has either ignored the issue of income distribution or has tended to view income distribution only in terms of its impact on economic growth. In this paper I argue that such an approach is misguided. I will explain, first, why I believe that it is desirable to give a great deal of attention to income distribution in the analysis of economic development and poverty reduction. My argument includes conceptual, political and practical elements. Second, I will suggest some of the ways in which …

The Road To Universal Health Coverage In Massachusetts: A Story In Three Parts, John E. Mcdonough

New England Journal of Public Policy

In 1988, the Massachusetts Legislature passed a new law, a “play or pay” employer mandate, requiring all employers with six or more workers to provide health insurance coverage for their employees. A few years later, with Medicaid identified as a “Budget Buster,” the Weld administration sought deregulation as the way to cut costs and expand access by establishing MassHealth, which dropped the employer mandate and expanded Medicaid, and eventually distinguished Massachusetts as the state with the greatest percent of covered citizens. But MassHealth enrollment has declined as premium costs have risen, and the Uncompensated Care Pool is once again faced …

The Professional Decline Of Physicians In The Era Of Managed Care, Aimee E. Marlow

New England Journal of Public Policy

Physicians have long enjoyed prestige, power, and autonomy, but the rise of managed care organizations has drastically changed their status. Many doctors are in thrall to the financial well-being of the corporations that employ them, their knowledge and expertise controlled and manipulated in the interest of profit maximization. This article investigates the professional decline of physicians, citing the use of gag clauses, incentives to withhold care, and the breakdown of their authority. In an effort to regain some measure of control, physicians have taken their concerns to the public, supporting state and federal legislation that attempts to curb questionable managed …

Labor's Response To Hospital And Workplace Transformation, Enid Eckstein

New England Journal of Public Policy

The health care industry and the nation's hospitals are in the throes of revolutionary change. The shift to managed care resulted in fundamental changes in the delivery of care and the structure of health care, For the past ten years, hospitals have actively been merging and creating large-scale integrated delivery systems. Employers, eager to expand market share and reduce costs, are engaged in radical reorganization of the hospital and the structure of work from which no group is immune. Physicians, nurses, technicians, and housekeepers are all affected by these changes. Hospitals are reducing their personnel, shifting work outside the hospital, …

Allied Health Professions In The Health-Sector Job Structure, Françoise J. Carré

New England Journal of Public Policy

This article reviews the characteristics of allied health professions in the U.S., Massachusetts, and Boston health sectors. These occupations are considered in the broader context of the multitiered job structure of the health sector and their gender and ethnic composition. The discussion includes surveys of vacancy rates and wage levels for selected allied health professions in Massachusetts hospitals. The article concludes with a more detailed, albeit national, picture of these occupations in the hospital sector per se, their demographic composition, and earnings level.

Aids And New England Hospitals, Jesse Green, Neil Wintfeld, Madeleine Singer, Kevin Schulman

New England Journal of Public Policy

The Centers for Disease Control projects that nine thousand persons with AIDS will be alive in New England in 1991, representing a sevenfold increase from 1986. Our analysis indicates that more than 2 percent of medical/surgical beds in New England will be used for AIDS care by 1991, representing 766 fully occupied hospital beds. The direct cost of providing hospital care to New England's AIDS patients is projected to be $195.2 million in 1991, reflecting 3 percent of all hospital inpatient costs in the region.

AIDS treatment is very unevenly distributed among hospitals in New England. Just twenty hospitals (8 …

Medical Care Of Aids In New England: Costs And Implications, Stewart J. Landers, George R. Seage Iii

New England Journal of Public Policy

This article presents an overview of cost issues related to AIDS. Data from the Massachusetts Cost of AIDS Study are combined with epidemiological projections to estimate the cost of treating people diagnosed with AIDS in New England. Aggregate inpatient, ambulatory, and home care costs are estimated to be $96.9 million and $524.8 million through 1987 and 1991, respectively. These estimates represent a relatively small percentage of total health care costs for all illnesses over the same time period.

The authors find that the cost of treating AIDS does not affect all health care providers uniformly and therefore argue that appropriate …