Americans Say Health Premiums Increased in 2015

Gallup: “Nearly three in four American adults (74%) who pay all or some of their health insurance premiums say the amount they pay has gone up over the past year. This percentage is up marginally from the 67% who last year said their costs increased, but it is generally in line with what Gallup has found in yearly updates since 2003.”

Self-Reports of Cost Changes Among Adults Who Pay All or Some of Their Health Premiums

“Though Americans are still more likely to be satisfied than dissatisfied with their personal healthcare costs, the latest poll indicates they are more likely to be grappling with higher premium costs than in previous years.”

“What Americans pay for their healthcare premiums has not noticeably improved since the ACA’s implementation, and experts have stressed that a rise in premiums will continue for several years. Meanwhile, the White House contends that recent premium increases would have been larger if not for the ACA.”

Another Robust Jobs Report

“The American economy created 211,000 jobs in November, the government reported Friday, a robust showing that all but guarantees policy makers at the Federal Reserve will raise interest rates for the first time in nearly a decade when they meet this month,” the New York Times reports.

“The unemployment rate held steady at 5 percent, unchanged from October.”

Which State Works the Hardest?

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Governing: “This broad definition of work considers the amount of time people spend engaged in income-generating activities, including tasks related to work (business lunches) or time spent looking for a job. Because estimates include those not working, the reported averages are lower than they would be for only employed workers.”

The Student Debt Problem, Mapped

Vox: “The student debt problem in the US is really two problems. The first is that a college degree is more expensive than it used to be, and students are graduating with higher debt loads than ever. The second is that some students are struggling to pay back their debt.”

“When you look at individual states or metropolitan areas, you see that the zip codes with high average loan balances aren’t the same as those where delinquency is high. In fact, they’re almost reversed. Here are the loan balances around Washington, DC, where a darker color indicates a higher balance:”

Map of debt loads around Washington

And here are the delinquencies. A darker shade indicates more people are delinquent:

Map of loan delinquencies in DC metro area

“This contradiction, that the people who borrow the most in student loans often end up doing fine, makes it hard to create a sensible student loan policy. Many people think of the student loan problem as all about balances. But it’s really about the hidden, struggling borrowers, whose inability to pay back their loans can follow them for life.”

Why Do We Pay More for Prescription Drugs?

The Wall Street Journal reports its findings on its study on “international drug-cost differences and what lies behind them.”

In the case of Norway, “U.S. prices were higher for 93% of 40 top branded drugs available in both countries in the third quarter. Similar patterns appeared when U.S. prices were compared with those in England and Canada’s Ontario province. Throughout the developed world, branded prescription drugs are generally cheaper than in the U.S.”

“The upshot is Americans fund much of the global drug industry’s earnings, and its efforts to find new medicines. ‘The U.S. is responsible for the majority of profits for most large pharmaceutical companies,’ said Richard Evans, a health-care analyst at SSR LLC.”

“The government systems also are the only large drug buyers in most of these countries, giving them substantial negotiating power.”

“Medicare, the largest single U.S. payer for prescription drugs, is by law unable to negotiate pricing. For Medicare Part B, companies report the average price at which they sell medicines to doctors’ offices or to distributors that sell to doctors. By law, Medicare adds 6% to these prices before reimbursing the doctors. Beneficiaries are responsible for 20% of the cost.”

“The arrangement means Medicare is essentially forfeiting its buying power, leaving bargaining to doctors’ offices that have little negotiating heft.”

Healthcare Costs Still a Concern for Americans

Gallup: “Slightly fewer than one in three Americans (31%) say that they or a family member have put off any sort of medical treatment in the past year because of the cost. This is essentially unchanged from the 33% who said this in 2014, and the figure has remained steady for the past decade. The majority of Americans (68%) say they did not have to put off care because of the cost.”

Trend: Percentage of Americans Putting Off Medical Treatment Because of Cost

Obamacare has “provisions that are designed to limit the cost of healthcare services, but despite all these measures, a consistent third of the country say that in the past year, they or their family has had to delay medical treatment. The ACA has achieved objectives considered important by the policymakers who crafted the law — most notably, ensuring that a greater a number of Americans have medical insurance — but on this cost-related metric, its influence has not been felt.”

Americans Concerned About Health Care Costs

Gallup: Americans continue to name the cost of (22%) and access to (20%) healthcare as the most urgent health problems facing the U.S. Obesity and cancer are next on the list, cited by 15% and 14%, respectively. No other issue receives more than 2% of mentions from Americans.

Trend: Cost and Access Remain Most Commonly Named as Urgent Health Problems

The Obama administration has made a major effort to address healthcare cost and access by passing the Affordable Care Act. Since its major provisions went into effect, there has been a drop in the percentage of Americans who lack health insurance. But the law probably did not affect the healthcare situation for the large majority of Americans, most of whom get health insurance through an employer or Medicare. The percentages mentioning both cost and access are down from the later years of George W. Bush’s administration, even though they remain the top overall issues.

Is a December Rate Hike a Done Deal?

Washington Post: “The minutes of the central bank’s October meeting shed light on the lingering divisions among the Fed’s top ranks over whether to raise its key interest rate for the first-time in nearly a decade when they convene in Washington next month.”

“The documents show that most of the 17 Fed officials who participate in the debate expected that the economy would be ready for a rate hike by December. Delaying a move could increase uncertainty in financial markets, which have been scrutinizing officials’ every word for signs of when the decision might come: Investors might interpret additional delay as a sign of the central bank’s lack of confidence in the economy. Additionally, the Fed’s target rate has been at zero since 2008, and participants noted that the long period of extraordinary stimulus could be distorting the financial system.”

“In a policy statement after its October meeting, the Fed explicitly stated it could raise rates in December. The minutes show most officials believed the wording indicated they were leaning toward action but also as ‘leaving policy options open’ … Expectations that the Fed will move next month have jumped to more than 60 percent since the October meeting and a blockbuster October jobs report.”

Fewer Employers Choosing to Terminate Coverage Due to Obamacare

Forbes: “The likelihood that small employers will terminate health coverage for their workers due to the Affordable Care Act is far less likely than the ‘early days of the health reform debate,’ according to a new analysis.”

“Employee benefits consultancy Mercer … said just 7% of employers with 50 to 499 employees now say they are ‘very likely’ or ‘likely’ to terminate coverage for their workers within the next five years.”

“This is in sharp contrast to the early days of the health reform debate when employers worried the law would ad layers of bureaucracy and higher costs from various new rules and mandates. In 2013, one in five small employers, or 21%, said they were ‘very likely’ or ‘likely’ to terminate their health plans, the Mercer annual employer health survey shows. And in 2014, the likelihood of employers dropping coverage fell to 15% of these smaller employers.”

Few employers now say they will drop coverage due to issues related to the Affordable Care Act. Source: Mercer’s National Survey of Employer-Sponsored Health Plans

Climate Change Risk Becomes an Investment Issue

CBC News: “Climate change risk has arrived as an investment issue, according to the world’s largest institutional investment manager. BlackRock Inc., with $4.5 trillion US under management, has begun watching carbon risk on all its portfolios.”

“In a new report, it warns a raft of new rules to curb carbon emissions out of the climate change summit in Paris may have a significant effect on investment returns in the years ahead.”

“This so-called ‘regulatory risk,’ meaning the impact of climate change regulations, is an impact that all corporations will be seeking to manage, says Ewen Cameron Watt of BlackRock.

“Long-term asset owners worry about ‘stranded’ assets, such as coal or oil that may have to be left in the ground to keep the world from warming by two degrees Celsius [and] there is the impact on the insurance industry of paying for repairs after extreme weather and the potential for growth among clean-energy companies.”

Recently “three new climate change indexes, which measure carbon exposure to individual companies, have been developed for the Toronto and New York markets. In addition BlackRock partnered with FTSE to create a Fossil Fuels Index Series that excludes companies linked to extraction and sale of fossil fuels.”

Watt: “The bigger the carbon footprint to start with, the greater the mitigation effort can be.”

White Working-Class Americans: A Persecuted Group?

Citylab reports on a recently released American Values Survey.

“With a focus on national-level concerns and the presidential election, the survey provides insight into why some Americans support the candidates they do. Particularly visible are the anxieties of white, working-class voters, who form the majority of Donald Trump’s Republican backers. Their support for Trump appears to be most closely linked to attitudes on immigration. Sixty-nine percent of Trump supporters responded that immigration is a critical issue to them personally, compared to just half of those who support other Republican candidates.”

“White, working-class Americans also voice also a strong sense of personal discrimination against them. Nearly three-quarters of Trump supporters feel that ‘discrimination against whites has become as big a problem as discrimination against blacks and other minorities,’ compared to 57 percent of supporters of other Republican candidates and 25 percent of all Americans. Forty-two percent of Trump’s backers believe that “white men face a lot of discrimination in the U.S. today,” 12 percent more than those supporting other Republican candidates.”

“Who cares what white, working-class Americans think? Obviously, it matters from a political perspective. But recall that this group has been making news for reasons other than its support of Trump.”