The Woefully Distorted Federal Policies on Child Abuse
Here’s something just in from the world of grossly distorted government policy:
Every year, roughly 680,000 children are reported victims of neglect or abuse by their parents in this country – a tragic statistic reflective of troubling societal, psychological and economic problems. Even worse, 1,520 children died from maltreatment in 2013, nearly 80 percent of them at the hands of their own parents.
Related: Feds Blow $100 Billion Annually on Incorrect Payments
Federal and state authorities over the years have developed a large and costly system for reporting and investigating maltreatment, removing endangered children from their homes, and preventing and treating problems of parents and children.
But as a new study touted on Wednesday by the Brookings Institution concludes, the federal government provides states with far more money to support kids once they have been removed from their homes and placed in foster care than it provides for prevention and treatment programs to keep the kids out of foster homes in the first place.
And the disparity is startling.
Two of the largest grant programs in Title IV-B of the Social Security Act provide states with funding totaling around $650 million annually for “front end” services designed to prevent or treat parent and child problems that contribute to abuse and neglect. They address problems such as substance abuse, family violence and mental health issues.
Related: Time to Stop Social Safety Net Child Abuse
Yet another series of programs in Title IV-E of the Social Security law provides states with open-ended funding that totaled about $6.9 billion in 2014. Those funds pay almost exclusively for out-of-home care for children from poor families, along with the administrative and training expenses associated with foster care, adoption, and guardianship.
That’s a 10 to 1 disparity in funding for the two efforts – one to try to hold families together and the other to move children out of their homes and into foster care.
“Congress has the opportunity to change the funding formula under Title IV of the Social Security Act so that states have the flexibility to put money where it will be most effective at keeping at-risk children safe, ensuring that they have a permanent home, and promoting their well-being,” wrote Ron Haskins, Lawrence M. Berger and Janet Currie, the authors of the study.
In their policy brief, “Can States Improve Children’s Health by Preventing Abuse and Neglect,” Haskins, a Senior Fellow in Economic Studies at Brookings, Currie of Princeton University and Berger of the University of Wisconsin-Madison, write that revising the grant programs could improve the welfare of children who are at risk of abuse or neglect.
This is something else that lawmakers might consider later this year when they begin to focus on disability insurance and other programs within the Social Security law.
Chart of the Day: High Deductible Blues
The higher the deductible in your health insurance plan, the less happy you probably are with it. That’s according to a new report on employer-sponsored health insurance from the Kaiser Family Foundation and the Los Angeles Times.
Chart of the Day: Tax Cuts and the Missing Capex Boom
Despite the Republican tax overhaul, businesses aren’t significantly increasing their capital expenditures. “The federal government will have to borrow an added $1 trillion through 2027 to pay for the corporate tax breaks,” says Bloomberg’s Mark Whitehouse. “So far, it’s hard to see what the country is getting in return.”
Chart of the Day: 2019’s Lobbying Leaders
Roll Call reports that trade, infrastructure and health care issues including prescription drug prices “dominated the lobbying agendas of some of the biggest spenders on K Street early this year.” Here’s Roll Call’s look at the top lobbying spenders so far this year:
Can You Fix Social Security? A New Tool Lets You Try
The Congressional Budget Office released an interactive tool Wednesday that shows how some widely discussed policy changes would affect the long-run financial health of the Social Security system.
“This interactive tool allows the user to explore seven policy options that could be used to improve the Social Security program’s finances and delay the trust funds’ exhaustion,” CBO said. “Four options would reduce benefits, and three options would increase payroll taxes. The tool allows for any combination of those options. It also lets the user change implementation dates and choose whether to show scheduled or payable benefits. … The tool also shows the impact of the options on different groups of people.”
Click here to view the interactive tool on the CBO website.
Why Prescription Drug Prices Keep Rising – and 3 Ways to Bring Them Down
Prescription drug prices have been rising at a blistering rate over the last few decades. Between 1980 and 2016, overall spending on prescription drugs rose from about $12 billion to roughly $330 billion, while its share of total health care spending doubled, from 5% to 10%.
Although lawmakers have shown renewed interest in addressing the problem, with pharmaceutical CEOs testifying before the Senate Finance Committee in February and pharmacy benefit managers (PBMS) scheduled to do so this week, no comprehensive plan to halt the relentless increase in prices has been proposed, let alone agreed upon.
Robin Feldman, a professor at the University of California Hastings College of Law, takes a look at the drug pricing system in a new book, “Drugs, Money and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices.” In a recent conversation with Bloomberg’s Joe Nocera, Feldman said that one of the key drivers of rising prices is the ongoing effort of pharmaceutical companies to maintain control of the market.
Fearing competition from lower-cost generics, drugmakers began over the last 10 or 15 years to focus on innovations “outside of the lab,” Feldman said. These innovations include paying PBMs to reduce competition from generics; creating complex systems of rebates to PBMs, hospitals and doctors to maintain high prices; and gaming the patent system to extend monopoly pricing power.
Feldman’s research on the dynamics of the drug market led her to formulate three general solutions for the problem of ever-rising prices:
1) Transparency: The current system thrives on secret deals between drug companies and middlemen. Transparency “lets competitors figure out how to compete and it lets regulators see where the bad behaviors occur,” Feldman says.
2) Patent limitations: Drugmakers have become experts at extending patents on existing drugs, often by making minor modifications in formulation, dosage or delivery. Feldman says that 78% of drugs getting new patents are actually old drugs gaining another round of protection, and thus another round of production and pricing exclusivity. A “one-and-done” patent system would eliminate this increasingly common strategy.
3) Simplification: Feldman says that “complexity breeds opportunity,” and warns that the U.S. “drug price system is so complex that the gaming opportunities are endless.” While “ruthless simplification” of regulatory rules and approval systems could help eliminate some of those opportunities, Feldman says that the U.S. doesn’t seem to be moving in this direction.
Read the full interview at Bloomberg News.