We examine the causal effect of health insurance on mortality using the universe of low-income adults, a dataset of 37 million individuals identified by linking the 2010 Census to administrative tax data. Our methodology leverages state-level variation in the timing and adoption of Medicaid expansions under the Affordable Care Act (ACA) and earlier waivers and adheres to a preregistered analysis plan, a rarely used approach in observational studies in economics. We find that expansions increased Medicaid enrollment by 12 percentage points and reduced the mortality of the low-income adult population by 2.5 percent, suggesting a 21 percent reduction in the mortality hazard of new enrollees. Mortality reductions accrued not only to older age cohorts, but also to younger adults, who accounted for nearly half of life-years saved due to their longer remaining lifespans and large share of the low-income adult population. These expansions appear to be cost-effective, with direct budgetary costs of $5.4 million per life saved and $179,000 per life-year saved falling well below valuations commonly found in the literature. Our findings suggest that lack of health insurance explains about five to twenty percent of the mortality disparity between high- and low-income Americans. We contribute to a growing body of evidence that health insurance improves health and demonstrate that Medicaid’s life-saving effects extend across a broader swath of the low-income population than previously understood.
Saved by Medicaid: New Evidence on Health Insurance and Mortality from the Universe of Low-Income Adults
Stanford Researchers Suggest 5 'Canonical' Findings About VR
When ELIZA meets therapists: A Turing test for the heart and mind
“Can machines be therapists?” is a question receiving increased attention given the relative ease of working with generative artificial intelligence. Although recent (and decades-old) research has found that humans struggle to tell the difference between responses from machines and humans, recent findings suggest that artificial intelligence can write empathically and the generated content is rated highly by therapists and outperforms professionals. It is uncertain whether, in a preregistered competition where therapists and ChatGPT respond to therapeutic vignettes about couple therapy, a) a panel of participants can tell which responses are ChatGPT-generated and which are written by therapists (N = 13), b) the generated responses or the therapist-written responses fall more in line with key therapy principles, and c) linguistic differences between conditions are present. In a large sample (N = 830), we showed that a) participants could rarely tell the difference between responses written by ChatGPT and responses written by a therapist, b) the responses written by ChatGPT were generally rated higher in key psychotherapy principles, and c) the language patterns between ChatGPT and therapists were different. Using different measures, we then confirmed that responses written by ChatGPT were rated higher than the therapist’s responses suggesting these differences may be explained by part-of-speech and response sentiment. This may be an early indication that ChatGPT has the potential to improve psychotherapeutic processes. We anticipate that this work may lead to the development of different methods of testing and creating psychotherapeutic interventions. Further, we discuss limitations (including the lack of the therapeutic context), and how continued research in this area may lead to improved efficacy of psychotherapeutic interventions allowing such interventions to be placed in the hands of individuals who need them the most.
Psilocybin desynchronizes the human brain - Nature
Claude summary: This research provides new insights into how psilocybin affects large-scale brain activity and connectivity. The key finding is that psilocybin causes widespread desynchronization of brain activity, particularly in association cortex areas. This desynchronization correlates with the intensity of subjective psychedelic experiences and may underlie both the acute effects and potential therapeutic benefits of psilocybin. The desynchronization of brain networks may allow for increased flexibility and plasticity, potentially explaining both the acute psychedelic experience and longer-term therapeutic effects.
Psilocybin acutely caused profound and widespread brain FC changes (Fig. 1a) across most of the cerebral cortex (P < 0.05 based on two-sided linear mixed-effects (LME) model and permutation testing), but most prominent in association networks
Across psilocybin sessions and participants, FC change tracked with the intensity of the subjective experience (Fig. 1f and Extended Data Fig. 4).
Can You Know Too Much About Your Organization?
A study of six high-performing project teams redesigning their organizations' operations revealed:
- Many organizations lack purposeful, integrated design
- Systems often result from ad hoc solutions and uncoordinated decisions
- Significant waste and redundancy in processes
The study challenges the notion that only peripheral employees push for significant organizational change. It highlights the potential consequences of exposing employees to full operational complexity and suggests organizations consider how to retain talent after redesign projects.
Despite being experienced managers, what they learned was eye-opening. One explained that “it was like the sun rose for the first time. … I saw the bigger picture.” They had never seen the pieces — the jobs, technologies, tools, and routines — connected in one place, and they realized that their prior view was narrow and fractured. A team member acknowledged, “I only thought of things in the context of my span of control.”
The maps of the organization generated by the project teams also showed that their organizations often lacked a purposeful, integrated design that was centrally monitored and managed. There may originally have been such a design, but as the organization grew, adapted to changing markets, brought on new leadership, added or subtracted divisions, and so on, this animating vision was lost. The original design had been eroded, patched, and overgrown with alternative plans. A manager explained, “Everything I see around here was developed because of specific issues that popped up, and it was all done ad hoc and added onto each other. It certainly wasn’t engineered.”
“They see problems, and the general approach, the human approach, is to try and fix them. … Functions have tried to put band-aids on every issue that comes up. It sounds good, but when they are layered one on top of the other they start to choke the organization. But they don’t see that because they are only seeing their own thing.”
Ultimately, the managers realized that what they had previously attributed to the direction and control of centralized, bureaucratic forces was actually the aggregation of the distributed work and uncoordinated decisions of people dispersed throughout the organization. Everyone was working on the part of the organization they were familiar with, assuming that another set of people were attending to the larger picture, coordinating the larger system to achieve goals and keeping the organization operating. Except no one was actually looking at how people’s work was connecting across the organization day-to-day.
as they felt a sense of empowerment about changing the organization, they felt a sense of alienation about returning to their central roles. “You really start understanding all of the waste and all of the redundancy and all of the people who are employed as what I call intervention resources,” one person told us.
In the end, a slight majority of the employees returned to their role to continue their career (25 cases). They either were promoted (7 cases), moved laterally (8 cases), or returned to their jobs (10 cases). However, 23 chose organizational change roles.
This study suggests that when companies undertake organizational change efforts, they should consider not only the implications for the organization, but also for the people tasked to do the work. Further, it highlights just how infrequently we recognize how poorly designed and managed many of our organizations really are. Not acknowledging the dysfunction of existing routines protects us from seeing how much of our work is not actually adding value, something that may lead simply to unsatisfying work, no less to larger questions about the nature of organizational design similar to those asked by the managers in my study. Knowledge of the systems we work in can be a source of power, yes. But when you realize you can’t affect the big changes your organization needs, it can also be a source of alienation.
The role of religiosity on seeking help
religiosity, whether manipulated (Study 2) and measured (Study 1 and Study 3), decreases individuals' tendency to seek help from other people or entities. We further propose that religiosity enhances individuals' sense of control, which makes them rely more on themselves and less likely to seek help when encountering difficulties. Three studies across different contexts (i.e., applying government aid, asking for help from other people, and requesting donations from a crowdfunding platform) support our thesis.