Alle VL

Mixed public and private system (for- & non-profit). Federal funding for Medicare, Medicaid, and other programs. Private insurance dominates, often provided by employers. Uninsured rate has decreased since the ACA.

Mandatory health insurance. Majority enrolled in statutory health insurance (SHI). Funded by wage contributions and supplementary income-dependent sums. Private insurance available for high earners.

Population: 325.7M, Elderly (65+): 16%, Physicians: 2.6 per 1,000, Nurse: 11.7 per 1,000, Hospital beds: 2.8 per 1,000.

Population: 82.7M, Elderly (65+): 21.4%, Physicians: 4.3 per 1,000, Nurse: 12.9 per 1,000, Hospital beds: 8.0 per 1,000.

Spending Level: Amount of spending (low / high / middle). Spending Growth: How spending levels change over time (quickly / slowly).

Federal government finances a third, Households 28%, Private Business 18%, State and local government 15%. Hospital care and physician services account for half. Prescription drug spending increased by 8.4%. Public health insurance covers 43%, private insurance covers 29%. Out-of-pocket spending increased by 6.6%.

Low-value care overused. High-value care underused. Declining patient health. High patient demand. Rising drug prices.

Price: Amount paid per unit. Cost: Production cost of the service. Spending: Total money spent (Price x Quantity).

General inefficiencies include overpaying and excessive utilization of care. Overpayment burdens payers. Excessive utilization constitutes resource misallocation. Vaccination as an example of underutilization inefficiency.

New technologies can be more or less expensive. Can lead to increased overall spending if used alongside existing treatments. Can drive increased utilization and spending due to improved longevity.

New technology can trigger a sequence of additional tests and treatments. Driven by anxiety, fear of malpractice, and patient requests.

High healthcare costs in the US due to advanced technologies and system complexities. Strategies include changing reimbursement methods and insurance structures.

If patients consume more than the efficient quantity, the value of the care that exceeds the efficient quantity is less than its price. If patients consume less, there is care that patients value at more than its price that they are not using.

Overconsumption of healthcare services because insurance covers part of the cost. Solutions: Increase out-of-pocket costs, utilization management, change payment models, limit healthcare resources.

Preferences, Income, Price of other goods, Demographics.

Elasticity measures how the quantity demanded changes with price changes. Price elastic: Services that people are willing to forego if the price rises. Price inelastic: Essential services that people will still buy even if the price increases.

Medicare is a federal health insurance for people over 65 or with certain disabilities. Parts: Part A (Inpatient care), Part B (Outpatient care), Medicare Advantage (Part C), Part D (Prescription drug coverage), Gap Plan.

Medicaid is a federal-state partnership providing health insurance with shared costs. States must cover basic services but can offer additional services and more generous eligibility.

Adverse Selection: Higher-risk individuals are more likely to buy insurance, leading to market imbalances. Solutions: Single Payer, Market-Based incentives.

Cost sharing, premiums, deductibles, and spending triggers determine how much care a person will consume. Cost sharing includes copays, indemnity, and coinsurance.

Chargemaster lists services and prices used to generate medical bills. Insurers negotiate allowed amounts with providers. Uninsured face full charges without negotiated discounts.

Limited in healthcare due to the importance of quality and expediency. Transparency helps patients shop for better prices but may not always improve outcomes.

Decision making, Utility, Rational choices, Economic vs. Accounting Costs, Perception and Information.

MCOs aim to reduce costs while maintaining health outcomes. Strategies include eliminating wasteful spending, using incentives, and structures like HMO, PPO, POS.

Phases: Preclinical and Phase 0, Phases I-III, New Drug Application (NDA), Post Market Observation.

Costs or benefits from an activity that affect others not involved in the decision. Positive externalities: Vaccination, Negative externalities: Smoking.

Provides restitution for harm caused by another's actions. Goals: Compensation and incentive to avoid malpractice. Includes economic, noneconomic, and punitive damages.

Income, local environment, intergenerational persistence, urban-rural differences. Assessed using John Rawls’ veil of ignorance.

Bismarck Model: Germany, Belgium, France, Japan. Beveridge Model: New Zealand, Spain, UK. Nationalized Health Insurance: Canada, South Korea. Fee-for-Service: Developing countries.