PubMed · 10272000
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G W Northrup. A strong commitment to excellence.. https://pubmed.ncbi.nlm.nih.gov/10272000/
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Most employees contribute towards the cost of employer-sponsored insurance, despite tax laws that favor zero contributions. Contribution levels vary markedly across firms, and the average contribution (as a percentage of the premium) has increased over time. We offer a novel explanation for these facts: employers raise contribution levels to encourage their employees to obtain coverage from their spouses' employer. We develop a model to show how the employee contribution required by a given firm depends on characteristics of the firm and its work force, and find empirical support for many of the model's predictions.
A competitive market for individual health insurance tends to risk-adjusted premiums. Premium rate restrictions are often considered a tool to increase access to coverage for high-risk individuals in such a market. However, such regulation induces selection which may have several adverse effects. As an alternative approach we consider risk-adjusted premium subsidies. Empirical results of simulated premium models and subsidy formulae are presented. It is shown that sufficiently adjusted subsidies eliminate the need for premium rate restrictions and consequently avoid their adverse effects. Therefore, the subsidy approach is the preferred strategy to increase access to coverage for high-risk individuals.
We present a model of the physician-patient relationship extending on the model by Farley [Farley, P.J., 1986. Theories of the price and quantity of physician services. Journal of Health Economics 5, 315-333] of supplier-induced demand (SID). First, we make a case for the way this model specifies professional ethics, physician competition, and SID itself. Second, we derive predictions from this model, and confront them with the neoclassical model. Finally, we stress the importance of considering how SID affects patient welfare in providing an example where physicians' ability to induce makes patients better off. To evaluate patient welfare, we derive approximations of the patients' welfare loss due to physician market power in both the neoclassical model and the inducement model.