Citizens Research Council of Michigan
 
Home
Publications
Tax Outline
Economic Development
Presentations
State Budget Analysis
Ballot Issues
CRC Column
Almanac
---------------
Contact CRC
CRC in the News
About Us
Staff
Directors
Links
 
E-Mail Updates
Search CRC Website
 
SEARCH PUBLICATIONS
BY YEAR
BY SUBJECT
 
Democracy Works When People Support It
 

 
 New Publications
 Ballot Issues
Help with RSS/XML

 

Facebook page

Twitter Page

LinkedIn Page

 

 

CRC Column

The right to criticize government is also an obligation to know what you are talking about. 
-Lent Upson, 1st Executive Director of CRC  


Public Health Issues

Public Health

Addressing Michigan's Obesity Problem
Report 387 ( August 2014 ) 64 pages

As a state, Michigan has a weight problem. With almost a third of its adult population classified as obese, Michigan has one of the highest average rates of obesity in the country. This report explores why high obesity rates are a problem, the potential causes driving high rates in Michigan, and the most effective solutions at the school, local, and state levels.

In addition to increased health risks, obesity results in significant economic costs for each and every Michigan resident, regardless of their weight status. Individuals, businesses, and governments incur costs from obesity through direct medical expenditures, the state's Medicaid program, reduced employee productivity, increased employee absenteeism, higher disability and other employer insurance costs, and a decline of the state's human capital through higher dropout rates and lower academic achievement in obese students. These factors decrease individuals' quality of life, make-up ten percent of Michigan's health costs, and diminish the competitiveness and economic viability of Michigan businesses.

The factors in our environment, which are magnifying the problem, are many and varied and include risk factors such as low nutrition foods in schools and neighborhoods, inadequate amounts of physical activity, insufficient health and physical education in schools, lack of community-focused programs to address obesity, a disconnect between the costs of obesity and who incurs those costs, insufficient coverage of treatment options by health insurers, and many more.

CRC's report identifies roughly a dozen ways that school, local government, and state leaders and policymakers can effectively impact obesity rates in the state. These solutions include:

  • Strengthening the nutritional profile of all foods served on school property and in child care settings;
  • Requiring physical activity during the school day and in child care settings and expand opportunities for activity before and after school hours;
  • Including detailed physical and health education requirements for all grade levels, K-12;
  • Increasing state public health spending;
  • Taxing unhealthy foods and beverages and providing subsidies to make healthy foods more accessible to low-income families;
  • Pursuing local government planning consistent with active lifestyles; and
  • Expanding community programs targeting obesity prevention and reduction.

Health Care Costs in Michigan: Drivers and Policy Options
Report 383 ( May 2013 ) 91 pages

In light of constantly increasing health care costs, policymakers at the state and federal levels are seeking policy options to reduce the burden for families, businesses, and governments. In 2009, Michigan families, businesses, and governments spent $65.9 billion on personal health care services and products, which is more than $6,600 per Michigan resident.

Perhaps even more alarming than the level of health care spending, is the growth rate. While health care spending growth in Michigan is below the national average, it is still higher than the rate of inflation and increasingly growing in its share of the economy. On average, households spend 6.2 percent of their adjusted personal income on health care costs. Businesses spend the equivalent of 10.2 percent of wages and salaries on health care costs. In 2003, health insurance premiums paid by individuals and their employers in Michigan represented 14.6 percent of household income, and by 2011, this figure had risen to 20.0 percent. At the same time that insurance premium prices are rising, employees are covering a larger portion of their health care costs through increased deductibles and other out of pocket expenses. High health care costs are a significant financial risk to the uninsured and even to some covered by health insurance.

CRC's new report, Health Care Costs in Michigan: Drivers and Policy Options outlines the problem with the current level and growth rate of health care spending. The report synthesizes the research on 17 potential cost drivers, and discusses over 20 state policy reform options that may lower the level of spending or cost growth going forward.

Major topics covered in the new CRC report include:

  • An overview of the state of health care spending nationally and in Michigan and how it has changed for families, businesses, and governments since 1990.
  • Analyses of various health care cost drivers and how they may be adding to Michigan's health spending. These drivers include high prices, opacity of prices, provider payment systems, competition among providers, medical malpractice, and no-fault auto insurance.
  • State-level policy reform options for each health care cost driver.
  • Pertinent information about how the federal Affordable Care Act may play a role in certain health care cost drivers.

State Constitutional Issues on the November General Election Ballot - I Proposal 02-04: Reallocate the Tobacco Settlement Revenue Received by the State from Cigarette Manufacturers,
CRC Memo 1066, ( September 2002 ) 8 pages

Proposal 02-04 would amend the Michigan Constitution to mandate appropriations from Michigan's share of the tobacco settlement, estimated at $330 million for Fiscal Year 2002-03 to various health care purposes and organizations.

pdf File State Health Expenditures in Michigan,
Note 2001-04 ( August 2001 ) 2 pages

Provides a summary of Report 333, Outline of State of Michigan Health Programs.

Outline of State of Michigan Health Programs,
Report 333 ( April 2001 )

Memo 1051, pdf File Statewide Ballot Issues, Analyzes the three proposals which are on the statewide ballot at the November 1998 general election. ( September 98 ) 8 pages

  • Proposal A: Constitutional Amendment to Replace the Term "Handicapped" with "Disabled"
  • Proposal B: Terminally Ill Patient's Right to End Unbearable Pain and Suffering Act (Physician Assisted Suicide);
  • Proposal C: Clean Michigan Initiative Bonds.

Health Conditions; Vital Statistics, Laws

State & Local Health Organizations & Administration

Health Insurance--Public and Private Plans

Medical Costs of No-fault Automobile Insurance
Report 385 ( October 2013 ) 35 pages

The report examines how Michigan's no-fault auto insurance system is contributing to higher health care spending in the state and outlines a variety of policy options that could be implemented to reduce the insurance system's medical costs.

Several factors are contributing to higher auto accident related medical costs in Michigan. Auto insurers pay higher prices than other payers for medical services and Michigan's auto accident victims use more medical services than in other states. Michigan is also unique in that its insurance coverage is unlimited for the lifetime of the sustained injuries. Finally, Michigan's Insurance Code ensures that auto accident victims have access to generous coverage, which provides a high quality insurance product, but undoubtedly causes it to be more expensive.

Topics covered in the new CRC report include:

  • Medical costs associated with no-fault auto insurance in Michigan.
  • The main drivers of auto accident related medical costs in Michigan.
  • No-fault auto insurance policy reform options, how they could be implemented to reduce medical spending, and how they would impact major features of the state's auto insurance policy.

Michigan Hospitals and State Administered Federal Health Insurance Programs: Payments and Participation,
CRC Memo 1069, ( November 2002 ) 16 pages

In the third of a series of papers on Issues on the Financing of Michigan Hospitals, this paper discusses state payments to Michigan hospitals for state administered health insurance programs.

Report 278, Regulation and Competition: Can They Be Used Together to Contain Health Care Costs? ( August 84 ) 14 pages

Health Care Reform

Public Health Departments--Services

Misc., pdf File Wayne County Proposal for a One-Half Mill Increase to Fund Health and Mental Health Programs ( July 92 ) 2 pages [5 KB]

Report 122, pdf File The Herman Kiefer Hospital, Examination of the administration of this health facility in response to newspaper allegations of mis-doings. (April 1931 ) 58 pages [131KB]

Detroit & Wayne County Health Departments

Misc., pdf File Wayne County Proposal #3: Request for One-Half Mill for Health Services ( October 92 ) 2 pages [7 KB]

Improving State Appropriation Control over the Resident County Hospitalization Program,
Misc. ( December 1987 ) 7 pages

Michigan counties provide hospitalization coverage for indigents under a state mandate. The state actually pays the hospital bills for participating counties and requires those counties to pay back a share of the costs; however, appropriation controls in the executive branch do not effectively enforce the payback requirement. This paper describes the steps that could bring adequate fiscal control.

CC 920, pdf File Ballot Issues: Wayne County: Proposition J -- A Separate and Fixed Tax Limit of 18 mills; Propositions K, L, & M--Extra-Voted Millage; Detroit: Proposal Y -- 3.5 Mills Extra-Voted for the Detroit Schools ( October 80 ) 5 pages

Hospitals & Nursing Homes

PDF File The Michigan Certificate of Need Program,
Report 338, ( February 2005 ) 68 pages

The Certificate of Need program is the subject of a new report by the Citizens Research Council of Michigan. Although CON was once encouraged and partially financed by the federal government, that changed in 1986 and fourteen states have since dropped the program. The remaining states, including Michigan, that have retained CON operate over a range of stringency in requirements and comparisons are difficult. The CRC report, The Michigan Certificate of Need Program, provides a history of the program and a detailed review of its structure and operation. It also identifies several issues related to the program and its impact.

Michigan Hospital Finances: Fiscal Years 1998-2002,
Memo 1075 ( December 2003 ) 16 pages

During the five years from 1998 to 2002, Michigan hospitals in total experienced a steady decline in financial status resulting from growing contractual allowances and discounts, operating expenses which grew faster than net patient revenues, and the effects of a weakened economy on investment and contributory income.

Michigan Hospitals and State Administered Federal Health Insurance Programs: Payments and Participation,
CRC Memo 1069, ( November 2002 ) 16 pages

In the third of a series of papers on Issues on the Financing of Michigan Hospitals, this paper discusses state payments to Michigan hospitals for state administered health insurance programs.

Health Insurance Coverage and Uninsured/Uncompensated Care in Michigan Hospitals,
CRC Memo 1061, ( June 2002 ) 12 pages

In the second of a series of papers on Issues on the Financing of Michigan Hospitals, this paper discusses the number of uninsured persons in Michigan, the sources of health insurance, and the charges and costs that hospitals incur as a result of uninsured and uncompensated care.

Michigan Hospital Finances,
CRC Memo 1060, ( June 2002 ) 12 pages

In the first of a series of papers on Issues on the Financing of Michigan Hospitals, this paper quantifies the surplus or deficit incurred by 151 hospitals for fiscal years ending in 1998 and 2000. The paper considers sources of hospital revenues and relevant expenditures that lead to the ending financial positions.

PDF File Proposed New Federal Medicaid Funds for Michigan
CRC Note 2002-01 ( April 2002 ) 2 pages

An analysis of the Governor's plan to implement a health care quality assurance program using funds from Qualified Health Plans and nursing homes to provide a new source of state Medicaid matching monies.

Improving State Appropriation Control over the Resident County Hospitalization Program,
Misc. ( December 1987 ) 7 pages

Michigan counties provide hospitalization coverage for indigents under a state mandate. The state actually pays the hospital bills for participating counties and requires those counties to pay back a share of the costs; however, appropriation controls in the executive branch do not effectively enforce the payback requirement. This paper describes the steps that could bring adequate fiscal control.

PDF File Regulation and Competition: Can They Be Used Together to Contain Health Care Costs?
Report 278, ( August 84 ) 14 pages

The problem of balancing concerns for equity and for efficiency is raised graphically by these two essays. Can we allow market forces to bring greater efficiency to the health care system without at the same time threatening the ability of those least able to pay to secure needed services? On the other hand, can we continue to support a system of care in which subsidies, hidden and direct, and regulation prevent economic discipline from removing inefficient producers of care from the market and lead to an ever-increasing burden on the economy?

Change In Eloise Board Proposed
CC 620 ( July 54 ) 2 pages

Officials at Eloise and members of the county board of supervisors requested that an administrative survey be made of the entire institution. A special committee of the county board of supervisors asked the Citizens Research Council to undertake the survey. The survey was drafted by the Council with the assistance of professional hospital consultants and was presented to the committee by the Research Council in March, 1954. the key recommendations concerned the board of county institutions itself, since it is this board which by law has charge of the institution.

Wayne County General Hospital

CC 920, pdf File Ballot Issues: Wayne County: Proposition J -- A Separate and Fixed Tax Limit of 18 mills; Propositions K, L, & M--Extra-Voted Millage; Detroit: Proposal Y -- 3.5 Mills Extra-Voted for the Detroit Schools ( October 80 ) 5 pages

Change In Eloise Board Proposed
CC 620 ( July 54 ) 2 pages

Officials at Eloise and members of the county board of supervisors requested that an administrative survey be made of the entire institution. A special committee of the county board of supervisors asked the Citizens Research Council to undertake the survey. The survey was drafted by the Council with the assistance of professional hospital consultants and was presented to the committee by the Research Council in March, 1954. the key recommendations concerned the board of county institutions itself, since it is this board which by law has charge of the institution.

Health Centers & Neighborhood Services

Maternal & Child Health (includes immunizations)

Public Health Nursing, Home Nursing

Public Employment, Civil Service, and Personnel

Statewide Ballot Issue: Proposal 2012-04
Establishing the Michigan Quality Home Care Council and
Provide Limited Collective Bargaining Rights to Home Health Care Workers

Memo 1119 ( September 2012 ) 7 pages

This is an analysis of a proposed constitutional amendment to provide limited collective bargaining rights to home health care workers and to establish a Michigan Quality Home Care Council. Proposal 2012-04 will appear on the November 6, 2012 statewide ballot.

The elderly or disabled beneficiaries of the Medicaid-funded Home Help Services Program employ home health care aides, who are often family members or friends, to assist them to stay in their own homes and out of nursing homes. While the aides are hired and fired by the program enrollees, they are paid by the Michigan Department of Community Health through the state and federally funded Home Help Services Program. That program will not be affected by the vote on Proposal 2012-04.

If Proposal 2012-04 is approved, the Michigan Quality Home Care Council would be established in the state constitution and would serve as the "public employer" of home health care aides for purposes of collective bargaining on wages and terms and conditions of employment. The Council would create a statewide registry of home health care aides, though patients would not be required to hire from that registry. The Council could offer training to aides and patients. This union-supported constitutional amendment would guarantee the collective bargaining rights of home health care aides (currently, only state police troopers and sergeants have collective bargaining rights enshrined in the state constitution), but aides would not be considered state employees for any other purpose, and would not be authorized to strike.

Medical Professions Regulation & Manpower

Medical Care Cost & Regulations (Medicare & Medicaid)

Proposal 2008-02: Human Embryonic Stem Cell Research
Report 353 ( October 2008 ) 23 pages

Michigan would join 47 other states in permitting research on human embryos and the creation of new embryonic stem cell lines in Michigan if Proposal 2008-02 is adopted by the voters on November 4. Current Michigan law is among the most restrictive in the nation. It prohibits non-therapeutic research that jeopardizes the life or health of a human embryo, fetus, or neonate, thereby precluding research on embryos to derive human embryonic stem cell lines. Researchers may, however, conduct research on embryonic stem cell lines created outside of Michigan and may study adult stem cells. The Citizens Research Council of Michigan has released its analysis of the proposed constitutional amendment that would remove these prohibitions.

Embryonic stem cells are derived from embryos by in vitro fertilization. A greater number of embryos are produced than are necessary or suitable for implantation resulting in "excess" embryos.

"Fertility patients have four options for these embryos," said Jill Roof, CRC research associate. "They can store them, donate them to others seeking fertility treatment, discard them as medical waste, or donate them to research. If Proposal 2008-02 passes, Michigan scientists will be able to conduct research using donated embryos and derive their own embryonic stem cells rather than relying on those from other states that may not meet their needs."

The analysis covers many issues surrounding embryonic stem cell research raised by both proponents and opponents and provides a ready reference for the various kinds of stem cells studied in regenerative medicine.

Proposal 2008-02: Human Embryonic Stem Cell Research
Memo 1088 ( October 2008 ) 6 pages

Summarizes Report 353

PDF File The Michigan Certificate of Need Program,
Report 338, ( February 2005 ) 68 pages

The Certificate of Need program is the subject of a new report by the Citizens Research Council of Michigan. Although CON was once encouraged and partially financed by the federal government, that changed in 1986 and fourteen states have since dropped the program. The remaining states, including Michigan, that have retained CON operate over a range of stringency in requirements and comparisons are difficult. The CRC report, The Michigan Certificate of Need Program, provides a history of the program and a detailed review of its structure and operation. It also identifies several issues related to the program and its impact.

pdf File State Ballot Proposals - I: Proposal A -- Medicaid Funding, Abortions; Proposal B -- Crime Victims "Bill of Rights",
CC 974, ( September 88 ) 4 pages

Analyzed the abortion funding and crime victims rights proposals which were on the statewide ballot at the November 1988 general election.

Mental Health

Report 318, pdf File Funding Community Mental Health in Michigan, Defines objectives and criteria for establishing a new funding formula whereby CMH dollars are distributed in a more equitable manner and which facilitates a move to managed care. ( January 97 ) 24 pages [232,902 bytes]

Misc., pdf File Wayne County Proposal #3: Request for One-Half Mill for Health Services ( October 92 ) 2 pages [7 KB]

Misc., pdf File Wayne County Proposal for a One-Half Mill Increase to Fund Health and Mental Health Programs ( July 92 ) 2 pages [5 KB]

Change In Eloise Board Proposed
CC 620 ( July 54 ) 2 pages

Officials at Eloise and members of the county board of supervisors requested that an administrative survey be made of the entire institution. A special committee of the county board of supervisors asked the Citizens Research Council to undertake the survey. The survey was drafted by the Council with the assistance of professional hospital consultants and was presented to the committee by the Research Council in March, 1954. the key recommendations concerned the board of county institutions itself, since it is this board which by law has charge of the institution.

Mental Retardation

Narcotics, Drug Addiction

Proposal 2008-01: Medical Marijuana
Report 352 ( September 2008 ) 16 pages

Proposal 2008-01 on the November 4 statewide ballot would make Michigan the first state in the Midwest to legalize the use of marijuana for medical purposes. This was one of the findings of the analysis of the proposal released today by the Citizens Research Council of Michigan.

The proposal would seek to protect qualified patients and physicians from arrest and other penalties for using or recommending marijuana for medical purposes. It would require the Michigan Department of Community Health to administer a medical marijuana registry and permit a primary caregiver to provide marijuana to patients upon written certification by a physician. No patient could have more than one caregiver and no caregiver could assist more than five patients.

The law would not legalize recreational use of marijuana and there is no convincing evidence from other states that legalization of medical marijuana has led to an increase in illicit use.

If adopted, the law would create a potential for conflict with federal drug laws in Michigan, although federal law enforcement tends to be limited to manufacture and sale, rather than use.

Alcoholism

Environmental Sanitation (Water Pollution, Air Pollution)

Health Research

 

 

 

Adobe Format

Downloadable CRC publications are provided in Adobe Acrobat's Portable Document Format (pdf). Access to these files requires use of Acrobat Reader. This software is available at no cost from the Adobe.

Acrobat and the Acrobat logo are trademarks of Adobe Systems Incorporated..

 

 

 

Last Updated November 17, 2014