Unbiased Analysis of Today's Healthcare Issues
Getting sick creates risk over two dimensions. First, you risk getting sick which of course decreases your utility. Second, getting sick impacts you financially as (i) medical procedures are often expensive and (ii) if you can’t work due to your illness your income may fall. With respect to financial risk, health insurance may provide a…
The answer should be ‘yes’. From an economist’s perspective, prices for goods and services should generally be set at marginal cost unless there are externalities. In the case of COVID-19, there are clear externalities. By finding out that someone is COVID-19 positive, one could not only treat the patient (not an externality) but also the…
There is a large literature on this topic including fairly recent work from the Oregon Health Insurance Experiment (see Finkelstein et al. (QJE 2012), Baicker et al. AER 2014, Finkelstein et al. JPE 2019). Many of these studies look at the population level; as the majority of people are healthy, the incremental benefit for health…
According to Chambers et al. (2019), the answer varies widely depending on the health plan. The authors use a data from the Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database. 203 specialty drugs issued by 17 of the 20 largest US commercial health plans are included in the database. This study examines nearly…
Last week I reviewed a paper the sought to understand why people don’t buy health insurance. A key finding was that there health insurance purchase was correlated with income, but not perfectly. One reason was that the cost of other goods–especially housing–affected individuals ability to purchase insurance. The paper was getting at whether health insurance…
The simple answer is, they can’t afford it. This may be a good argument for low-income individuals but for middle class and even upper middle class individuals we see people going without health insurance. The question is why. If income was the whole story, we would observe different incomes levels would have closer to 100%…
According to a February 2019 report, the Council of Economic Advisors proposes to improve health insurance markets through three key policies: Eliminate the individual mandate Permitting more small businesses to form Association Health Plans Expanding short-term, limited-duration insurance (STLDI) plans The report claims that these changes will generate $450 billion in social surplus over the…
In 2010, Premera Blue Cross (Premera), a large nonprofit health plan in the Pacific Northwest implemented a value-based formulary design for its beneficiaries. In essence, enrollees could purchase high-value treatments for low copayments and low-value treatments for higher copayments. Can we use this change from more standard to value-base formulary designs to estimate the price elasticity…
Alain Einthoven is the father of managed competition. In a recent Health Affairs article, he and Laurence C. Baker look ]at managed competition in California and ask whether the standard conception of managed competition needs to be altered. Before we get to the article, we first need to ask a basic question: what is managed competition? The…
Competition matters for markets…even health care markets. A paper by Van Parys (2018) relies on a database of plan premium and market characteristics among states with federally-facilitated health insurance exchange Marketplaces. In this analysis, she finds that: In 2018, Marketplace premiums were 50 percent ($180) higher, on average, in rating areas with monopolist insurers, compared…