Cost-Sharing or Rebate: The Impact of Health Insurance Design on Reducing Inefficient Care

2020 ◽  
Author(s):  
Markus Fels ◽  
Nadja Kairies-Schwarz ◽  
Christian Waibel
2016 ◽  
Vol 9 (1) ◽  
pp. 38-61 ◽  
Author(s):  
Qin Zhou ◽  
Gordon G. Liu ◽  
Yankun Sun ◽  
Sam A. Vortherms

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 614-621
Author(s):  
Barbara Starfield ◽  
Diana Dutton

The reports of Valdez et al1 and Leibowitz et al2 mark the culmination of a landmark effort. Initiated over a decade ago, the Rand Health Insurance Experiment—the most ambitious and expensive randomized controlled trial ever conducted in health services research—was designed to produce estimates of the costs of various forms of national health insurance. Projected estimates of the costs of Medicaid and Medicare had been far too low and health policy experts hoped to obtain information that would prove closer to the mark in the (then) seemingly likely passage of some form of national health insurance. Although national health insurance has not materialized, the impact of medical care costs on utilization of services and health status is still of great interest. The amount of "cost-sharing" (medical costs paid by patients) has increased dramatically in public insurance programs, and many health policymakers favor increases in private insurance programs. The central question now, however, is how much of the cost burden can be borne by patients without inducing reductions in utilization that are harmful to health. The two papers1,2 in the May issue of Pediatrics reported on the impact of cost-sharing on children's utilization and health. The basic findings were similar to those for adults. In general, the higher the costs paid by families, the fewer the children receiving medical care and the fewer the services per user. The only exception was hospitalization of children aged 5 to 13, which was largely unaffected by cost-sharing; higher costs did appear to reduce hospitalization of younger children, as well as ambulatory care for children of all ages.


2019 ◽  
Vol 11 (2) ◽  
pp. 37-73 ◽  
Author(s):  
Marika Cabral ◽  
Neale Mahoney

Most health insurance uses cost-sharing to reduce excess utilization. Supplemental insurance can blunt the impact of this cost-sharing, increasing utilization and exerting a negative externality on the primary insurer. This paper estimates the effect of private Medigap supplemental insurance on public Medicare spending using Medigap premium discontinuities in local medical markets that span state boundaries. Using administrative data on the universe of Medicare beneficiaries, we estimate that Medigap increases an individual’s Medicare spending by 22.2 percent. We calculate that a 15 percent tax on Medigap premiums generates savings of $12.9 billion annually with a standard error of $4.9 billion. (JEL G22, H24, H51, I13, J14)


2020 ◽  
Vol 13 (1) ◽  
pp. 271
Author(s):  
Carmen Valentina Radulescu ◽  
Georgiana-Raluca Ladaru ◽  
Sorin Burlacu ◽  
Florentina Constantin ◽  
Corina Ioanăș ◽  
...  

The present research aims to establish the impact that the current crisis situation the planet is facing, namely the COVID-19 pandemic, has had so far on the Romanian labor force market. In this context, given the lack of information and information regarding this pandemic and its effects, the administration of a questionnaire among the population was considered to identify the research results. The method of semantic differential and the method of ordering the ranks were used for the interpretation of the results. With the help of this questionnaire, it will be possible to answer the question of the research in this study: What are the main effects of the COVID-19 pandemic on the Romanian labor market? The main results showed that the COVID-19 pandemic affected the Romanian workforce; the respondents of the applied questionnaire claimed that they obtained better results and maintained a similar income, but the health crisis also influenced the mentality of employees, with respondents stating that in the event of changing jobs, they would consider it very important for the new employer to ensure the conditions for preventing and combating COVID-19, as well as complex health insurance. However, analyzing at the macroeconomic level, it was found that the COVID-19 pandemic induced an increase in the number of unemployed people in the Romanian labor market.


2010 ◽  
Vol 13 (1) ◽  
Author(s):  
Gary Burtless ◽  
Pavel Svaton

Cash income offers an incomplete picture of the resources available to finance household consumption. Most American families are covered by an insurance plan that pays for some or all of the health care they consume. Only a comparatively small percentage of families pays for the full cost of this insurance out of their cash incomes. As health care has claimed a growing share of consumption, the percentage of care that is financed out of household incomes has declined. Because health care consumption is more important for some groups in the population than others, the growth in spending and changes in the payment system for medical care have reduced the value of standard income measures for assessing relative incomes of the rich and poor and the young and old. More than a seventh of total personal consumption now consists of health care that is purchased with government insurance and employer contributions to employee health plans. This paper combines health care spending and insurance reimbursement data in the Medical Expenditure Panel Study and money income and health coverage data in the Current Population Survey to assess the impact of health insurance on the distribution of income. Our estimates imply that gross money income significantly understates the resources available to finance household purchases. The estimates imply that a more complete measure of resources would show less inequality than the income measures that are currently used. The addition of estimates of the value of health insurance to countable incomes reduces measured inequality in the population and the income gap between young and old. If the analysis were extended over a longer period, it would show a sizeable impact of insurance on inequality trends in the United States.


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