This week's round-up considers alternative health care models, the immigrant experience in Philadelphia, forthcoming Defense budget fights and leading indicators of our economic crisis. In short, TTR runs the gamut!
- With comparison comes revelation. The journal Health Affairs published a study last week that surveyed chronically ill adults in the U.S. and seven other industrialized nations (Australia, Canada, France, Germany, the Netherlands, New Zealand, and the U.K.). It compared their experiences of hospitalization or serious illness among a range of insurance designs and primary care models. U.S. patients were at a particularly high risk of forgoing recommended care -- like taking medicine or scheduling specialized appointments -- because of costs. They also experienced less efficient, poorly-organized care; and had to cope with more errors, such as getting the wrong medication or failing to receive prompt notice of abnormal test results. The report, highlighting the need for revision of the U.S. system, concludes with suggested innovations for improving patient outcomes everywhere. -- DH
- Illadelphia studies. Brookings digested thirty-plus years of research in a new report on immigration to Philadelphia. The key finding -- as in most reports on recent immigration trends -- is that foreign-born residents have swollen the metropolitan area in the 21st century. But instead of belaboring the stresses this can cause a city, the authors emphasize immigrants' "infusion of cosmopolitanism" and encourage the development of city infrastructure to better serve this burgeoning population. With special sections on refugees, South Philly, suburbia, health workers, and taxi drivers, this 40-pager explains why, how, when, from where, and what it means that immigration took hold of once-Anglo Philadelphia. -- CP
- Good cop, bad cop [PDF]. In a Center for Strategic and International Studies report, Anthony Cordesman and Hans Kaeser delve into the defense budgetary crisis that President-elect Obama will inevitably face. The Bush administration has more or less neglected the increased costs of manpower, maintenance, procurement, and contracts that naturally accompany engagement in two wars. The authors conclude that Obama's fiscal program will presumably involve axing (or scalpeling, if you will) large portions of the defense budget, much to the chagrin of many in the defense community. The Army's Armed Reconnaissance Helicopter (ARH), the Air Force's Transformational Communications Satellite (TSAT), the Combat Search and Rescue Helicopter (CSAR), and the Aerial Refueling Tanker (KC-X) are four specific contract programs (totaling almost $70 billion) that will likely face downsizing due to funding cuts. These cuts should not be interpreted as defense cuts; rather, they will be attempts to clean up the "current administration's unfinished business." -- SW
- Movin' on up [PDF]. Income inequality matters, but economic mobility -- the increase in economic status over a lifetime -- is what you have to keep your eye on, according to a recent report from the Urban Institute. Even with income inequality rivaling that of the 1920s, the report argues that disparities in opportunities may be more powerfully reflected by the stagnation in economic mobility. The study shows that both relative and absolute mobility have remained essentially the same for the past two decades, even as the economy has undergone serious transformations and extended periods of high growth that have been particularly rewarding for the wealthiest Americans. -- ZA
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