Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly

The RAND health insurance experiment (HIE) demonstrated that increasing coinsurance rates decreases medical care utilization. The HIE also found that health outcomes did not vary between individuals with high, low and zero coinsurance rates. A working paper by Chandra, Gruber and McKnight (“Patient Cost Sharing…“) re-examines whether or not this is the case using a…

Government Expenditures and Health Outcomes

Do increases in government spending affect health outcomes? While this seems like a simple question, proving whether or not spending impacts outcomes is difficult. There are questions of reverse causality: the governments of countries or regions with more serious health problems ceteris paribus may decide to increase their allocation of health spending; thus one may…

Reauthorizing SCHIP

Politicians are faced with a serious dilemma in the near future: reauthorize the State Children’s Health Insurance Program (SCHIP) and spend billions of dollars on a single-payer government health program or fail to renew the program and leave many children uninsured and many constituents angry. The Kaiser Family Foundation reports (“Several Lawmakers…“) that the SCHIP…

Crowd Out

In recent years, the federal government has attempted to increase access to government provided health insurance. Between 1984 and 2004, the percentage of non-elderly individual with government provided health insurance rose from 13.5% to 17.5%. Over the same time period, however, the percentage of American without health insurance also rose from 13.7% to 17.8%. In…

Decrease price…increase supply?

In a typical market, an increase in the consumers’ willingness to pay will increase price and increase quantity (see graph).  On the other hand, a decrease in willingness to pay will decrease price and decrease quantity.  This axiom of economics does not hold in the health care market; at least not according to a 1998…

Eye of Newt

Ever wonder what Newt Gingrich is up to?  You may be surprised to learn that he’s working to change healthcare in the U.S.  Mr. Gingrich has founded the Center for Health Transformation.  On the Consumer Health World Blog, Gingrich proposes dividing Medicaid into 3 different programs. Capabilities Program – This program would help both Americans…

Adverse Selection and the purchase of in Medigap Insurance

Jason has insurance and his brother Nosaj does not.  Jason utilizes more medical services than Nosaj.  Is this situation occuring because Jason is truly sicker than Nosaj (adverse selection), or is this because since Jason has insurance, medical services are cheaper for him than Nosaj (moral hazard)?  Disentangling the problems of moral hazard and adverse selection…

Medicare Fraud: $630 million

Why is publicly provided health care so expensive?  One reason is the the fraud which is bound to occur.  The New York Times reports (“Hospital Grew…“) that New Jersey’s largest health care provider–St. Barnabas Health Care System–bilked $630 million from the federal government between 1995 to 2003.  Medicare pays extra cash to hospitals for the…