October 24, 2011
Host: Ted Simons
100 Years 100 Ranchers
- Scott Baxter’s photographic essay of 100 ranchers whose families have been ranching in Arizona since 1912 or earlier is on exhibition at Sky Harbor Airport (Terminal Four, Level Three) through mid May 2012. Follow Scott Baxter as he photographs the Amado family at their ranch in southern Arizona.
, amado family
Domestic Violence: Address Confidentiality
- The new “Address Confidentiality Program” allows victims of domestic violence to keep their residential addresses confidential by substituting the address of the Secretary of State’s Office. Betty McEntire, the program’s first Executive Director, explains how the program works.
- Betty McEntire - First Executive Director,Address Confidentiality Program
| Keywords: domestic violence
, Address Confidentiality Program
Ted Simons: October is Domestic Violence Awareness Month. And Arizona has a new way to help protect abuse victims. It's called the Address Confidentiality Program and it lets victims of domestic violence use the Arizona Secretary of State's office as their mailing address. Here with more on the program is its new Executive Director Betty McIntyre, the former training coordinator for the Arizona Coalition against Domestic Violence. Good to have you here, thank you so much for joining us. A better definition of this particular program.
Betty McEntire: This program will do -- actually you have two functions. One provides a substitute mailing address as you stated- the secretary of state's office. And the second component is a mail forwarding service. It's another layer of a safety plan for victims of domestic violence, sexual offenses and stalking.
Ted Simons: And I guess all of those factors come into play when you don't change your address. You are where you always were.
Betty McEntire: One of the key aspects of this program once it's up and running will be about victims of those crimes who are being stalked by their perpetrator. Needing to relocate to a new address. The program is not going work if you stay in the home in which your perpetrator knows where you live, it kind of defeats the purpose of limiting your ability to be found.
Ted Simons: Sure.
Betty McEntire: So it's protecting all your public records by utilizing that mailing address. Instead of putting your real address of where you actually live you would put the designated substitute address.
Ted Simons: Abuse victims can get the secretary of state's office as basically mail forwarded there? How long does this last?
Betty McEntire: Once we start enrolling participants, all potential applicants need to apply through what we're calling an application assistant, a specialized trained domestic violence or sexual violence advocate who understands the safety measures of that victimization. And then once they apply and are certified into our program, we will provide them their substitute address, that participant will go and write out their address on any application or any information asking for a residential work or school address. Any mail that will be sent to a normal physical location like your home, if you are a participant, instead of your mail going to your house, it would come to me first. I would forward that mail back to your real address. No one knows your address for myself.
Ted Simons: So it's not a bunch of folks standing in line at secretary of state’s office trying to pick up their mail?
Betty McEntire: No, not at all. I will be the only person who knows your real address.
Ted Simons: How much is this expected to cost the state?
Betty McEntire: We are anticipating our program to be fairly small due to the fact that all of our budgets are estimated off the $50 fine that will be levied against persons convicted under certain statutory offenses like domestic violence and stalking.
Ted Simons: So the $50 assessment goes to this particular program?
Betty McEntire: Correct. If you're convicted of let's say 133601, a domestic violence statute, it's a tax statute. If you are convicted the judge will order an additional fine of $50. $45 of that comes to my program to facilitate and pay for the postage, envelopes, mailing, and 5% to the Clerk of the Court for administrating the funds.
Ted Simons: This was passed by the legislature this last session, correct?
Betty McEntire: Correct. It was signed into law April 19th by the governor.
Ted Simons: Are there other states doing this? Is it a model somewhere else that you looked at and said, “Hey, this isn't a bad idea?”
Betty McEntire: Yes, we're the 27th state to have a full address confidentiality program. Ours was particularly modeled after the Colorado address confidentiality program. Washington state, for example, theirs has been around for 20 years doing that. There's a variety of states doing this.
Ted Simons: Time to get on the ball and figure this thing out.
Betty McEntire: That’s right. We're really happy that the state legislature and the Governor passed and signed it into law.
Ted Simons: What are your duties now as the program's very first executive director?
Betty McEntire: Right now we're meeting with the state and local government entities impacted by this address confidentiality program. Once everyone is informed about the program, we'll go and we will be training applicant assistants across the state. Once that all happens it's going to be the day-to-day monitoring of receiving mail, forwarding the mail. It'll be our commitment that there's only a slight delay. So mail in, mail out, same day. So no one's impacted by being involved in this program.
Ted Simons: You represent the secretary state's office in domestic violence and domestic abuse cases in general, correct?
Betty McEntire: I will be serving as a representative to the domestic violence and sexual assault community through the secretary of state’s office so being able to sit on the task force and the committees.
Ted Simons: How can this program make a real difference for domestic violence victims?
Betty McEntire: That's actually a really great question. One of the things that’s very important for anyone thinking about enrolling in any address confidentiality program is understanding its limitations. This is not a catch-all, be-all program. We can't do that, especially in this day and age of technology. But if we can limit, if the participant can limit the ability of having their physical address placed on Google Maps, and it's the secretary of state's office, then it's going prevent we hope an abuser from stalking them and causing further harm. It's another tool for their tool chest.
Ted Simons: You mentioned how folks would enroll in this and kind of move down the chain, down the line. Can folks currently enroll in this program?
Betty McEntire: Not at this point. We are hoping to get it open for business by spring of next year.
Ted Simons: All right.
Betty McEntire: That is our goal.
Ted Simons: Until then we've got a website up there. If you go to the website you can get more information on this. If you are thinking about some sort of action in the future, making a move in the future go, to the website and write the website down, bookmark it, whatever you've got to do, because then the information will come out.
Betty McEntire: I would actually encourage anyone looking at this to not bookmark it quite yet. For safety reasons.
Ted Simons: I gotcha, boy you really have to think about this don’t you?
Betty McEntire: Memorize the address and we can get you connected with advocates.
Ted Simons: You have quite a bit of background in this issue, don't you?
Betty McEntire: 15 years.
Ted Simons: Good thing for Arizona?
Betty McEntire: I think it's a great thing.
Ted Simons: Good to have you.
Betty McEntire: Thank you very much.
- New research from the W. P. Carey School of Business at ASU is shows that the Medicare Part D program is preventing wasteful spending on health care. The study’s lead author, Jonathan Ketcham, talks about the research and its implications for health care in general.
- Jonathan Ketcham - Lead Author, Medicare Part D Program
| Keywords: Medicare
, health care
Ted Simons: Good evening, and welcome to "Horizon," I'm Ted Simons. Consumers can save money on health care when given numerous private insurance options. That's one of the findings in a recently published study of “Medicare Part D.” A federal program that gives Medicare beneficiaries a menu of options for prescription drug coverage. Joining me to talk about the study is its lead author ASU professor Johnathan Ketchum of the W.P. Carey School of Economics. Good to have you here. Thanks for joining us. Is that what Medicare Part D is?
Jonathan Ketcham: Part D is the stand-alone prescription program created in 2006. A lot of seniors were left to pay for prescription drug costs out of pocket. The government created a new program where people were left to choose from private insurance companies competing for their business rather than having a standard “one size fits all” much like traditional Medicare.
Ted Simons: And your study looked at this why?
Jonathan Ketcham: You know, I think early on there were a lot of thought leaders declaring this a failure even before the data had come in. Dan McFadden, Noble Prize winner as well as Paul Krugman, other luminaries such as Stephen Colbert mocking the design and the fact that people were left to choose on their own, the thought was this was an older population left to use online Internet-based tools to choose from really complicated products. There was widespread fears it would be too confusing and hard, and companies would be able to profit by selling not good products but by confusing the consumers.
Ted Simons: What did your study find?
Jonathan Ketcham: One of the important features of the data is we were able to look at how people's choices changed over time. In 2006, this was a brand-new market. Nobody had any experience or had made a choice like this exactly before. So we predicted perhaps in 2006 people made mistakes but they corrected them by 2007. That's exactly what we found. People were leaving money on the table in the first year of the program, and they were quickly correcting that the next year.
Ted Simons: Looking at anything in 2006 or 2007 would be a different beasts I would imagine from looking at it now. How much did economic conditions back then and economic conditions now, how does that change the variable? How does it change the dynamic?
Jonathan Ketcham: If anything, it actually has made people more sensitive to those costs. It likely has made them pay even more attention and choose even more effectively. The general framework of the program is the same. Consumers are allowed and left to choose on their own. One of the big differences with Part D, people now have five years of experience on this program and maybe know how to evaluate plans better.
Ted Simons: You mentioned people choosing more carefully. Are they choosing more carefully? Because again, one of the criticisms is you give folks an option, they will go for the cheapest or something that may not be enough for what they need.
Jonathan Ketcham: That's the prevailing wisdom, at least before our study took it to the data. People just paid attention to premiums. Perhaps people were buying plans that were way too stingy, and we found that wasn't the story. People were able to lower their total spending between the first year and the second year of the program.
Ted Simons: Participation higher than expected, correct?
Jonathan Ketcham: It was. It didn't come from our study, but our study was building on the prior evidence about how Part D proceeded.
Ted Simons: Expanded drug use, correct?
Jonathan Ketcham: To some degree yes.
Ted Simons: And why do we think that is? Because people figured it out?
Jonathan Ketcham: Because insurance lowers the cost and increased access. That was one of the stated goals of the program.
Ted Simons: A higher level of consumer satisfaction was noted. What does that mean and how was it measured?
Jonathan Ketcham: Again, those are from other studies outside of our study. We were sort of building on that evidence. They were asking consumers, how happy are you with your plan, your choice?
Ted Simons: From what you looked at and from what the other studies where everything was kind of gathered together, what kind of sample size was used?
Jonathan Ketcham: We looked at 72,000 people enrolled in a plan either sold or administered by CVS Caremark which is one of the big three prescription drug managers. They were kind enough to share those data with us to look under the hood a little bit. We combined that with data from CMS, the government agency that actually runs these plans. Then we could generate an estimate of what everybody would have spent under every plan available to them. So we could see how well their actual choice was compared to the full range of options given the drugs they were consuming.
Ted Simons: The over spending was reduced by?
Jonathan Ketcham: $300 on average. Four out of five people shared on those gains. Those are very large and widespread gains that we found.
Ted Simons: So the bottom line is that folks can make good choices, even folks that might be a little older or infirm or not necessarily of the soundest mind or body, they can make good choices. How do we explain this?
Jonathan Ketcham: What we found was the oldest consumers improved by the most. That was a really surprising result out of this. We also saw consumers taking medication for Alzheimer's disease shared in these gains, too. We couldn't see the choice process but we could see the end result. It's a testament to the role that family members and health care providers and other people are playing in helping some of these populations make good choices.
Ted Simons: So if someone came back and said, “You've got too many folks paralyzed by too many choices here it just doesn't make sense and folks will sit there and not know what to do” how are you going respond to that with what you found?
Jonathan Ketcham: Our data showed people didn't have inertia. They weren’t overwhelmed with too much in this context. Even though I think ahead of time we would have expected this as the very context where consumer confusion would have been prevalent, we didn't find that. People evaluated their plans and switched plans and lowered spending as a result.
Ted Simons: What do we take from all this?
Jonathan Ketcham: Even in health care, people can make good choices. For beneficiaries on Medicare who may be facing open enrollment right now, keep up the good work. If you're feeling overwhelmed reach out to someone. We couldn't see the actions happening but we could see the results of those actions. And it seems like it’s paying off.
Ted Simons: For states trying to figure out the exchanges because of the Health Care Reform Bill, and those things coming up, how does this play into that?
Jonathan Ketcham: Yeah, I think not finding evidence of consumer confusion in Medicare Part D provides some insights both about health insurance reform in general, and other products such as mortgages and credit cards, where we think that perhaps consumers might be confused. The fact that we don't see consumers confusion or being too overwhelmed in this context suggests there are real benefits from allowing people to choose what's the best option for themselves.
Ted Simons: Would you suggest, judging from the study that there are certain regulations that need to be limited but not as focused as they are on these issues?
Jonathan Ketcham: You know, I think I would like to see more widespread evidence as a researcher. I'm always going for more research. I'd like to see more widespread evidence. But at least provoke some thought, “Maybe people really can navigate and find products that are best suited for them.” These plans are really different, and people are really different from each other. Rather than having a government agency restrict choice and try to make this a one size fits all question.
Ted Simons: You've got the government agency and one size fits all, and you’ve got your research showing folks can handle this pretty well on their own. Which still would help more folks?
Jonathan Ketcham: I think it's always a question of bang for your buck. How can we get the most value, this is part of the conversation we're having as a country, how to get the most value out of our individual and government spending. I think we have some tension between these two extremes. Medicare Part D is an interesting blend of the two where the government is relying on private companies and individuals.
Ted Simons: Were you surprised by any of these results?
Jonathan Ketcham: The results showing that the Alzheimer's population and oldest population improved by the most was surprising. I went into this with an open mind to see what this data actually showed to see how people’s choices changed over time.
Ted Simons: All right, very good, thanks for joining us. We appreciate it.
Jonathan Ketcham: Thank you.