Healthcare 2 Flashcards
what are the two empirical papers for healthcare *
finkelstein et al (oregon study) focusing on medicaid expansion in oregon,
johnson and rehavi study of overuse of c-section births relative to natural births
what does johnson and rehavi compare
compare physician patients to non-physicians (moral hazard)
what does hmo stand for
health maintenance organisation
what is medicaid
medicaid is the public health insurance program for the low-income individuals
features of medicaid
federal program run by the states,
some flexibility in setting eligibility criteria,
privately provided care
what are the main results of the oregon experiment
increases in health care use,
increases in commpliance with recommended preventive care,
improvements in quality and access,
improvements in self-reported health and depression,
no significant change in physical measures (blood pressure for ex)
what is the problem with previous studies thats related to oregon study
simply compare insured versus uninsured which suffers from a selection problem that uninsured may be more healthy
how is the oregon study different from other studies
gets rid of selection issue and still suggests that having insurance does improve health outcomes
what is significant about the early adopters for the oregon study
10% signed up on the first day, these early adopters have higher healthcare utilisation indicating either adverse selection or moral hazard
what does johnson and rehavi focus on
look at moral hazard in healthcare industry,
focus on level of information available to patients and physician financial incentives,
compare procedures chosen by patients that are also doctors with non-doctor patients
results of johnson and rehavi *
patients that are doctors are significantly less likely to opt for a c-section in the birth of their first child,
changes in financial incentives has an impact on treatment of non-doctors but no impact on treatment of doctors,
both support presence of moral hazard
what does johnson and rehavi compare *
compare rates of c-section births when parents are doctors with when parents are college educated,
compare rates of c-section births by incentive structure (HMO v non HMO)
why did johnson and rehavi use childbirth
c-section is expensive, invasive surgery requiring general anesthesia (not suitable for all),
they are more expensive (and more profitable) from the perspective of the doctor
what did johnson and rehavi find about effect of mother being a doctor
there was a significant negative effect of mother being a doctor
summary for johnson and rehavi
better information for the patient has an impact on choice of medical procedure,
c-sections are overconsumed this suggests the presence of ordinary moral hazard,
removing the profit incentive reduces the use of c-sections
