Unbiased Analysis of Today's Healthcare Issues
In April 2006, Ontario instituted the Diabetes Management Incentive (DMI) that increased payments to physicians that provided high-quality diabetes care. Did the incentive improve payments quality? According to a paper by Kantarevic and Kralj (2012), it turns out that the answer is yes, but the magnitude of the change depends on the type of physician.…
A few years ago, changing federal laws to lower drug prices was a key political issue. Some proposed allowing Medicare to negotiate lower prices from drug manufacturers and others recommended allowing U.S. citizens to import drugs from lower-priced developed countries such as Canada. These policies would certainly reduce drug prices, however, lower prices could also…
The answer is because using more intensive services does reduce mortality. This is the finding of a recent JAMA paper. After controlling for patient case mix, the authors examine variation in hospital spending in the last year of a patient’s life. The authors note that “Higher-spending hospitals differed in many ways, such as greater use…
Many recent healthcare policies aim to consolidate the provision of medical services. For instance, Accountable Care Organizations consolidate providers with the goal of providing seamless, integrated patient care. Consolidation can increase efficiency and (potentially) drive down prices. If a market is highly concentrated, however, problems in a single supplier can lead to shortages. Consider the…
This blog has posted frequently on comparisons between the U.S. and Canadian healthcare systems (see here, here, here and here). Although there are many points of contention, it is clear that the Canadian system is less expensive than the American. According to the OECD, in 2006 Canada spent $3,678 per person on health care and…
How do hospitals estimate the cost of different inpatient stays? A paper by Clement et al. (2009) reviews 3 techniques: Microcosting. “With microcosting, a detailed list of each component of a patient’s care is created and costed separately for each facet of a patient’s hospitalization. Given the level of detail, microcosting is generally considered the…
Does Social Security work? By that, I mean does giving elderly individuals a government pension increase their level of income, the amount of goods the can consume, or even their happiness? An NBER working paper by Baker, Gruber and Milligan (2009) tries to answer this question in the Canadian setting. Background Currently, Canadian income transfer…
In the U.S. a much higher percentage of medical is paid for out of pocket. Further, there are about 45 million uninsured. In Canada, the government pays for almost all health care. The benefits and costs of a centralized, universal health care system have been discussed previously on this blog (see Oct 2, 2007 and…
Does physician compensation affect the quantity of medical care provided? My paper “Operating on Commission” claims that the answer is yes. I find that surgery rates increase 78% when patients switch from capitation to fee-for-service (FFS) specialists. A paper by Devlin and Sarma (2008) examines a similar question for Canadian family physicians. Since the inception…
Canada has a single payer system but the provinces have the bulk of the responsibility of running the health care system for their own residents. In order to qualify for federal funding, each province must meet the following criteria. Universality. Available to all provincial residents on uniform terms and conditions; Comprehensiveness. Covering all medically necessary…