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CHAPTER 9

CHAPTER 9. The Health Care Market. Social Insurance. Social insurance - government programs that provide insurance to protect against adverse events Examples Medicaid Medicare Social Security Unemployment Compensation. How Health Insurance Works. Insurance premium Expected Value

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CHAPTER 9

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  1. CHAPTER 9 The Health Care Market

  2. Social Insurance • Social insurance - government programs that provide insurance to protect against adverse events • Examples • Medicaid • Medicare • Social Security • Unemployment Compensation

  3. How Health Insurance Works • Insurance premium • Expected Value • Expected value (EV) = probability of outcome 1) * (Payout in outcome 1) + probability of outcome 2)*(Payout in outcome 2) + … + (probability of outcome n)*(Payout in outcome n)

  4. Expected Value Computation Draw cards from deck of cards Draw heart and receive $12 Draw spade, diamond or club and lose $4 Probability of drawing heart = 13/52 = ¼ Probability of drawing spade, diamond or club = 39/52 = ¾ EV = (1/4)($12) + (3/4)(-$4) = $0

  5. Why Buy Insurance? Actuarially Fair Insurance Policy

  6. Why People Buy Insurance B UB Utility D UD UC C • Expected Utility • Risk Smoothing A UA Income 20,000 47,000 50,000

  7. Do People Buy Insurance with Loading Fees? • Risk Aversion • Risk Premium • Loading Fee

  8. The Role of Risk Pooling • Insurance in a small population • Insurance in a large population • Law of large numbers

  9. Adverse Selection in the Health Insurance Market • Asymmetric information

  10. Asymmetric Information and Adverse Selection

  11. Does Adverse Selection Justify Government Intervention? • Experience rating • Experience rating and equity • Community rating

  12. Insurance and Moral Hazard • Moral hazard • Deductible • Co-payment • Co-insurance

  13. Moral Hazard Flat-of-the-curve medicine Price per unit deadweight loss b a Sm P0 h .2P0 Dm 0 M0 M1 Medical services per year

  14. Health Care Expenditures and Health Outcomes

  15. Additional Considerations • The Elasticity of Demand for Medical Services • Does Moral Hazard Justify Government Intervention? • Third Party Payment

  16. Other Market Failures in the Health Care Market • Information Problems • Externalities

  17. Do We Want Efficient Provision of Health Care? • Paternalism • The Problem of the Uninsured • Who are the uninsured? • Does health insurance improve health

  18. High Health Care Costs

  19. Causes of Health Care Cost Inflation • The Graying of America • Income Growth • Improvements in Quality • Commodity Egalitarianism

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