Why shopping for health insurance is hard

The premise is simple.  Create markets, let consumers choose the products that fit them best, and the competition will lead to higher quality and lower prices.  That is the premise behind the Affordable Care Act’s health insurance exchanges.  A necessary condition for this to work, however, is that patients have visibility into the quality and…

The Next Big Growth Industry is…

the ‘second opinions’ industry. Currently, many people have an almost religious trust in their doctor’s recommendation. “A 2010 Gallup poll found that 70% of Americans are so respectful of their doctor’s advice that they never get a second opinion or do additional research.” This finding is despite the fact that medical errors may cost the…

Value-Based Cost Sharing

Many policy experts have been proponents of value-based cost sharing.  Under value-based cost sharing, medical care that is seen to provide a higher marginal benefit to the patient will have lower coinsurance rates than medical care with lower marginal benefits.  If value-based cost sharing would be implemented, preventive care should have low coinsurance rates because…

Learning and Drug Diffusion

How do doctors know which drugs to give to which patients?  Of course there are clinical trials giving the relative efficacy of each drug.  With less than perfect adherence, however, clinical trials may not accurately predict a drug’s efficacy or the potential side effects. A paper by  Chintadunta, Jiang and Jin (2008) look at two…

Optimal Contracts in the British NHS

One of the perennial questions of interest for health services researchers how to pay for health care.  A paper by Chalkley and McVicar (2008) examines this question in the contest of a reform in Britain’s National Health Service (NHS). “After 1990 hospitals, which had previously been under the direct control of Health Authorities, could apply for NHS…

Insurance Markets and Advantageous Selection

Adverse selection is often seen as a major impediment to the efficient functioning of insurance markets. Rothschild and Stiglitz (1976) create a model where high risk people buy full insurance while low risk individuals buy partial insurance. Yet empirically, one finds that in some insurance markets, low risk individuals purchase more insurance than high risk…