US

Medicare Funding

Question A:

If it is implemented, the proposed increase in the tax rate on earned and business income above $400,000 in the Biden budget, along with other proposed changes to Medicare, would extend the solvency of the Medicare program for the next 25 years.

Responses weighted by each expert's confidence

Question B:

If it is implemented, the proposed reform of Medicare drug negotiations in the Biden budget is likely to lead to a substantial reduction in drug prices for beneficiaries.

Responses weighted by each expert's confidence

Question C:

If it is implemented, the proposed reform of Medicare drug negotiations in the Biden budget is likely to lead to a substantial reduction in the development of beneficial new drugs.

Responses weighted by each expert's confidence

Question A Participant Responses

Participant University Vote Confidence Bio/Vote History
Acemoglu
Daron Acemoglu
MIT
Agree
3
Bio/Vote History
Altonji
Joseph Altonji
Yale
Agree
4
Bio/Vote History
Auerbach
Alan Auerbach
Berkeley
Uncertain
3
Bio/Vote History
Autor
David Autor
MIT
Agree
8
Bio/Vote History
Banerjee
Abhijit Banerjee
MIT Did Not Answer Bio/Vote History
Bertrand
Marianne Bertrand
Chicago
No Opinion
Bio/Vote History
Brunnermeier
Markus Brunnermeier
Princeton
Agree
5
Bio/Vote History
Chetty
Raj Chetty
Harvard Did Not Answer Bio/Vote History
Chevalier
Judith Chevalier
Yale Did Not Answer Bio/Vote History
Cutler
David Cutler
Harvard
Strongly Agree
5
Bio/Vote History
Deaton
Angus Deaton
Princeton
Agree
7
Bio/Vote History
Duffie
Darrell Duffie
Stanford
Uncertain
2
Bio/Vote History
Money is fungible--hard to say that this particular tax is the source of revenue that will "save Medicare," which draws on the entire fiscal purse. Anyway, it's hard (at least for me) to guess how much more funding Medicare needs to survive in its current form.
Edlin
Aaron Edlin
Berkeley Did Not Answer Bio/Vote History
Eichengreen
Barry Eichengreen
Berkeley
Agree
5
Bio/Vote History
Einav
Liran Einav
Stanford
No Opinion
Bio/Vote History
Fair
Ray Fair
Yale
Uncertain
5
Bio/Vote History
Finkelstein
Amy Finkelstein
MIT Did Not Answer Bio/Vote History
Goldberg
Pinelopi Goldberg
Yale Did Not Answer Bio/Vote History
Greenstone
Michael Greenstone
University of Chicago Did Not Answer Bio/Vote History
Hall
Robert Hall
Stanford
Disagree
4
Bio/Vote History
There is only one budget constraint, that of the fed gov. It is meaningless to talk about the solvency of a federal program.
Hart
Oliver Hart
Harvard
Uncertain
5
Bio/Vote History
Holmström
Bengt Holmström
MIT
Uncertain
3
Bio/Vote History
Depends on follow-up actions
Hoxby
Caroline Hoxby
Stanford Did Not Answer Bio/Vote History
Hoynes
Hilary Hoynes
Berkeley
Agree
5
Bio/Vote History
Judd
Kenneth Judd
Stanford
Agree
7
Bio/Vote History
Yes, but the taxes will reduce economic efficiency.
Kaplan
Steven Kaplan
Chicago Booth
Strongly Disagree
7
Bio/Vote History
Does not solve structural problems. And will reduce long-term growth.
Kashyap
Anil Kashyap
Chicago Booth
Uncertain
2
Bio/Vote History
Definitely would improve solvency, but a lot hinges on how fast health care costs grow.
Klenow
Pete Klenow
Stanford
Uncertain
4
Bio/Vote History
Levin
Jonathan Levin
Stanford
Uncertain
4
Bio/Vote History
25 years is a long time to predict anything
Maskin
Eric Maskin
Harvard
Disagree
3
Bio/Vote History
Administrations usually make over-optimistic long-term predictions. Mainly for that reason, I am skeptical of this prediction.
Nordhaus
William Nordhaus
Yale
Agree
5
Bio/Vote History
Obstfeld
Maurice Obstfeld
Berkeley
Uncertain
2
Bio/Vote History
Saez
Emmanuel Saez
Berkeley
Agree
7
Bio/Vote History
Samuelson
Larry Samuelson
Yale
Agree
6
Bio/Vote History
One would need to look more carefully at the details to be sure, but it looks as if the proposed funding increases would suffice.
Scheinkman
José Scheinkman
Columbia University Did Not Answer Bio/Vote History
Schmalensee
Richard Schmalensee
MIT
No Opinion
Bio/Vote History
Not enough information.
Shapiro
Carl Shapiro
Berkeley Did Not Answer Bio/Vote History
Shimer
Robert Shimer
University of Chicago
Disagree
3
Bio/Vote History
Biden's revenue expectations are optimistic, as are his expectations of government savings from pharmaceutical price negotiations.
Stock
James Stock
Harvard
Agree
3
Bio/Vote History
Thaler
Richard Thaler
Chicago Booth
Agree
4
Bio/Vote History
I read this question as asking whether it will *help* solvency, which it will. Solve is a big word.
Udry
Christopher Udry
Northwestern
Agree
4
Bio/Vote History
Also have to deal with Medicare advantage

Question B Participant Responses

Participant University Vote Confidence Bio/Vote History
Acemoglu
Daron Acemoglu
MIT
Agree
4
Bio/Vote History
Altonji
Joseph Altonji
Yale
Agree
3
Bio/Vote History
Auerbach
Alan Auerbach
Berkeley
Agree
3
Bio/Vote History
Autor
David Autor
MIT
Agree
7
Bio/Vote History
Banerjee
Abhijit Banerjee
MIT Did Not Answer Bio/Vote History
Bertrand
Marianne Bertrand
Chicago
Agree
2
Bio/Vote History
Brunnermeier
Markus Brunnermeier
Princeton
Agree
7
Bio/Vote History
Chetty
Raj Chetty
Harvard Did Not Answer Bio/Vote History
Chevalier
Judith Chevalier
Yale Did Not Answer Bio/Vote History
Cutler
David Cutler
Harvard
Strongly Agree
5
Bio/Vote History
Deaton
Angus Deaton
Princeton
Agree
8
Bio/Vote History
Duffie
Darrell Duffie
Stanford
Agree
2
Bio/Vote History
Something related to this approach worked in Canada, for example.
-see background information here
Edlin
Aaron Edlin
Berkeley Did Not Answer Bio/Vote History
Eichengreen
Barry Eichengreen
Berkeley
Agree
5
Bio/Vote History
Einav
Liran Einav
Stanford
Uncertain
1
Bio/Vote History
Fair
Ray Fair
Yale
Agree
5
Bio/Vote History
Finkelstein
Amy Finkelstein
MIT Did Not Answer Bio/Vote History
Goldberg
Pinelopi Goldberg
Yale Did Not Answer Bio/Vote History
Greenstone
Michael Greenstone
University of Chicago Did Not Answer Bio/Vote History
Hall
Robert Hall
Stanford
No Opinion
Bio/Vote History
Hart
Oliver Hart
Harvard
Agree
5
Bio/Vote History
Holmström
Bengt Holmström
MIT
Agree
4
Bio/Vote History
Hoxby
Caroline Hoxby
Stanford Did Not Answer Bio/Vote History
Hoynes
Hilary Hoynes
Berkeley
Agree
5
Bio/Vote History
Judd
Kenneth Judd
Stanford
Agree
7
Bio/Vote History
Kaplan
Steven Kaplan
Chicago Booth
Agree
2
Bio/Vote History
Will reduce costs. Not clear if substantial.
Kashyap
Anil Kashyap
Chicago Booth
Agree
2
Bio/Vote History
Klenow
Pete Klenow
Stanford
Disagree
3
Bio/Vote History
Levin
Jonathan Levin
Stanford
Agree
4
Bio/Vote History
Maskin
Eric Maskin
Harvard
Agree
5
Bio/Vote History
Nordhaus
William Nordhaus
Yale
Uncertain
5
Bio/Vote History
Obstfeld
Maurice Obstfeld
Berkeley
Agree
2
Bio/Vote History
Saez
Emmanuel Saez
Berkeley
Agree
6
Bio/Vote History
Samuelson
Larry Samuelson
Yale
Uncertain
1
Bio/Vote History
Enhanced Medicare negotiating power should lower prices, but it remains to be seen if the expansion is enough to ensure significant reductions.
Scheinkman
José Scheinkman
Columbia University Did Not Answer Bio/Vote History
Schmalensee
Richard Schmalensee
MIT
No Opinion
Bio/Vote History
Not enough information to have an opinion on "substantially."
Shapiro
Carl Shapiro
Berkeley Did Not Answer Bio/Vote History
Shimer
Robert Shimer
University of Chicago
Agree
3
Bio/Vote History
Stock
James Stock
Harvard
Agree
4
Bio/Vote History
Thaler
Richard Thaler
Chicago Booth
Uncertain
1
Bio/Vote History
You lose me at substantial. It should help!
Udry
Christopher Udry
Northwestern
Agree
3
Bio/Vote History
Probably, at least in the short term

Question C Participant Responses

Participant University Vote Confidence Bio/Vote History
Acemoglu
Daron Acemoglu
MIT
Uncertain
4
Bio/Vote History
Composition of pharma innovation is highly responsive to profits. This may lead to excessive investment in expensive drugs for end-of-life care. Lower profit margins across the board may not have huge effects on overall R&D, and may even lead to better composition of R&D.
-see background information here
-see background information here
Altonji
Joseph Altonji
Yale
Uncertain
3
Bio/Vote History
Auerbach
Alan Auerbach
Berkeley
Uncertain
3
Bio/Vote History
Autor
David Autor
MIT
Uncertain
7
Bio/Vote History
The incentives around drug development are so distorted that it's hard to say. Reducing profits will reduce R&D, but whether these would have been "beneficial new drugs" is much less certain.
Banerjee
Abhijit Banerjee
MIT Did Not Answer Bio/Vote History
Bertrand
Marianne Bertrand
Chicago
Uncertain
4
Bio/Vote History
Brunnermeier
Markus Brunnermeier
Princeton
Uncertain
7
Bio/Vote History
Chetty
Raj Chetty
Harvard Did Not Answer Bio/Vote History
Chevalier
Judith Chevalier
Yale Did Not Answer Bio/Vote History
Cutler
David Cutler
Harvard
Disagree
5
Bio/Vote History
Deaton
Angus Deaton
Princeton
Disagree
7
Bio/Vote History
The make plenty already.
Duffie
Darrell Duffie
Stanford
Uncertain
1
Bio/Vote History
The concept is that if pharma firms can't anticipate large markups on marginal cost per unit, then they won't commit large amounts of capital to high-risk multi-year R&D. That's a reasonable guess, but I'm not confident enough in this topic to click 'Agree.'
Edlin
Aaron Edlin
Berkeley Did Not Answer Bio/Vote History
Eichengreen
Barry Eichengreen
Berkeley
Uncertain
5
Bio/Vote History
Einav
Liran Einav
Stanford
Uncertain
1
Bio/Vote History
Fair
Ray Fair
Yale
Disagree
5
Bio/Vote History
Finkelstein
Amy Finkelstein
MIT Did Not Answer Bio/Vote History
Goldberg
Pinelopi Goldberg
Yale Did Not Answer Bio/Vote History
Greenstone
Michael Greenstone
University of Chicago Did Not Answer Bio/Vote History
Hall
Robert Hall
Stanford
No Opinion
Bio/Vote History
Hart
Oliver Hart
Harvard
Disagree
5
Bio/Vote History
Holmström
Bengt Holmström
MIT
Uncertain
3
Bio/Vote History
Hoxby
Caroline Hoxby
Stanford Did Not Answer Bio/Vote History
Hoynes
Hilary Hoynes
Berkeley
Disagree
5
Bio/Vote History
Judd
Kenneth Judd
Stanford
Uncertain
7
Bio/Vote History
The market is much bigger than just Medicare.
Kaplan
Steven Kaplan
Chicago Booth
Agree
3
Bio/Vote History
Will reduce incentive to invest in new drugs, but substantial depends on how much price reduction. Also, possible that drug discovery improves with technology.
Kashyap
Anil Kashyap
Chicago Booth
Agree
3
Bio/Vote History
Klenow
Pete Klenow
Stanford
Disagree
3
Bio/Vote History
Levin
Jonathan Levin
Stanford
Uncertain
4
Bio/Vote History
Maskin
Eric Maskin
Harvard
Uncertain
4
Bio/Vote History
Economic logic suggests that capping drug prices will induce less drug discovery. But whether this effect will be "substantial" is hard to predict.
Nordhaus
William Nordhaus
Yale
Disagree
7
Bio/Vote History
Obstfeld
Maurice Obstfeld
Berkeley
Uncertain
2
Bio/Vote History
Saez
Emmanuel Saez
Berkeley
Disagree
5
Bio/Vote History
Samuelson
Larry Samuelson
Yale
Uncertain
1
Bio/Vote History
Drugs research will remain lucrative, and so the dire projections of the drug industry may not come to pass.
Scheinkman
José Scheinkman
Columbia University Did Not Answer Bio/Vote History
Schmalensee
Richard Schmalensee
MIT
No Opinion
Bio/Vote History
Not enough information to have an opinion on "substantial".
Shapiro
Carl Shapiro
Berkeley Did Not Answer Bio/Vote History
Shimer
Robert Shimer
University of Chicago
Agree
3
Bio/Vote History
Stock
James Stock
Harvard
Disagree
4
Bio/Vote History
Thaler
Richard Thaler
Chicago Booth
Uncertain
1
Bio/Vote History
Same problem. I dont' know the scope. Pharma came up big on Covid without a huge profit incentive but that will not always be the case.
Udry
Christopher Udry
Northwestern
Agree
3
Bio/Vote History