The sharp decline and equally sharp recovery in public health care spending in the 1990s in Canada set the stage for a broad consideration of reform options but also established hurdles to be overcome in taking action. By moving health care to the center of the federal-provincial agenda,...

To examine the extent to which Canadian residents seek medical care across the border, we collected data about Canadians' use of services from ambulatory care facilities and hospitals located in Michigan, New York State, and Washington State during 1994-1998. We also collected information from...

This paper examines the comparative financial protection provided by individual and group health insurance. Data sources include two national surveys of employer-based health plans and e-health insurance listings for individual coverage on the World Wide Web. Data on the use and cost of services...

The number of uninsured Americans fell in 2000 for the second consecutive year. The reduction has been attributed to the continued expansion of employer-sponsored insurance. However, the increase in employer coverage among adults was offset by declines of other types of coverage. For children,...

Cost-effectiveness analysis is versatile and used widely to assist in health care decision making. This chapter discusses how cost-effectiveness analysis is used at the system or national level, particularly in the domain of coverage and payment policy. We describe its relationship to other...

There are widespread differences in health care spending and utilization across regions of the US as well as in other countries. Are these variations caused by demand-side factors such as patient preferences, health status, income, or access? Or are they caused by supply-side factors such as...

The COVID-19 crisis has starkly illustrated both the strengths and limitations of U.S. biomedical innovation institutions as deployed to fight a pandemic. These innovation institutions include not just intellectual property law, but also other legal systems that structure incentives for...

There is much debate about the effects of pharmaceutical direct to consumer advertising (DTCA) on health care use. In this paper, we inform this debate by examining the effects of DTCA on office visits, as well as treatment courses resulting from those visits, for five common chronic conditions...

Ensuring affordable access to novel medicines has been identified as a policy priority among OECD and EU countries, yet systematic monitoring of the various dimensions of access is lacking. Previous efforts to measure access have focused primarily on one or at most two of these dimensions, such...

The extent of premature death and ill health in the developing world is staggering. Death and ill health on such a scale are matters of concern in their own right. They also foster a brake on economic development. It was these twin concerns that led the international community to put health...