Category: Uncategorized

That is a claim by a recent JAMA article by Shrank et al. (2020). The Incidental Economist has a nice video explaining their findings. Of the $760 billion in total waste, the largest component is administration and billing, costing $266 billion. There is an easy way to eliminate most of this waste: eliminate insurance. If…

The central proposition of the Grossman model (Grossman 1972) is that health can be viewed as a durable capital stock that produces an output of healthy time. It is assumed that individuals inherit an initial stock of health that depreciates with age and can be increased by investment. The model is similar to human capital…

Drug pricing and broader quality of life. What are ‘dark antigens’? Did ACA increase sexually transmitted infections? Mystery shopping for HIV testing.  California youth in mental health crisis.

That is the title of an article by my colleagues Anupam B. Jena, Rebecca Kee, James R. Baumgardner and others in an article published this month in Harvard Business Review. While the FDA has created “Breakthrough” designations for drug approvals, getting innovative, but high-priced drugs to patients is often delayed by hurdles in coverage and…

Bernie Sanders and others are advocating a Medicare for All system.  At first glance this is a sensible approach.  Why not allow the government to provide equitable health insurance coverage for all?  Don’t we want to let all Americans have high quality care?  Why not use the power of the federal government to help negotiate…

How does one select health state utilities used to populate a cost effectiveness model? This can be a challenge as outlined in Brazier et al. (2019): Selecting evidence in an ad hoc manner results in unjustifiable conclusions and raises the possibility of cherry picking. For consistency within a model, utility data on all health states…

Clinical trials aim to measure how different treatments affect outcomes of interest to patients.  In many cases, however, measuring the ultimate outcomes of interest proves logistically difficult.  For instance, measuring overall survival for some oncology patients may be impractical if survival for the standard of care is long since the required time and expense to…

Economic theory would say that in normal markets, the answer is yes. When prices are widely known, suppliers can compete on prices–as well as quality–and markets become more efficient. In the health care setting, however, a key question is ‘which price’? For hospital services, patients are the ultimate consumers of the service and do pay…

At least that is the finding from a study in the UK from Parkinson et al. (2019): We investigate hospital responses to a 32% increase in price for two treatments in emergency departments in England in April 2011 using data on 11,532,304 attendances (79 hospitals) between 2009/2010 and 2013/2014. We compare changes in the volumes…