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Over the past four decades, the share of income devoted to health care nearly tripled. If policy is unchanged, this trend is likely to continue. Should Americans decide to rein in the growth of health care spending, they will be forced to consider whether to ration care for the well-insured, a prospect that is odious and unthinkable to many. This book argues that sensible health care rationing can not only save money but improve general welfare and public health. It reviews the experience with health care rationing in Great Britain. The choices the British have made point up the nature of the options Americans will face if they wish to keep public health care budgets from driving taxes ever higher and private health care spending from crowding out increases in other forms of worker compensation and consumption. This book explains why serious consideration of health care rationing is inescapable. It also provides the information policymakers and concerned citizens need to think clearly about these difficult issues and engage in an informed debate.

Along with being the biggest sector of the U.S. economy, healthcare is also the most dysfunctional. This book presents a compelling vision of how healthcare can work better and how we can get there with the current resources. Providing a comprehensive, positive, and intriguing vision of the future, this book tells healthcare providers how they can reposition their organizations to thrive regardless of what the government does in regards to policy. It also outlines how employers can save money by changing the way they provide healthcare to their employees.

Now in its fourth edition, The Economics of Health Reconsidered presents an argument that still holds true: despite assertions to the contrary, neither economic theory nor evidence shows that reliance on market forces leads to superior outcomes in healthcare systems. Government plays a crucial role in making the healthcare sector not only more equitable but also more efficient. This book reconsiders the field of health economics as it is traditionally taught and practiced. It critically examines economic theory as applied to the health sector and questions the prevailing belief that a competitive healthcare marketplace results in the best outcomes. Fully revised and updated, this new edition incorporates information on the impact of the implementation of the Affordable Care Act as well as: A new chapter on healthcare expenditures, which examines healthcare spending in the United States and in other high-income countries, including the magnitude, growth, and causes of high expenditures and the different policies that have been used or proposed to help control them A new chapter that describes the various types of economic evaluation currently used in healthcare, discusses the issues that arise with the use of economic evaluations, and provides information on how to conduct an economic evaluation New and updated data throughout chapters and exhibits This book serves as an ideal stand-alone text for health economics and health policy courses and as a general reference for issues in health economics.

It has become trite to observe that increases in health care costs have become unsustainable. How best for policy to address these increases, however, depends in part on the degree to which they represent increases in the real quantity of medical services as opposed to increased unit prices of existing services. And an even more fundamental question is the degree to which the increased spending actually has purchased improved health. Accounting for Health and Health Care addresses both these issues. The government agencies responsible for measuring unit prices for medical services have taken steps in recent years that have greatly improved the accuracy of those measures. Nonetheless, this book has several recommendations aimed at further improving the price indices.

The development challenges of addressing health problems in low- and middle-income countries are daunting but not insurmountable. There are now known and affordable interventions to deal with many aspects of the HIV/AIDS crisis as well as the continued challenge posed by malaria and other major infectious diseases. Three major development objectives of health insurance in low- and middle income countries are highlighted in this volume: securing sustainable financing for health care providers that serve the health needs of vulnerable populations; providing financial protection against the impoverishing cost of illness; and reducing social exclusion from organized health financing and delivery systems. Private health insurance schemes can address the needs of the poor and other vulnerable populations with appropriate combinations of subsidies, risk pooling, household savings, and user charges. The authors of this book argue in favor of a multipillar approach to health care financing in low- and middle-income countries that combines these instruments in addressing the underlying development objectives described above, while putting a strong emphasis on private voluntary health insurance. In this way, private means can make a significant contribution to public ends.

The debate rages on over how to cope with the rising costs of medical care--proposed solutions range from a single payer system with a broad government control to loosely defined market-driven plans. The authors look at three key elements of health care costs and offer thoughtful, realistic suggestions to help stem the tide of rising expenses for everyone.

In Crisis of Abundance: Rethinking How We Pay for Health Care, economist Arnold Kling argues that the way we finance health care matches neither the needs of patients nor the way medicine is practiced. The availability of \"premium medicine,\" combined with patients who are insulated from costs, means Americans are not getting maximum value per dollar spent.

Hidden Cost, Value Lost , the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining so many people without health insurance. The book explores the potential economic and societal benefits that could be realized if everyone had health insurance on a continuous basis, as people over age 65 currently do with Medicare. Hidden Costs, Value Lost concludes that the estimated benefits across society in health years of life gained by providing the uninsured with the kind and amount of health services that the insured use, are likely greater than the additional social costs of doing so. The potential economic value to be gained in better health outcomes from uninterrupted coverage for all Americans is estimated to be between $65 and $130 billion each year.

INTRODUCTION Older adults with dementia incur considerable out‐of‐pocket (OOP) health care expenses, but it is unclear how their financial burden differs by dementia stage. METHODS We identified 2939 respondents aged ≥65 with dementia in the 2018 Health and Retirement Study, representing 9.8 million individuals on weighted analysis. We grouped respondents into four severity stages and examined their OOP expenditures, prevalence of financial risk (i.e., catastrophic or impoverishing levels of health care spending), and factors associated with financial risk. RESULTS Individuals with severe dementia had significantly higher OOP costs, with 21% experiencing catastrophic expenditures and 12% falling below poverty thresholds due to these costs. Regression analyses indicated nursing home residence, poor subjective health, advanced age, and other factors are associated with an increased odds of financial risk. DISCUSSION Financial risk increases in advanced dementia stages, likely reflecting more complex care needs and poorer overall health. Highlights Out‐of‐pocket health care costs increase with dementia severity. Twenty‐one percent of people with severe dementia spend at least 40% of their income on health care. The risk of impoverishment from health care costs increases in severe dementia. Care needs, poor health, and nursing home residence may contribute to financial risk.