In the News

Yesterday, Newark Mayor Cory Booker finished his widely publicized “SNAP Challenge,” during which he subsisted solely on meals he could prepare on an average week’s worth of SNAP (formerly food stamps) benefits – which works out to about $1.40 a meal. While certainly difficult, the SNAP Challenge cannot mimic the actual experience of receiving and surviving on SNAP benefits; as others have pointed out, the exercise cannot simulate the “psychic costs” or cumulative effects of living in poverty: hunger, insecure housing, and inadequate healthcare. Moreover, participants in the challenge are neither subject to the often taxing application and recertification processes nor the burden of actually using an EBT card. Ensuring that a given store accepts SNAP; separating eligible food items from ineligible purchases; and enduring the perceived stigma of using an EBT card in the checkout line are all aspects of participating in the program that the SNAP Challenge cannot encapsulate.

Nevertheless, the challenge can play an important role in bringing attention to SNAP’s low benefit levels, as recently documented in a new report by the Food Research and Action Center. Furthermore, efforts like Booker’s can stimulate national conversation about the experience of using SNAP, with the voices of families that have participated in the program often the strongest in revealing both its crucial importance and its structural shortcomings.

We don't often weigh in on electoral politcs here on New Health Dialogue, but the introduction of Paul Ryan into the race as Mitt Romney's running mate has distinctly shifted the focus of the debate onto Medicare, at least for the moment, and the editor of Delve Into '12, the New America campaign blog, asked for our thoughts.

You should definitely check out the full post (here) and the rest of their campaign commentary, but if you're short on time, here's an excerpt from the end of our post:

[...T]he Ryan budget slashes government healthcare spending, but it does relatively little to reduce total health spending. (In fact, if Ryan’s plan was implemented, it could reduce Medicare’s bargaining power and actually increase total spending.) While the ACA includes specific programs aimed at reducing waste (for instance by giving doctors incentives to reduce spending on ineffective treatments, funding research on which treatments actually benefit patients, and making it easier for cheaper generic drugs to get approved), the Ryan plan’s main savings mechanism is competition among private insurers. In theory, giving people a choice of insurer should reduce healthcare spending –people will choose plans that offer  better value, forcing inefficient plans out of the market. But competition among private insurers has failed to control spending in the private insurance market for decades, so some skepticism of its ability to rein in spending on the elderly is warranted. If that doesn’t actually work and total medical spending doesn’t go down, the Ryan budget saves money by shifting spending from the federal government to individuals.

Ultimately, the Ryan budget's laser-like focus on reducing the federal deficit has led to a glaring oversight in the proposal’s healthcare component. Policy should be focused on reducing total healthcare spending, including private insurance premiums and out-of-pocket payments, not just on reducing what the federal government spends. Healthcare spending has become a drag on the economy, accounting for up to two percentage points of unemployment—and that drag isn’t dependent on whether it’s funded by the government or the private sector. That’s the much more important challenge, and the Ryan budget ignores it completely.

Enjoy the weekend!

Remember how the Internet community stopped SOPA?

Come on out to Irish Whiskey this Thursday at 8pm for the official launch of the Internet Defense League (IDL), a network of people and organizations committed to defending the open Internet. The goal of IDL is to sound the alarm quickly to millions of users whenever the Internet is in peril.

Reniqua Allen explains the controversy behind Texas' voter ID law and weighs in on Mitt Romney's cold reception at the NAACP. Konstantin Kakaes breaks down the science of the Higgs Boson, and argues that its discovery has been overhyped. Elizabeth Weingarten hosts.

The MIT Sloan Management Review in collaboration with The Boston Consulting Group recently released a report, “Sustainability Nears a Tipping Point.” In a survey of over 4,000 managers from 113 countries, the study found “70% of companies have placed sustainability permanently on their management agendas.”

Sustainability is here and it is the future. It is transforming companies, commercial networks, and industries. Will the tipping point soon reach government?

Rosa Brooks and Charles Kenny discuss the challenges facing the US military in Afghanistan after reports of Korans being burned, the role of humanitarian aid in conflict zones, and the status of the UN’s Millennium Development Goals. Pamela Chan hosts.

Forbes blogger Avik Roy commented during yesterday’s IPAB hearing that “studies show that health outcomes for many Medicaid patients are worse than those who have no insurance at all.” That assertion has been around for a while. Unfortunately for Roy, it’s been frequently refuted, with a new study out of Oregon containing further evidence that patients do, in fact, benefit from Medicaid coverage.

The National Bureau of Economic Research study, released earlier this month, details results from  a study of Oregon’s Medicaid program. Three years ago, the state discovered that it had additional funds for Medicaid and wanted to enroll more people. But there were more eligible recipients than there was money, so the state created a lottery to decide who could apply and who couldn't.   The study, conducted by researchers from Harvard, MIT and other institutions, is the only randomized experiment ever done on the effects of having insurance compared to no insurance.* It compared utilization, health outcomes and self-reported health status, and financial hardship due to medical expenses among people who won the eligibility lottery and those who did not.

One key result: The authors describe an “overwhelming sense from the survey outcomes that individuals feel better about their health.”

Individuals who won the lottery also used more medical services, had improved self-assessed physical and mental health, and reduced likelihood of medical debts being sent to a collections agency. While none of the results directly relate to mortality or other measures of actual health (because mortality among the adult population is extremely low, even without insurance), there is a clear benefit to Medicaid in terms of beneficiaries’ general well-being. (Future papers will present more data on traditional measures of health outcomes.)

So much for the claim that Medicaid makes people sicker.

*The RAND Health Insurance Experiment(the only other randomized trial looking at the effects of insurance) examined the effects of different amounts of insurance, using different cost-sharing arrangements, but did not include any participants with no insurance at all.

Fresh out of college and just beginning his work as a syndicated columnist and a researcher at the New America Foundation, Brian Till set out to interview the former world leaders he most admired. He hardly expected to get his foot in the door--much less to have revelatory, insightful conversations with so many of them. Here, he distills their collective wisdom into key lessons for aspiring leaders of the future, including the best ways to handle opposition, public opinion, and the information revolution.

To all of our California Asset Building colleagues and friends,

The other day, when the Anti-Defamation League came out against building a mosque near Ground Zero, I think I heard a sound—the sound of chickens coming home to roost.