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1
UID:
gbv_825903505
Format: Online Ressource (xi, 890 pages)
Edition: 1st ed.
ISBN: 9780444504708 , 0444504702
Series Statement: Handbooks in economics 17
Content: The Handbook of Health Economics provide an up-to-date survey of the burgeoning literature in health economics. As a relatively recent subdiscipline of economics, health economics has been remarkably successful. It has made or stimulated numerous contributions to various areas of the main discipline: the theory of human capital; the economics of insurance; principal-agent theory; asymmetric information; econometrics; the theory of incomplete markets; and the foundations of welfare economics, among others. Perhaps it has had an even greater effect outside the field of economics, introducing terms such as opportunity cost, elasticity, the margin, and the production function into medical parlance. Indeed, health economists are likely to be as heavily cited in the clinical as in the economics literature. Partly because of the large share of public resources that health care commands in almost every developed country, health policy is often a contentious and visible issue; elections have sometimes turned on issues of health policy. Showing the versatility of economic theory, health economics and health economists have usually been part of policy debates, despite the vast differences in medical care institutions across countries. The publication of the first Handbook of Health Economics marks another step in the evolution of health economics
Content: The Handbook of Health Economics provide an up-to-date survey of the burgeoning literature in health economics. As a relatively recent subdiscipline of economics, health economics has been remarkably successful. It has made or stimulated numerous contributions to various areas of the main discipline: the theory of human capital; the economics of insurance; principal-agent theory; asymmetric information; econometrics; the theory of incomplete markets; and the foundations of welfare economics, among others. Perhaps it has had an even greater effect outside the field of economics, introducing terms such as opportunity cost, elasticity, the margin, and the production function into medical parlance. Indeed, health economists are likely to be as heavily cited in the clinical as in the economics literature. Partly because of the large share of public resources that health care commands in almost every developed country, health policy is often a contentious and visible issue; elections have sometimes turned on issues of health policy. Showing the versatility of economic theory, health economics and health economists have usually been part of policy debates, despite the vast differences in medical care institutions across countries. The publication of the first Handbook of Health Economics marks another step in the evolution of health economics
Note: Includes bibliographical references and indexes , v. 1A. The state and scope of health economics / Anthony J. Culyer and Joseph P. Newhouse ; International comparisons of health expenditure / Ulf-G. Gerdtham and Benet Jönsson ; An overview of the normative economics of the health sector / Jeremiah Hurley ; Medical care prices and output / Ernest R. Berndt ... [et al.] ; Advances in CE analysis / Alan M. Garber ; Information diffusion and best practice adoption / Charles E. Phelps ; Health econometrics / Andrew M. Jones ; The human capital model / Michael Grossman ; Moral hazard and consumer incentives in health care / Peter Zweifel and Willard G. Manning ; Physician agency / Thomas G. McGuire ; Insurance reimbursement / Mark V. Pauly ; The anatomy of health insurance / David M. Cutler and Richard J. Zeckhauser ; Health insurance and the labor market / Jonathan Gruber ; Managed care / Sherry Glied ; Risk adjustment in competitive health plan markets / Wynand P.M.M. van de Ven and Randall P. Ellis ; Government purchasing of health services / Martin Chalkley and James M. Malcomson.
Additional Edition: ISBN 9780444504708
Additional Edition: ISBN 0444504702
Language: English
Subjects: Economics
RVK:
Keywords: Gesundheitsökonomie ; Electronic books
URL: Volltext  (Deutschlandweit zugänglich)
Author information: Culyer, Anthony J. 1942-
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Associated Volumes
  • 2
    UID:
    gbv_1831638576
    ISBN: 9780444504708
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite xi, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:xi
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 3
    Online Resource
    Online Resource
    UID:
    gbv_1831638614
    ISBN: 9780444504708
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite I-1-I-44, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:I-1-I-44
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 4
    UID:
    gbv_1831638762
    ISBN: 9780444504708
    Content: Comparisons of aggregate health expenditure across different countries have become popular over the last three decades as they permit a systematic investigation of the impact of different institutional regimes and other explanatory variables. Over the years, several regression analyses based on cross-section and panel data have been used to explain the international differences in health expenditure. A common result of these studies is that aggregate income appears to be the most important factor explaining health expenditure variation between countries and that the size of the estimated income elasticity is high and even higher than unity which in that case indicates that health care is a luxury good. Additional results indicates, for example, that the use of primary care gatekeepers lowers health expenditure and also that the way of remunerating physicians in the ambulatory care sector appears to influence health expenditure; capitation systems tend to lead to lower expenditure than fee-for-service systems. Finally, we also list some issues for the future. We demand more efforts on theory of the macroeconomic analysis of health expenditure, which is underdeveloped at least relative to the macroeconometrics of health expenditure. We also demand more replications based on updated data and methods that seeks to unify the many differing results of previous studies.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 11-53, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:11-53
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 5
    UID:
    gbv_1831638673
    ISBN: 9780444504708
    Content: This paper discusses theoretical and empirical findings concerning insurance reimbursement of patients or providers by insurers operating in private markets or in mixed public and private systems. Most insurances other than health insurance do not reimburse; instead they pay cash to insureds conditional on the occurrence of a prespecified event. In contrast, health insurance ties the payment to medical expenditures or costs incurred in some fashion, often making payments directly to medical providers. These differences are caused by a much higher degree of moral hazard and the dominant effect of insurer demand on provider prices. Health insurances also often prohibit balance billing, provider charges in excess of some prespecified amount. Such prohibitions are related to patient inability to shop or bargain, and to insurer market power. Empirical evidence suggests that some versions of physician and hospital reimbursement have increased the level of medical spending relative to the level that would be experienced under prospective payment. In particular, cost-based reimbursement raises total spending. Optimal reimbursement, with balance billing prohibited, may also be chosen to control moral hazard; payment will generally involve a mix of fee-for-service and predetermined (salary or capitation) payment, and may well involve positive patient cost sharing. Monopsony behavior by dominant insurers is possible, and may improve consumer welfare but not total welfare.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 537-560, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:537-560
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 6
    UID:
    gbv_1831638665
    ISBN: 9780444504708
    Content: This article describes the anatomy of health insurance. It begins by considering the optimal design of health insurance policies. Such policies must make tradeoffs appropriately between risk sharing on the one hand and agency problems such as moral hazard (the incentive of people to seek more care when they are insured) and supplier-induced demand (the incentive of physicians to provide more care when they are well reimbursed) on the other. Optimal coinsurance arrangements make patients pay for care up to the point where the marginal gains from less risk sharing are just offset by the marginal benefits from reduced provision of low valued care. Empirical evidence shows that both moral hazard and demand-inducement are quantitatively important. Coinsurance based on expenditure is a crude control mechanism. Moreover, it places no direct incentives on physicians, who are responsible for most expenditure decisions. To place such incentives on physicians is the goal of supply-side cost containment measures, such as utilization review and capitation. This goal motivates the surge in managed care in the United States, which unites the functions of insurance and provision, and allows for active management of the care that is delivered. The analysis then turns to the operation of health insurance markets. Economists generally favor choice in health insurance for the same reasons they favor choice in other markets: choice allows people to opt for the plan that is best for them and encourages plans to provide services efficiently. But choice in health insurance is a mixed blessing because of adverse selection the tendency of the sick to choose more generous insurance than the healthy. When sick and healthy enroll in different plans, plans disproportionately composed of poor risks have to charge more than they would if they insured an average mix of people. The resulting high premiums create two adverse effects: they discourage those who are healthier but would prefer generous care from enrolling in those plans (because the premiums are so high), and they encourage plans to adopt measures that deter the sick from enrolling (to reduce their overall costs). The welfare losses from adverse selection are large in practice. Added to them are further losses from premiums that vary with observable health status. Because insurance is contracted for annually, people are denied a valuable form of intertemporal insurance the right to buy health coverage at average rates in the future should they get sick today. As the ability to predict future health status increases, the lack of intertemporal insurance will become more problematic. The article concludes by relating health insurance to the central goal of medical care expenditures better health. Studies to date are not clear on which approaches to health insurance promote health in the most cost-efficient manner. Resolving this question is the central policy concern in health economics.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 563-643, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:563-643
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 7
    UID:
    gbv_1831638657
    ISBN: 9780444504708
    Content: A distinctive feature of the health insurance market in the US is the restriction of group insurance availability to the workplace. This has a number of important implications for the functioning of the labor market, through mobility from job-to-job or in and out of the labor force, wage determination, and hiring decisions. This paper reviews the large literature that has emerged in recent years to assess the impact of health insurance on the labor market. I begin with an overview of the institutional details relevant to assessing the interaction of health insurance and the labor market. I then present a theoretical overview of the effects of health insurance on mobility and wage/employment determination. I critically review the empirical literature on these topics, focusing in particular on the methodological issues that have been raised, and highlighting the unanswered questions which can be the focus of future work in this area.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 645-706, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:645-706
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 8
    Online Resource
    Online Resource
    UID:
    gbv_1831638649
    ISBN: 9780444504708
    Content: By 1993, over 70 of all Americans with health insurance were enrolled in some form of managed care plan. The term managed care encompasses a diverse array of institutional arrangements, which combine various sets of mechanisms, that, in turn, have changed over time. The chapter reviews these mechanisms, which, in addition to the methods employed by traditional insurance plans, include the selection and organization of providers, the choice of payment methods (including capitation and salary payment), and the monitoring of service utilization. Managed care has a long history. For an extended period, this form of organization was discouraged by a hostile regulatory environment. Since the early 1980s, however, managed care has grown dramatically. Neither theoretical nor empirical research has yet provided an explanation for this pattern of growth. The growth of managed care may be due to this organizational form's relative success in responding to underlying market failures in the health care system asymmetric information about health risks, moral hazard, limited information on quality, and limited industry competitiveness. The chapter next explores managed care's response to each of these problems. The chapter then turns to empirical research on managed care. Managed care plans appear to attract a population that is somewhat lower cost than that enrolled in conventional insurance. This complicates analysis of the effect of managed care on utilization. Nonetheless, many studies suggest that managed care plans reduce the rate of health care utilization somewhat. Less evidence exists on their effect on overall health care costs and cost growth.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 707-753, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:707-753
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 9
    UID:
    gbv_1831638630
    ISBN: 9780444504708
    Content: In the 1990s many countries have chosen to use prospective payment arrangements for health plans (e.g., health insurers, sickness funds or HMOs) together with health plan competition, as a means of creating incentives to be cost conscious, while preserving quality, innovation and responsiveness to consumer preferences. Risk adjustment is an important mechanism for attenuating problems that threaten the effectiveness of this strategy for resource allocation in health care. Without adequate risk adjustment, competing health plans have incentives to avoid individuals with predictable losses and to select predictably profitable members. This selection and the resulting risk segmentation can have adverse effects in terms of access to care, quality of care and efficiency in the production of care. This chapter first provides a conceptual framework for thinking about risk adjustment. Second, it gives an overview of the progress developing risk adjustment models in recent years. Third, several forms of risk sharing are discussed, which can be used as a tool for reducing selection in case of imperfect risk adjustment. Fourth, an overview is given of the current practice of risk adjustment and risk sharing in 11 countries. Finally some directions for future research are discussed.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 755-845, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:755-845
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 10
    UID:
    gbv_1831638622
    ISBN: 9780444504708
    Content: This chapter reviews the literature on payment schemes for government purchases of health services. It focuses on four themes: (1) the tension between obtaining appropriate quality of services and keeping the cost of those services at an acceptable level; (2) the role of cost sharing by the payer when there is asymmetric information between purchaser and supplier about costs or case-mix; (3) the importance of commitment in purchasing; and (4) the role of reputation in maintaining quality in long term relationships between purchasers and suppliers.
    In: Handbook of health economics, Amsterdam : Elsevier, 2000, (2000), Seite 847-890, 9780444504708
    In: 0444504702
    In: year:2000
    In: pages:847-890
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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