Unbiased Analysis of Today's Healthcare Issues
The Scientific American magazine has an interesting article (“Science 2.0“) about the web, open-access, blogging and research. Should researchers post their results online? Should scientists blog about their methodology? Pros It seems like academic research is the perfect forum for social networking and blogging. The sharing of ideas is a key means towards scientific invention/innovation.…
Differences in the health outcomes between white and minority patients has been well documented in the medical and economics literature. Reasons for this difference could be: Unequal access to treatment. Minorities are poorer and less likely to be covered by insurance than whites. Unequal treatment – Minorities are less likely to have a regular doc,…
Economists and health researchers have generally shown that when doctors are paid on a fee-for-service basis, they will advice the patient to undergo more medical procedures than when the doctor is paid on a capitation or salaried basis (see my own paper: “Operating on Commission“). Which payment method maximizes welfare has not been proven and…
In February of 2007, the UK’s Office of Fair Trading (OFT) recommended reform to Britain’s current Pharmaceutical Price Regulation Scheme (PPRS). The PPRS sets maximum and minimum profit levels from the sale of branded drugs to the NHS. The PPRS allows companies freedom to set prices as they please on new substances, but restricts subsequent…
I recently read a Health Affairs article analyzing a pay-for-performance (P4P) demonstration. The Local Initiative Rewarding Results (LIRR) demonstration in California involved seven Medicaid-focused health plans in California between 2003 and 2005. Here are some of my most recent thoughts on P4P: The article seemed to show that P4P worked best when there was much…
Recently, there has been much controversy regarding whether or not the RAND Health Insurance Experiment (HIE) results are truly robust. Many blogs have been questioning the results (see here, here and here). One of the major conclusions of the HIE are that higher co-insurance rates lead to lower levels of medical utilization and lower medical…
Traditional instrumental variables (IV) econometric methodologies often fail to take into account response heterogeneity. Response heterogeneity based on characteristics not observed by the researcher can create a heterogeneity in the self-selection process. For instance, one group of people who elect to receive surgery may have knowledge of a family history where surgery is typically successful,…
Many people believe that better information technology (IT) can help improve the quality of medical care in the U.S. and around the world. For instance, if a doctor prescribes a drug which interacts harmfully with a drug the patient is already taking, a computer program could notify the doctor of this problem. If a patient…
Many studies have revealed patient non-compliance with medical prescriptions (e.g.: not taking prescribed drugs, not visiting the doctor) at around 50%. Most medical researchers believe that non-adherence is either due to 1) irrationality or 2) misinformation. Yet a Health Economics article by Lamiraud and Geoffard (2007) tests the hypothesis of whether or not this behavior…
Revascularization (bypass surgery or angioplasty) have been frequently used procedures to treat patients who have experienced a myocardial infarction (MI). These procedure are expensive, but are supposed to enhance longevity. Do they? This is the question analyzed by David Cutler in his NBER working paper titled “The Lifetime Benefits of Medical Technology.” The problem with…