The newsletter of the New Hampshire Center for Public Policy Studies
In this issue:
The New Hampshire Center for Public Policy Studies appears on local radio and television, continuing the Center's mission to inform and educate the public concerning important policy matters.
New Hampshire’s Next Budget Conversation: Spending and Revenues in 2010-2011
New Hampshire has a ‘biennial budget problem’, where every two years the legislature must carefully address spending growth and, in most biennia, find new revenue to balance the budget. The upcoming biennium may be different, and in important respects, more problematic than in the past. The Governor and the Legislature will have to make changes in the state budget totaling between $372 and $495 million dollars over the next three years, beyond current state law.
The Center's analysis is not meant to predict what will happen in the future. Instead, it provides policymakers with an estimate of the scale of changes that will have to be implemented to balance the budget in the next biennium in the absence of a strong economic recovery.
Driving Health Care Premiums: Cost-shifting in New Hampshire.
The phenomenon of hospital cost-shifting in New Hampshire has been well documented by the Center. In an environment in which the public payers – which account for almost 50 percent of health care expenditures – pay less than the costs of services, the hospital industry has to find ways to support patient care services. Hospitals use their ability to ‘cost-shift’ to private payers to recover costs and to generate positive operating margins. The private payers are largely insurance companies whose clients are New Hampshire businesses and consumers.
The financial burden of cost-shifting and the generation of operating margins are borne directly by New Hampshire businesses and consumers. In 2007, over $600 million in below cost reimbursement from the public sector, charitable care and operating margins were shifted onto the privately insured. By extension, in the aggregate health care premiums in New Hampshire may have been as much as $600 million dollars higher than they otherwise would have been in the absence of this ‘cost-shifting’ phenomenon. Put another way, healthcare premiums in New Hampshire could have been as much as 25% lower than they were if there was no cost-shifting and no operating margins.
Papers of Interest
Mental Health and Adults: Aging Will Drive the System.
In New Hampshire more than 250,000 adults have a diagnosable mental health disorder and slightly more than 150,000 have a mental illness that significantly affects their ability to engage in daily living. Because the elderly account for a surprisingly significant share of the Medicaid funded mental health services, it is clear that the aging of the population will have significant implications for the system of mental health services and both the state and county budgets. The state, insurers, and county governments will all need to develop strategies to manage the staffing, budgetary and systems implications of this aging population, as the population over the age of 65 is anticipated to double in the next 20 years.
Center Graph of the Month
Energy and Health Care as a Percent of GDP is a summary of the Center’s article in the September BusinessNH magazine.
The Center offers the Graph of the Month from the array of data we use to understand the policy landscape across a wide range of policy issues.
The Graph of the Month continues our mission to provide new perspectives on available data which will raise new ideas and improve policy debates through quality information and analysis on issues shaping New Hampshire's future.
Policy Points informs you about our current research topics, including highlights of the important policy discussions going on in and around the State of New Hampshire. Any links to other websites do not necessarily represent an endorsement of that organization by the New Hampshire Center for Public Policy Studies
To find out more, please visit us at www.nhpolicy.org