Politics, hospital behaviour and health care spending

This paper examines the link between legislative politics, hospital behaviour, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for re-election. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending

Politics, Hospital Behavior, and Health Care Spending

This paper examines the link between legislative politics, hospital behavior, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for reelection. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending

Revisiting Public Opinion in the 1930s and 1940s

Studies of mass political attitudes and behavior before the 1950s have been limited by a lack of high-quality, individual-level data. Fortunately, data from public opinion polls conducted during the late New Deal and World War II periods are available, although the many difficulties of working with these data have left them largely untouched for over 60 years. We compiled and produced readily usable computer files for over 400 public opinion polls undertaken between 1936 and 1945 by the four major survey organizations active during that period. We also developed a series of weights to ameliorate the problems introduced by the quota-sampling procedures employed at the time. The corrected data files and weights were released in May 2011. In this article, we briefly discuss the data and weighting procedures and then present selected time series determined using questions that were repeated on 10 or more surveys. The time series provide considerable leverage for understanding the dynamics of public opinion in one of the most volatile—and pivotal—eras in American history

Replication data for: Driving Support: Workers, PACs, and Congressional Support of the Auto Industry

These files provide a guide to the code and data objects associated with Moore, Ryan T., Eleanor Neff Powell, and Andrew Reeves. "Driving Support: Workers, PACs, and Congressional Support of the Auto Industry". Business and Politics, 15(2):137-162, 2013