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Conference Paper
Costs, benefits, and rationing of health care: comments on Cutler’s “What Is Good Care, and What Is Bad?”
National health care goals generally include providing broad access to appropriate amounts of high-quality health care at appropriate cost to the ultimate payers. Yet all countries, regardless of how they deliver and finance health care, struggle to achieve a sustainable balance among the implicit tradeoffs. Does this struggle stem from the limited scope for competition in health care or from information asymmetries? Or does it simply reflect the inherent difficulty of measuring health care output and quality? Alternatively, does it result from deep-seated human behavior - a tendency for ...
Conference Paper
Health financing: challenges and opportunities, coverage and cost
This policy panel will present and debate proposals for the next steps in reforming the U.S. health care system. Which challenge deserves the highest priority – providing universal access; instituting better measures of quality and outcomes and better management systems; or reining in costs? How should these challenges be addressed? What keeps us from "having it all"? Does the fundamental obstacle lie in market behavior, inadequate or asymmetric information, lack of political will, or the human psyche? How would the proposed reforms tackle the underlying issue and help us maintain a ...
Working Paper
Equilibrium Labor Market Search and Health Insurance Reform
We present and empirically implement an equilibrium labor market search model where risk averse workers facing medical expenditure shocks are matched with firms making health insurance coverage decisions. Our model delivers a rich set of predictions that can account for a wide variety of phenomenon observed in the data including the correlations among firm sizes, wages, health insurance offering rates, turnover rates and workers? health compositions. We estimate our model by Generalized Method of Moments using a combination of micro datasets including Survey of Income and Program ...
Conference Paper
Wanting it all: the challenge of reforming the U. S. health care system - a conference sponsored by the Federal Reserve Bank of Boston
How should we value ? and pay for ? health care? How can we ensure that medical progress continues unabated and that its blessings are equitably distributed? How do we prevent future health care commitments from absorbing resources that might better be spent on other important components of current and future well-being? Finally, is the key to maintaining balance among these goals to be found in better functioning markets, better regulation, better information, better IT management, or in a better understanding of human behavior? ; This conference brought together economists, health ...
Journal Article
Federal health care law promises coverage for all, but at a price
The Patient Protection and Affordable Care Act, better known as health care reform, was signed into law last March. The measure ostensibly provides health care coverage to almost all Americans while simultaneously reducing the deficit by $143 billion over 10 years and by a greater amount over the longer term.
Working Paper
The Effects of the Massachusetts Health Reform on Financial Distress
A major benefit of health insurance coverage is that it protects the insured from unexpected medical costs that may devastate their personal finances. In this paper, we use detailed credit report information on a large panel of individuals to examine the effect of a major health care reform in Massachusetts in 2006 on a broad set of financial outcomes. The Massachusetts model served as the basis for the Affordable Care Act and allows us to examine the effect of coverage on financial outcomes for the entire population of the uninsured, not just those with very low incomes. We exploit plausibly ...
Journal Article
Medicaid-the need for reform
Recent administration proposals to address the rising cost of Medicaid will do little to contain costs or truly reform the program. The primary issues are the large differences among state Medicaid programs in coverage and benefits and the programs high and rising costs. In this paper, we describe and develop several options for Medicaid reform that would expand coverage, provide fiscal relief to states, shift responsibility for some or all of the cost of dual eligibles to the federal government, and eliminate or restructure the disproportionate share programs. A number of other issues are ...
Conference Paper
Employer-funded health care and labor markets: an insider’s view
This session will explore the impact of the U.S. health care system on U.S. labor markets. ; Why do employers believe that rising health care costs are a major cause for concern when economists insist that workers are the ones who actually bear the costs? What are the implications of large health care liabilities for the long-run viability of U.S. employers? How do rising health care costs affect employment and compensation decisions and labor mobility? Do behavioral insights shed any light on these issues?
Journal Article
Does health care reform support self-employment?
Didem Tzemen and Thealexa Becker study the Massachusetts Health Care Reform Act and find the reform may have supported self-employment in the state.
Working Paper
How do Doctors Respond to Incentives? Unintended Consequences of Paying Doctors to Reduce Costs
Billions of dollars have been spent on pilot programs searching for ways to reduce healthcare costs. I study one such program, where hospitals pay doctors bonuses for reducing the total hospital costs of admitted Medicare patients (a ?bundled payment?). Doctors respond to the bonuses by becoming more likely to admit patients whose treatment can generate high bonuses, and sorting healthier patients into participating hospitals. Conditional on patient health, however, doctors do not reduce costs or change procedure use. These results highlight the ability of doctors to game incentive schemes, ...