behaving differently when you know someone else
is taking the risk (Induced demand)
adverse selection
the sicker people likely want more insurance (the
healthier, less)
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pooling of risk
sharing risk proportionately among many is a basic insurance
concept
Non marketability of risks
inherent in medicine and medical practice
Health insurance
Asymmetries of information Healthcare
Physician vs. patient (vs. 3rd Party payer)
Uncertainty and Health Care
financing health care in the United States is a complex matter
,•Workarounds
•Redundancies
•Contradictions
single national payment system
because the United States lacks a__________________________, for healthcare, how the
money is paid to the providers of health care has become very complicated.
•Situation that to this point, health care reform policies have not reduced
National Health Expenditure Accounts (NHEA)
•Provide official estimates of health care spending in the United States
•Measures health care consumption and health care investment
Benefits of NHEA
•Comprehensive—includes all major components of health care system in a unified, mutually
exclusive, and exhaustive structure
Health Care Financing
•Multidimensional—encompasses expenditures as well as payers
•Consistent—applies a common set of definitions that permits longitudinal comparisons
Published by the U.S. Department of Health and Human Services (DHHS)
NHEA produce
National Health Expenditures (NHE)
,Health Consumption Expenditures (HCE)
Personal Health Care (PHC)
NHE – HCE = Amount of investment in the Medical Sector of economy
National Health Expenditures (NHE)
•All health care consumption and investments in medical structures and equipment and
noncommercial health services and biomedical research
Health Consumption Expenditures (HCE)
•A subset of NHE
•Includes personal health care spending, government administration and net cost of private
health insurance, and public health activities
Personal Health Care (PHC)
•A subset of HCE
•Includes all medical goods and services that are used to diagnose, treat, and prevent health
problems in a specific person
Health care spending has
increased in the United States every year since 1960 except for slight dips in 2013 and 2017.
•Absolute amount
•Per capita amount
•Percentage of Gross Domestic Product (GDP)
, In 2017, the National Health Expenditures (NHE) were
•$3.49 trillion
•17.9% of GDP
•$10,739 per capita
per capita spending on health care
not adjusted for inflation—was $146 in 1960, compared to $10,739 in 2017
Buying power
of $146 in 1960 equates to about $1,207 when adjusted by the Consumer Price Index (CPI)
direct and indirect health care spending
were it to be allocated evenly across the population—would be larger than any other household
expense
In 2017, median household income
was $57,652, and median rent or owner costs for housing was $11,784.
$29,000
50%
•With per household NHE at around ______, health care expenditures would be more than
_____of the median household income.
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