« Why do women like cads? | Main | I wish to expand in the bookselling market »

Jason Furman has an interesting health care plan

Make people pay more:

This paper proposes a template for a progressive cost sharing plan that would require typical families to pay half of their health costs until they reached 7.5 percent of their income; low-income families would not have any cost sharing.  The analysis shows that this template could reduce total health spending by 13 to 30 percent, reducing premiums by 22 to 34 percent without hurting health outcomes.  Moreover, low- and moderate-income families would face less cost sharing than they do under typical plans today while the premium savings would be more than enough to compensate middle- and upper-income families for the modest increase in their exposure to small risks.  Every family would have an affordable limit on their out-of-pocket payments, in contrast to the situation today, where many families have insurance policies that expose them to unlimited cost sharing.  In addition, the paper suggests the potential inclusion of evidence-based exceptions for highly valuable preventive care and chronic disease treatments as well as other mechanisms to protect the chronically ill.

This plan, of course, can be applied to either markets or government provision.  It finesses the problems with Bush health savings accounts, including the distributional issues and the lack of directness in achieving first-party payment.  It also assumes that the individual desire for comprehensive insulation from risk -- clearly the market tendency where markets are present -- is the fundamental problem in the health care sector.  If I protect myself from risk, I don't take into account my diminished incentive to monitor health care costs, which creates larger dilemmas for the market as a whole.

An alternative plan is simply to tax the health insurance purchases of the relatively wealthy.  But if people overestimate anxiety costs of non-comprehensive coverage, they'll be too ready to pay the tax and we might prefer Furman's method of allocating health insurance according to a formula.  How easily supplemental insurance can be prevented remains an open question.

Addendum: Matt Yglesias comments.

Posted by Tyler Cowen on April 11, 2007 at 07:52 AM in Medicine | Permalink

Comments

Question: Why should the population segment that takes the most health risks (e.g. highest number of smokers, greater rates of alcohol use) pay the least?

Posted by: Ted Craig at Apr 11, 2007 8:14:05 AM

two thoughts:

1. this sounds like a significant increase in marginal income tax rates at the bottom aswell as at the top.

2. it seems to treat health costs as entirely exogenous (especially for low-income families). I'm not sure how it proposes to decide which health expenditures are worth the money and which aren't. Do low-income people get to have MRI scans whenever they have broken fingers?

3. i'm quite happy with my plan at the moment, and what it costs. i can keep my money in my pocket if i don't value what i'm offered. this seems like a huge leap away from accountability.

Posted by: Chris at Apr 11, 2007 9:30:08 AM

err. i guess that was three thoughts.

also, since people face high health costs because they're old, and people are usually low-income when they're young, doesn't a Rawlsian calculus produce nonsense here?

Posted by: Chris at Apr 11, 2007 9:37:50 AM

At least one company I know of is offering such a plan at a lower premium as an alternative to standard insurance. The deductible was set near 7% of the median salary of employees. They also added a company controbution to a medical savings account.The company claimed the the total average costs to employees of the two plans would the same, if the demand for medical services were unchanged. Most people and virtually everyone with children stayed with the standard plan.

Posted by: joan at Apr 11, 2007 11:21:19 AM

Nothing is going to work until health care providers are required to post prices in a consumer friendly form. Today, it is not possible to shop for health care based on price or quality. I have tried!!!!

Posted by: ciwood at Apr 11, 2007 11:42:35 AM

A 7% deductible is very, VERY different from 50% coverage to a maximum coinsurance of 7.5%.
It means that you have to front the entire 7% up front, if needed. That is almost a whole month's salary, and many of us are given a serious pause at the prospect, particularly if we know that we have significant ongoing health needs. There have been years when I have opted out of the lower-premium-higher-deductible plans solely because I could not afford to pay the deductible up front. HRCA plans with debit cards have (mostly) amiliorated the problem, (for those who know how to squeeze HRCA properly) but I dno't know how many people have them.

And yes, the U&C scam makes it impossible to price compare doctors. Note that this is in turn a side effect of a vicious struggle between doctors spawned by the way insurance companies are attempting to control costs--a vicious cycle.

Posted by: Nathan Zook at Apr 11, 2007 1:42:17 PM

"Moderate income" is different in the NE v. other parts of America.

And don't forget STDs, Ted.

Posted by: Sandy P at Apr 11, 2007 2:20:57 PM

The comments on Yglesias' web page are pretty scary. Maybe we should be subsidizing econmics courses for lefties (and courses on the history of ideas for people who do not know what "liberal" means.

Jeff

Posted by: Jeff Smith at Apr 11, 2007 3:00:40 PM

Here's a wacky idea: we could let people pay for their own health insurance and let them buy whatever plan they think is reasonable. If people really want total insulation from risk, and are willing to pay for it, let 'em have it. And if we're feeling in the mood for charity, we could give poor people vouchers (or even cash, except that would conflict with our paternalistic ideas that we know better than they do what they need).

It's so crazy it just might work.

Posted by: eddie at Apr 11, 2007 5:08:47 PM

doesn't a Rawlsian calculus produce nonsense here?

Doesn't it always?

Posted by: eddie at Apr 11, 2007 5:10:04 PM


liqingchao 07年8月14日

google排名
google排名
wow gold
wow gold
powerleveling
powerleveling
wow gold
wow gold
powerleveling
powerleveling
wow powerleveling
wow powerleveling
wow power leveling
wow power leveling
wow power level
wow power level
world of warcraft powerleveling
world of warcraft powerleveling
world of warcraft power leveling
world of warcraft power leveling

china tour
china tour
hongkong hotel
hongkong hotel
beijing tour
beijing tour
翻译公司
翻译公司
上海翻译公司
上海翻译公司
北京翻译公司
北京翻译公司
北京搬家公司
北京搬家公司
鼓风机
风机
风机
货架
光盘刻录
光盘刻录
光盘制作
光盘制作
光盘印刷
光盘印刷
红外测温仪
红外测温仪
超声波测厚仪
超声波测厚仪

超声波探伤仪
超声波探伤仪
频闪仪
频闪仪
涂层测厚仪
涂层测厚仪
电火花检测仪
电火花检测仪
google排名
仓库
仓库
仓库出租
仓库出租
物流园区
物流园区
集团电话
集团电话
四环素牙
口腔常识
口腔常识
口腔医生
口腔医生
网站设计
网站设计
多媒体
监控
监控
监控系统
监控系统
门禁
门禁
门禁系统
门禁系统
搬家公司
搬家公司
条码打印机
条码打印机
牙周炎
牙周炎


牙周炎
多媒体
world of warcraft power leveling
四环素牙
wow power leveling
SFP
SFP

wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold

北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
北京搬家公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
翻译公司
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold
wow gold

Posted by: wslmwps at Aug 14, 2007 3:56:13 AM

maple story
maple story mesos
maple story cheats
maple story meso
maple story hacks
maple story items
maple story guides
cheap maple story
buy maple story mesos

rf online
rf online cp
rf online currency
rf online dalant
rf online disena
buy rf online currency
buy rf online cp
buy rf online dalant

Posted by: maple story at Sep 11, 2007 3:45:37 AM

welcome to IGXE, buy world

of warcraft gold, cheap world of warcraft gold--

cheap, easy, world of warcraft gold purchasing. You can

buy world of warcraft gold here

Posted by: wowgold at Oct 19, 2007 3:20:16 AM

大家好,我是臺灣人,從臺灣一個人搬家來到美國,環境很陌生,感覺很孤單。以前在臺灣幾家知名的徵信社工作過,我是一個優秀的徵信工作者,希望早點找到適合自己的工作。希望通過貴站,認識更多的朋友。

Posted by: 謝文豪 at Apr 2, 2008 3:08:06 AM

資金を増やそうとするのに不動産投資をするのが手っ取り早い。日本で不動産で東京 賃貸をさがすのはきわめて難しくシステム開発は日本の会社が良い。

Posted by: 不動産投資 at Jul 18, 2008 1:02:32 AM

出会い
チャットレディ
出会い

Posted by: masinn at Aug 28, 2008 12:55:05 AM

Post a comment