Competition among health insurers is widely considered to be a means of enhancing efficiency and containing costs in the health care system. In this paper, it is argued that this could be unsuccessful since health care providers hold a strong position on the market for health care services....

We study the effects of "balance billing", i.e., allowing physicians to charge a fee from patients in addition to the fee paid by Medicare. First, we show that on pure efficiency grounds the optimal Medicare fee under balance billing is zero. An active Medicare policy thus can only be justified...

We study the role of physicians in driving geographic variation of US healthcare utilization. We estimate a model that separates variation in average utilization of Medicare beneficiaries due to physicians, non-physician supply side factors, and patient demand. The model is identified by...

We present a growth model with micro-foundations of a mixed health care system and physician dual-practice, to analyze for welfare-optimal government financing strategy for a mixed health system in developing countries. Calibrating the model for Indonesia, we find that a government subsidy to...

Provider cost-control incentives have become an important part of the health insurance landscape in the United States. These incentives are strongest in capitated managed care organizations, especially HMOs, because such organizations are paid a fixed amount regardless of the spending they...

Despite promises that Medicare would not interfere with patients' ability to choose their physician and to purchase additional health coverage on the open market, over the decades Medicare rules and regulations have gradually eroded senior citizens' ability to control their healthcare choices....

The difficulties that Medicaid beneficiaries face accessing medical care are often attributed to the program's low reimbursement rates relative to other payers. There is little evidence, however, as to the actual effects of Medicaid doctor payment rates on access and health outcomes for...

Healthcare payers try to reduce costs by promoting the use of cheaper generic drugs. We show strong interrelations in drug prescriptions between the inpatient and outpatient sectors by using a large administrative dataset from Austria. Patients with prior hospital visits have a significantly...

This toolkit contains the elements needed to understand the problem of medical malpractice in America today, and whether alternative dispute resolution (i.e., arbitration) clauses might be viable among other tort reform options. The toolkit introduces medical liability as an intrinsic component...

The questions addressed in this paper are related to access rules to primary care services and the potential for patient driven competition between GPs and specialists. Most of the literature on the performance of primary care has dealt with reforming payment schemes, little attention being paid...