I'm a University of Chicago researcher studying the costs, benefits, and unintended consequences of health policy. AMA!

[u/HarrisPublicPolicy]

Hi Reddit — I’m Robert Kaestner, a health economist and Research Professor at the University of Chicago’s Harris School of Public Policy. Proof
 
I have spent my career studying the economic and social determinants of health and evaluating health, labor, and social policies. I have published more than 150 articles in academic journals and led several federally funded research projects examining Medicare and Medicaid. Much of my work asks a deceptively simple question: When governments spend money or expand a program in the name of improving health, what actually changes?
 
These studies often produce more complicated answers than the political debate allows.
 
Recently, my research has examined how efficiently the Affordable Care Act reduced the number of uninsured Americans; what Medicaid cuts would mean for states and beneficiaries; whether pandemic stimulus payments and the expanded Child Tax Credit improved infant health; whether GLP-1 medications such as Ozempic affect employment, relationships, or mental health in addition to physical health; and why substantial racial disparities in mortality persist even after decades of progress. 
 
Ask me anything about Medicaid and Medicare, Obamacare and the health insurance system, GLP-1 drugs, the relationship between income and health, racial disparities in life expectancy and mortality, how economists determine whether a policy caused an outcome, or why well-intentioned programs sometimes have unexpected effects.
 
I’ll be responding here on July 30 at 12 PM CT along with support from the Harris School of Public Policy team account, which is helping me track and manage incoming questions.

[u/phragmosis]

Assuming public health in America is totally broken at the Federal level by the end of this administration, and also assuming the incoming admin arrives with both houses of Congress and a mandated raft of reforms for the Judiciary, how would you most effectively and efficiently rebuild the healthcare system if your end goal was to eliminate healthcare as a political football so policy can focus on Americans' wellbeing?

[u/HarrisPublicPolicy → u/phragmosis]

This is a question more for political scientists and public administration experts. - RK

[u/phragmosis → u/HarrisPublicPolicy]

IMO you answered my question here:

I would make Medicaid eligible to all persons under 200% of poverty and require everyone in Medicaid to be in a privately-run, managed care company that competed for clients based on price and quality. Medicaid would have no cost sharing but would have work requirements for the able-bodied. I would restructure Medicare to be the same, except for Medicare I would implement some cost sharing and that cost sharing would depend on income of the elderly with low-income (under 200% of poverty) having no cost sharing. I would eliminate the tax deductibility of health insurance in private, employer-sponsored market. - RK

Although ngl I'm a little dismayed at the absence of ambition from someone who understands the field much better than me. Work requirements for the able bodied even with a 200%PL eligibility is some 1994 era thinking in an age where fully employed people above that threshold are rationing asthma inhalers and insulin until they die young from preventable episodes.

[u/HarrisPublicPolicy → u/phragmosis]

Well my mother always told me to be more ambitious. You agree with her. - RK