U.S. health care spending rose 7.9 percent to $1.9 trillion in 2004, or $6,280 per person. Health spending accounted for 16 percent of gross domestic product (GDP), nearly the same as in 2003. The pace of health spending growth has slowed, compared with the 2000-2002 period, for both public and private payers. Hospital spending accounted for 30 percent of the aggregate increase between 2002 and 2004, and prescription drugs accounted for an 11 percent share-smaller than its share of the increase in recent years and much slower in absolute terms.
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"Nursing home expenditures totaled $115.2 billion in 2004, which represented 6.1 percent of national health expenditures (Smith et al. 2006). The nursing home market consists of both chronic (long-stay) and post-acute (short-stay) residents. "
[Show abstract][Hide abstract] ABSTRACT: Given the preferential tax treatment afforded nonprofit firms, policymakers and researchers have been interested in whether the nonprofit sector provides higher nursing home quality relative to its for-profit counterpart. However, differential selection into for-profits and nonprofits can lead to biased estimates of the effect of ownership form. By using "differential distance" to the nearest nonprofit nursing home relative to the nearest for-profit nursing home, we mimic randomization of residents into more or less "exposure" to nonprofit homes when estimating the effects of ownership on quality of care. Using national Minimum Data Set assessments linked with Medicare claims, we use a national cohort of post-acute patients who were newly admitted to nursing homes within an 18-month period spanning January 1, 2004 and June 30, 2005. After instrumenting for ownership status, we found that post-acute patients in nonprofit facilities had fewer 30-day hospitalizations and greater improvement in mobility, pain, and functioning.
Full-text · Article · Sep 2012 · Journal of Health Economics
"3 They estimate a savings potential of 1.4 Billion $US if 10% of concerned patients were to demand relevant treatment abroad. Measured on the total expenditures of almost 2 trillion US$ (Smith et al. (2006)), this figure appears small. However, considering the degree of out-of-pocket payments in the United States and the chronic cost pressures in a number of other countries, price gradients could be useful instruments in the debate about options for making health systems more efficient. "
[Show abstract][Hide abstract] ABSTRACT: There is a growing interest in cross-border medical care and its comparative advantages. In addition, medical care can be defined as a local assurance good. Little research is being carried out in this field. This paper discusses the individual considerations for medical treatment offered at home and abroad within a micro-economical framework. Specific assumptions as mistrust, monetary and non-monetary transaction-costs, a price and cost gradient, illness severity as well as a lump-sum insurance are discussed. We show that a demand abroad can be utility maximizing, however, only second best. There are inefficiencies in the dimensions of ex-post demand and income risk either on the side of gross-income or of costs. Furthermore, the foreign demand is restricted for low health stages driven by mistrust and restrictions in quality. Higher stages are more capable if fixed costs are low. To demand abroad the marginal treatment costs abroad must fall short of a threshold level. Finally, an out-of-pocket payment can reduce the moral hazard when treatment takes place abroad.
Preview · Article · Nov 2009 · SSRN Electronic Journal
"In fact, health costs continue to climb at a pace that far exceeds the growth in income, threatening individuals' abilities to finance their own medical care. Spending on health care in the United States reached $1.9 trillion in 2004, and accounted for 16 percent of the nation's Gross Domestic Product (Smith et al. 2006a). Growth in spending for health insurance premiums, an indicator of what workers and employers are paying for health care is significantly outpacing inflation and the growth in personal income (Claxton et al. 2005). "
[Show abstract][Hide abstract] ABSTRACT: The health issues women face over the course of their lives, as well as policies that shape Medicare, Medicaid, and other supplemental coverage can affect retired women's economic well-being. This study uses a nationally representative sample of Medicare beneficiaries aged 65 and older in 2002 to explore gender-based differences in health and long-term care use, spending patterns, and the financial burden of health and long-term care out-of-pocket health expenses. Women's health care expenses were higher than men's; older women paid for a greater share of their total spending out of pocket and they faced a greater financial burden by shouldering these out-of-pocket costs with less income at their disposal. Low-income women, those with Medigap or no supple-mental coverage, and white women, who are less likely to qualify for Medicaid which covers long term care, faced the greatest financial burdens associated with health and long-term care costs. The implications of these findings for women in the context of the current health policy landscape are discussed. Controlling health spending and developing options to finance long-term care are key elements of the policy solutions that will need to be developed to preserve and support economic security for millions of retired women in the United States.
Preview · Article · Sep 2009 · Journal of Women Politics & Policy