Health affairs
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Medicaid has had an enormous impact on the shape and impact of public mental health care. Medicaid mental health policy has expanded access, fostered consumerism, and created incentives for expansion of community-based providers. It also has dramatically changed the economic rules governing public mental health care, leading state governments to alter their behavior. The result has been a tilting of public mental health care toward Medicaid-covered people and services.
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With the number of uninsured people exceeding forty-one million in 2001, insuring the uninsured is again a major policy issue. This analysis establishes benchmarks for the inevitable debate over the cost of expanding coverage: How much is being spent on care for the uninsured, and where does the money come from? This information is essential for assessing how much new money will be required for expanded coverage, how much can be reallocated from existing sources, and how a new financing system would redistribute the burden of subsidizing care for the uninsured from private to public sources.
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We use a regression framework and nationally representative data to compute aggregate overweight- and obesity-attributable medical spending for the United States and for select payers. Combined, such expenditures accounted for 9.1 percent of total annual U. S. medical expenditures in 1998 and may have been as high as dollar 78.5 billion (dollar 92.6 billion in 2002 dollars). Medicare and Medicaid finance approximately half of these costs.