Obamacare and Environmental Production Efficiency Rankings for the 50 U.S. State Governments: A Data Envelopment Analysis of Health Outcomes from Environmental Factors and State Health Care Expenditures

Journal of Economics and Banking, Volume 3, Issue 1, pp.1-19, February 2017, DOI: 10.18103/jeb.v3i1.822

19 Pages Posted: 19 May 2017 Last revised: 25 Nov 2018

See all articles by Ehsan H. Feroz

Ehsan H. Feroz

University of Washington, Milgard School of Business-Accounting ; University of Illinois at Urbana-Champaign; Government of the United States of America - US GAO Advisory Council; University of Minnesota, Labovitz School of Business-Department of Accounting; University of Minnesota, Carlson School of Management-Department of Accounting; American Accounting Association

Raymond L. Raab

University of Minnesota, Duluth - Labovitz School of Business and Economics (LSBE)

Jennifer Schultz

University of Minnesota - Duluth

Gerald T. Ulleberg

Independent

Date Written: May 19, 2017

Abstract

This paper examines the health performance rankings of the 50 U.S. state governments (SGs), and addresses the relationship between SG performance rankings and SG environmental health, economic prosperity, and state healthcare policy. We use the data envelopment analysis (DEA) to estimate and compare the relative performance of the 50 SGs in a single measure. Our analyses indicate that new federal mandates, such as, universal or nearly universal health care coverage, and timely resources or lack of them from the federal government, may lead to very different state health performance outcomes. Our analyses also highlight the tradeoffs between given inputs and desired outputs involved in attaining a certain level of health performance efficiency. In particular, they show that limiting harmful exposures by timely investments in prevention is far more cost-effective than subsequent incurrence of health care expenditures in treatment of the affected population. Finally, our findings indicate that a fixed amount of federal funding per capita could lead to different health performance outcomes in different states, depending on the level of efficiency with which the SG operates during the funding period.

Keywords: Environment, Health Care, Obamacare, Affordable Care Act, Efficiency Ranking, DEA, U.S. State Governments, Political Economy, Accounting and Economics

JEL Classification: C44, C61, C67, D61, G18, G30, H10, I22, L30,L51, M41, P16, P17, Q20

Suggested Citation

Feroz, Ehsan H. and Raab, Raymond L. and Schultz, Jennifer and Ulleberg, Gerald T., Obamacare and Environmental Production Efficiency Rankings for the 50 U.S. State Governments: A Data Envelopment Analysis of Health Outcomes from Environmental Factors and State Health Care Expenditures (May 19, 2017). Journal of Economics and Banking, Volume 3, Issue 1, pp.1-19, February 2017, DOI: 10.18103/jeb.v3i1.822 . Available at SSRN: https://ssrn.com/abstract=2970865

Ehsan H. Feroz (Contact Author)

University of Washington, Milgard School of Business-Accounting ( email )

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University of Illinois at Urbana-Champaign ( email )

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Government of the United States of America - US GAO Advisory Council ( email )

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University of Minnesota, Labovitz School of Business-Department of Accounting ( email )

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University of Minnesota, Carlson School of Management-Department of Accounting ( email )

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American Accounting Association ( email )

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Raymond L. Raab

University of Minnesota, Duluth - Labovitz School of Business and Economics (LSBE) ( email )

412 Library Drive
Duluth, MN 55812-3029
United States

Jennifer Schultz

University of Minnesota - Duluth ( email )

1049 University Drive
Duluth, MN 55812
United States
218-726-6695 (Phone)

HOME PAGE: http://www.d.umn.edu/~jschultz/

Gerald T. Ulleberg

Independent ( email )

No Address Available

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