Introduksjon til helseøkonomi i USA.

President Obama fikk først godkjent helsereform, nå har kongressen tatt bort pengene (blir nok begravd i senatet), så spørsmålet er egentlig: hvordan fungerer egentlig helsesystemet i USA. Her i Norge har vi ‘universal healthcare’, men i USA har de bare vært nære èn gang, Harry Truman etter andre verdenskrig (FDR var inne på noe av det samme før krigen). Det skjedde ikke.

Austin Frakt ved The Incidental Economist har blitt utfordret til å forklare hele grøten for oss:

Simply put: Introduction:

I’ve been challenged by Aaron to put basic concepts that underlie our health system into simple terms that everyone can understand. I think this is a great idea. It’ll test my understanding of ideas from health economics and my ability to strip away the math and jargon while retaining conceptual accuracy. (This was an implicit challenge, but I’ll take it up anyway.)

The first question is: what are the concepts? I can think of some off the top of my head (listed below). But I’ll bet you can think of many I’ve overlooked. As you request them, I’ll add them to the list below. When I have time I’ll put out a ‘Simply put’ post. I’d like to say I’ll do one per week, but I shouldn’t make an explicit commitment.

The following will also serve as an index. I’ll come back here and hyperlink the list items to posts.

  • Third-party payment
  • Employer-sponsored insurance tax subsidy
  • Adverse selection
  • Favorable selection
  • Physician-patient information asymmetry
  • Physician-insurer information asymmetry
  • Moral hazard
  • Cost shifting
  • Medical underwriting
  • Market power
  • Network contracting
  • Socialized medicine
  • Nationalized medicine
  • All-payer rate setting
  • Single-payer system
  • Risk adjustment
  • Self-insured plans
  • Consumer driven health plans
  • Managed care
  • Managed competition
  • Community rating
  • Risk/experience rating
  • Guaranteed issue/guaranteed renewability
  • Reinsurance
  • Global budgeting
  • Insurance death spiral
  • Gain sharing/shared savings
  • Bundled payment
  • Medical home
  • RAND Health Insurance Experiment
  • Quality-adjusted life years
  • Marginal utility/cost/benefit

Please put your suggestions in the comments and I’ll add them to the list. Anything is fair game, so long as it is a basic concept. Think of the key words that get tossed around. What must an individual know in order to fully understand the health policy debate?

(Via The Incidental Economist (Posts).)

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