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Papers

Economic Facts Jun 13, 2018

The State of Competition and Dynamism: Facts about Concentration, Start-Ups, and Related Policies

Over the past few decades there have been troubling indications that dynamism and competition in the U.S. economy have declined. Markets are more concentrated than they were a few decades ago, and entrepreneurship is less common, with both the number and employment share of new firms well below the levels of previous decades. Carefully assessing these trends as they relate to public policy is necessary to achieving a more competitive, productive economy that generates broadly shared growth.

Policy Proposal Jun 13, 2018

Removing Anticompetitive Barriers for Advanced Practice Registered Nurses and Physician Assistants

High levels of U.S. health-care spending and inadequate health outcomes make it vital for policymakers to explore opportunities for enhancing productivity in the health-care sector. However, the potential for these gains is sharply limited by anticompetitive policy barriers in the form of restrictive scope of practice laws imposed on physician assistants and advanced practice registered nurses. Adams and Markowitz examine evidence on the impacts of these restrictions, concluding that states should move to fully authorized scope of practice for these practitioners. The authors explore state and federal policies that could help facilitate this shift.

Framing Paper Jun 29, 2016

The Changing Landscape of American Life Expectancy

During the past 100 years, life expectancy at birth has increased by about 25 years in the United States. However, certain groups—notably older whites and low-income Americans—find their mortality rates either stagnating or rising in recent years. In a new framing paper, The Hamilton Project examines the widening gap in life expectancy and explores policy reforms aimed at extending life expectancy gains for more Americans.

Policy Proposal Oct 7, 2015

Getting the Most from Marketplaces: Smart Policies on Health Insurance Choice

Substantial evidence shows that consumers often lack the high-quality information to select the best insurance plan, and once they have selected a plan they are less likely to switch, even as better plans become available. In response, Ben Handel and Jonathan Kolstad propose that exchanges develop a personalized decision support tool to give consumers the information they need to select the best plan. Additionally, they propose that exchanges establish a system of smart defaults, where an algorithm is used to move consumers to new plans if those plans deliver more value.