Reading list

Reforming health care reform in the 112th Congress, by Joseph Antos.

What is value in health care? by Michael Porter.

Putting the value framework to work, by Thomas H. Lee.

Rapidly evolving physician-payment policy — more than the SGR, by Paul Ginsburg.

Social Transformation Twenty Years On, by Paul Starr.

Public and private health-care financing with alternate public rationing rules, by Katherine Cuff, Jeremiah Hurley, Stuart Mestelman, Andrew Muller, Robert Nuscheler.

We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals’ willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random.

Which health conditions cause the most unhappiness? by Carol Graham, Lucas Higuera, Eduardo Lora

This paper assesses the effects of different health conditions on happiness. Based on new data for Latin America, we examine the effects of different conditions across age, gender, and income cohorts. Anxiety and pain have stronger effects than physical problems, likely because people adapt better to one-time shocks than to constant uncertainty. The negative effects of health conditions are very large when compared with the effects of income on happiness. And, while higher peer income typically elicits envy, better peer health provides positive signals for life and health satisfaction. Health norms vary widely across countries.

Information asymmetry and performance tilting in hospitals: a national empirical study, by Jong-Yi Wang, Janice C. Probst, Carleen H. Stoskopf, Jimy M. Sanders, James F. McTigue

Objective: To test the performance tilting hypothesis using information asymmetry (IA) within the community oriented activities of prospective payment system (PPS) hospitals.

Data sources: American Hospital Association (AHA) Annual Survey Database and Medicare Cost Report from the Centers for Medicare and Medicaid Services both in fiscal year 2000; Health maintenance organization (HMO) penetration from the Area Resource File.

Study design: A cross-sectional analysis was performed, using a national sample of 3162 PPS hospitals merged from the AHA data set and Medicare profit data. The individual hospital serves as the unit of empirical analysis. General linear model, multiple and logistic regressions are utilized to examine the association between IA and hospital performance indicators.

Principal findings: A positive relationship between IA and Medicare profit margins was found. Higher IA was associated with decreased likelihood that the hospital would report having a long-term plan for the health of its host community, and with increased likelihood of performance tilting.

Conclusion: Information asymmetry offers hospitals an advantageous position in achieving profit maximization. The study also documented the presence of performance tilting by health-care management. Whether increased information demands from a society accustomed to significant disclosure will reduce this agency problem is not yet clear.

[Book] The End of Influence: What Happens When Other Countries Have the Money, by Brad DeLong and Stephen Cohen.

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