iFHP 2012 Comparative Price Report

The International Federation of Health Plans, (iFHP) a network of leading health insurance CEO’s from over 25 countries, has released the 2012 Comparative Price Report. This is the fourth annual survey of prices of the cost of specific medical and products and services, compiled from data collected by iFHP member plans.

The study aims to help plans better understand why health care costs are so much higher in some countries than others. The survey data showed that average US prices were once again the highest of those in the countries surveyed for nearly all of the common services and procedures reviewed.

via news153.

Why Do Americans Spend so Much More on Health Care than Europeans? A General Equilibrium Macroeconomic Analysis by Hui He, Kevin Huang :: SSRN

Empirical evidence suggests that both leisure time and medical care are important for maintaining health. We develop a general equilibrium macroeconomic model in which taxation is a key determinant of the composition of these two inputs in the endogenous accumulation of health capital. In our model, higher taxes lead to using relatively more leisure time and less medical care in maintaining health. We find that the difference in taxation can account for a large fraction of the difference in health expenditure-GDP ratio and almost all of the difference in time input for health production between the US and Europe.

via Why Do Americans Spend so Much More on Health Care than Europeans? A General Equilibrium Macroeconomic Analysis by Hui He, Kevin Huang :: SSRN.

Access to Treatment and Educational Inequalities in Cancer Survival by Jon Fiva, Torbjorn Haegeland, Marte Ronning, Astri Syse :: SSRN

The public health care systems in the Nordic countries provide high quality care almost free of charge to all citizens. However, social inequalities in health persist. Previous research has, for example, documented substantial educational inequalities in cancer survival. We investigate to what extent this may be driven by differential access to and utilization of high quality treatment options. Quasi-experimental evidence based on the establishment of regional cancer wards indicates that i) highly educated individuals utilized centralized specialized treatment to a greater extent than less educated patients and ii) the use of such treatment improved these patients’ survival.

via Access to Treatment and Educational Inequalities in Cancer Survival by Jon Fiva, Torbjorn Haegeland, Marte Ronning, Astri Syse :: SSRN.

Testing for Asymmetric Information in Private Health Insurance by Pau Olivella, Marcos Vera‐Hernández :: SSRN

We test for asymmetric information in the UK private health insurance (PHI) market. In contrast to earlier research that considers either a purely private system or one where private insurance is complementary to public insurance, PHI is substitutive of the public system in the UK. Using a theoretical model of competition among insurers incorporating this characteristic, we link the type of selection (adverse or propitious) with the existence of risk‐related information asymmetries. Using the British Household Panel Survey, we find evidence that adverse selection is present in the PHI market, which leads us to conclude that such information asymmetries exist.

via Testing for Asymmetric Information in Private Health Insurance by Pau Olivella, Marcos Vera‐Hernández :: SSRN.

Do Politicians Serve the One Percent? Evidence from OECD Countries by Pablo Torija :: SSRN

Present social movements, as “Occupy Wall Street” or the Spanish “Indignados”, claim that politicians work for an economic elite, the 1%, that drives the world economic policies. In this paper we show through econometric analysis that these movements are accurate: politicians in OECD countries maximize the happiness of the economic elite. In 2009 center-right parties maximized the happiness of the 100th-98th richest percentile and center-left parties the 100th-95th richest percentile. The situation has evolved from the seventies when politicians represented, approximately, the median voter.

via Do Politicians Serve the One Percent? Evidence from OECD Countries by Pablo Torija :: SSRN.

Canadian Health Policy in the News: Why Evidence Matters by Noralou Roos, Sharon Manson Singer, Kathleen O’Grady, Shannon Turczak, Camilla Tapp, Nicholas Hirst, Alan Cassels, Robert Brown, Neena Chappell, Marcus Hollander, Michael Wolfson, Varena Menec, Kimberlyn McGrail, Jason Sutherland, Trafford Crump, Livio Di Matteo, Eric Bohm, Nadya Repin, Gina Browne, Marc-André Gagnon, Steve Morgan, Jamie Daw, Gregory P. Marchildon, Sergio Sismondo, Colleen Flood, Allan M. Maslove, Irfan Dhalla, Damien Contandriopoulos, Ann Silversides, Cornelia Baines, Charles Wright, Alan Katz, Therese Stukel, James McCormack, Elizabeth Ford-Jones, Marni D. Brownell, Rick Linden, Ben Levin, Mark Stabile, Vass Bednar, Paul Kershaw, Cy Frank, Ron Zernicke, Gary Bloch, Theodore Marmor, Raisa Deber, Michael Law, Rivian Weinerman, Michael Rachlis, Ivy Bourgeault, Morris Barer, John Millar, Francois Beland, Philippe Couillard, Garey Mazowita, Linda Silas :: SSRN

Canadian Health Policy in the News is a compendium of the commentaries (or OpEds) published by the Evidence Network of Canadian Health Policy (or EvidenceNetwork.ca) in major newspapers across the country since the birth of EvidenceNetwork.ca in April 2011 up to October 2012. It is a timely, balanced and non-partisan snapshot of what’s new and controversial concerning our healthcare system and related social programs that affect health and well-being in our country – with evidence at the forefront.

For the first time, we’ve collected this Creative Commons content together in an e-book format to make the information ever more widely available and accessible. The essays you’ll find here, in both English and French, are organized by date published and according to eight loosely overlapping categories: Aging Population and Its Potential Impact addresses concerns over healthcare strains associated with our graying population. Is there a silver tsunami about to bankrupt our healthcare system? Would reforms in chronic healthcare delivery better accommodate this population? Will changes to pension benefits mean more of our seniors will live in poverty? Authors tackle these issues with evidence, and the answers may surprise many readers.

Healthcare Costs and Spending addresses the increased costs for both out-of-pocket and public spending on health services in Canada. How are the numbers calculated (and spun by vested interests)? What’s going on to cause these increases? And what can we do about it? Authors follow the money and give us the goods in accessible language. Private, For-Profit Solutions to Funding and Delivery deals with the public vs. private debate: loaded words in the Canadian context. There can (and already exists) public and private roles in both the funding and delivery of healthcare. What is the best balance for Canadians? Who pays and who should pay for healthcare? Who should deliver healthcare? Authors explore models and evidence from both inside the country and internationally to help forge the path forward.

In More Care Is Not Always Better, authors tackle the question: ‘What is the right amount of healthcare?’ It’s easy to assume that the real problem with the healthcare system is ‘not enough,’ but what does the evidence say? A growing number of studies show that more healthcare is not always better and the more expensive solutions are not always the best. In Health is More Than Healthcare, the authors sketch the relationship between various ‘social determinants’ of health, such as education, poverty and homelessness, and indicate that some of the most fruitful policy levers for improving public health lie outside of the domain of health services.

In Patient Financing of Healthcare, the essays address direct patient financing of healthcare delivery. Would this result in a more efficient and cost-effective healthcare system? Would user fees, for example, prevent overuse and bring in needed revenue? Or would they negatively impact those who may need the health system the most? Sustainability includes OpEds which address whether Canadians can afford the level of healthcare we expect at a cost which is acceptable to the public; and whether we are at risk of losing our publicly funded health system from a financial perspective. Finally, in Waiting for Care, the authors assess wait times and access to care. How bad are wait times, really? And what will it cost to improve the situation?

This book is available free-of-charge so that you can share it widely, in your classrooms, amongst your friends and colleagues, on your websites and via social media.

Canadian health policy will always be emerging and unfolding, responding to changing environmental and economic factors, new technologies, publicly held values and differing political landscapes. Canadian Health Policy in the News captures a moment in time and presents the issues that concern Canadians most, grounding our national discourse and debate on healthcare in the best evidence.

via Canadian Health Policy in the News: Why Evidence Matters by Noralou Roos, Sharon Manson Singer, Kathleen O’Grady, Shannon Turczak, Camilla Tapp, Nicholas Hirst, Alan Cassels, Robert Brown, Neena Chappell, Marcus Hollander, Michael Wolfson, Varena Menec, Kimberlyn McGrail, Jason Sutherland, Trafford Crump, Livio Di Matteo, Eric Bohm, Nadya Repin, Gina Browne, Marc-André Gagnon, Steve Morgan, Jamie Daw, Gregory P. Marchildon, Sergio Sismondo, Colleen Flood, Allan M. Maslove, Irfan Dhalla, Damien Contandriopoulos, Ann Silversides, Cornelia Baines, Charles Wright, Alan Katz, Therese Stukel, James McCormack, Elizabeth Ford-Jones, Marni D. Brownell, Rick Linden, Ben Levin, Mark Stabile, Vass Bednar, Paul Kershaw, Cy Frank, Ron Zernicke, Gary Bloch, Theodore Marmor, Raisa Deber, Michael Law, Rivian Weinerman, Michael Rachlis, Ivy Bourgeault, Morris Barer, John Millar, Francois Beland, Philippe Couillard, Garey Mazowita, Linda Silas :: SSRN.

Stephens: Roman Decadence, American Sequester – WSJ.com

A better place to look is the growth of Italy’s entitlement state. In 1950—the beginning of Italy’s Miracolo Economico—GDP per capita stood at €4,407 (in current euros). By 1978 it had nearly quadrupled to €16,596. But afterward it began to stagnate. Per capita GDP has now been essentially flat since 1998.

What happened in 1978? Funnily enough, that was the year Italy adopted universal health care. The Italian economy did continue to grow in the 1980s, nominally becoming the world’s fourth-largest economy in the late ’80s. But it did so on borrowed money. In 1982, the debt-to-GDP ratio stood at 51%. By 1990 it was 102%. Since then there have been a variety of attempts to curb the growth of government and loosen the shackles of over-regulation, none of them especially serious. Italy’s debt now stands at 126% of GDP, second only in Europe to Greece.

via Stephens: Roman Decadence, American Sequester – WSJ.com.

Drug Launch Timing and International Reference Pricing by Houy Nicolas, Izabela Jelovac :: SSRN

This paper analyzes the timing decisions of pharmaceutical firms to launch a new drug in countries involved in international reference pricing. We show three important features of launch timing when all countries reference the prices in all other countries and in all previous periods of time. First, there is no withdrawal of drugs in any country and in any period of time. Second, there is no strict incentive to delay the launch of a drug in any country. Third, whenever the drug is sold in a country, it is also sold in all countries with larger willingness to pay. We then show that the three results do not hold when the countries only reference a subset of all countries. The first two results do not hold when the reference is on the last period prices only.

via Drug Launch Timing and International Reference Pricing by Houy Nicolas, Izabela Jelovac :: SSRN.

JHPPL Review | Foreign Remedies: What the Experience of Other Nations Can Tell Us about Next Steps in Reforming U.S. Health Care

David A. Rochefort and Kevin P. Donnelly. Foreign Remedies: What the Experience of Other Nations Can Tell Us about Next Steps in Reforming U.S. Health Care. New York: Rutledge, 2012. 106 pp. $9.95 paper.

Rochefort and Donnelly have produced a concise guide to the policy process for health reform using the Patient Protection and Affordable Health Care Act of 2012 (PPACA) as their entrée into that sometimes enigmatic and often frustrating world of health policy and politics. The book is part of a series dedicated to framing disparate social issues and presenting them in accessible, debatable, and ultimately teachable formats. The series is targeted at undergraduates and, in this case, novices in health policy. But Rochefort and Donnelly contend that Foreign Remedies will be of interest to anyone new to health policy issues. They substantiate this contention in three ways.

First, their writing is clear, direct, and well organized.

Second, they provide a largely nonbiased presentation of health policy, politics, and health care reform. Third, they offer realistic and usable endof-chapter questions for discussion and debate. Foreign Remedies provides a solid foundation for understanding health policy and politics.

More at Review.

Free to Choose? Reform and Demand Response in the Englishnational Health Service by Martin Gaynor, Carol Propper, Stephan Seiler :: SSRN

The impacts of choice in public services are controversial. We exploit a reform in the English National Health Service to assess the impact of relaxing constraints on patient choice. We estimate a demand model to evaluate whether increased choice increased demand elasticity faced by hospitals with regard to clinical quality and waiting time for an important surgical procedure. We find substantial impacts of the removal of restrictions. Patients became more responsive to clinical quality. Sicker patients and better informed patients were more a effected. We leverage our model to calculate potential benefits. We find increased demand responsiveness led to a significant reduction in mortality and an increase in patient welfare. The elasticity of demand faced by hospitals increased post-reform, giving hospitals potentially large incentives to improve their quality of care and find suggestive evidence that hospitals responded strongly to the enhanced incentives due to increased demand elasticity. The results suggests greater choice can enhance quality.

via Free to Choose? Reform and Demand Response in the Englishnational Health Service by Martin Gaynor, Carol Propper, Stephan Seiler :: SSRN.