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Health Market: Incentives and Competition

Special Issue Editor


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Guest Editor
Department of Economics, Boston University, Boston, MA 02215, USA
Interests: incentives and payment design in the health market; competition in the health market; interaction between public and private health sectors
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Special Issue Information

Dear Colleagues,

The health care market continues its growth in many economies. Stakeholders’ foremost concern is the cost of health care. For example, the upcoming health care reform in the United States will begin by the mandate that consumers have health insurance. An additional 30 to 40 million Americans acquiring health insurance will lead to higher health care expenditure if costs and prices stay constant. The US Affordable Care act therefore must proceed to initiate cost-control measures. Other economies face similar issues. Those countries that have already instituted universal health insurance or services are mindful of the high cost. Competition policies and incentive designs are the instruments that may advert rising costs. The complexity in the health care market makes the research on such policies and designs both exciting and difficult. Furthermore, recent advances in behavioral and information economics have yet to impact fully research on payment methods, quantity controls, horizontal and vertical mergers, entries and exits. This special issue has a broad focus on incentive and competition in relation to the health market as its goal is to publish a collection of state-of-the-art research articles. Both theoretical and empirical submissions are welcome.

Prof. Dr. Ching-To Albert Ma
Guest Editor

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Keywords

  • incentive design
  • competition policy
  • payment mechanism
  • quantity control
  • managed care
  • health insurance
  • health care delivery

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Published Papers (2 papers)

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Research

610 KiB  
Article
Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas
by Randall P. Ellis and Juan Gabriel Fernandez
Int. J. Environ. Res. Public Health 2013, 10(11), 5299-5332; https://doi.org/10.3390/ijerph10115299 - 25 Oct 2013
Cited by 9 | Viewed by 6915
Abstract
Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the [...] Read more.
Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. Full article
(This article belongs to the Special Issue Health Market: Incentives and Competition)
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419 KiB  
Article
Can Decision Biases Improve Insurance Outcomes? An Experiment on Status Quo Bias in Health Insurance Choice
by Miriam Krieger and Stefan Felder
Int. J. Environ. Res. Public Health 2013, 10(6), 2560-2577; https://doi.org/10.3390/ijerph10062560 - 19 Jun 2013
Cited by 18 | Viewed by 10227
Abstract
Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory [...] Read more.
Rather than conforming to the assumption of perfect rationality in neoclassical economic theory, decision behavior has been shown to display a host of systematic biases. Properly understood, these patterns can be instrumentalized to improve outcomes in the public realm. We conducted a laboratory experiment to study whether decisions over health insurance policies are subject to status quo bias and, if so, whether experience mitigates this framing effect. Choices in two treatment groups with status quo defaults are compared to choices in a neutrally framed control group. A two-step design features sorting of subjects into the groups, allowing us to control for selection effects due to risk preferences. The results confirm the presence of a status quo bias in consumer choices over health insurance policies. However, this effect of the default framing does not persist as subjects repeat this decision in later periods of the experiment. Our results have implications for health care policy, for example suggesting that the use of non-binding defaults in health insurance can facilitate the spread of co-insurance policies and thereby help contain health care expenditure. Full article
(This article belongs to the Special Issue Health Market: Incentives and Competition)
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