Public and private health‐care financing with alternate public rationing rules

Cuff, Katharine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

doi:10.1002/hec.1698

Cited by 19 publications

(53 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To model the interaction between parallel public and private health care financing and the allocation rule of the public health care system, Cuff et al (2010) assume a continuum of individuals who differ along two dimensions: income ( Y ) and severity of illness ( s ). An individual knows her income but is unaware of her severity of illness.…”

Section: Theoretical Modelmentioning

confidence: 99%

“…Cuff et al (2010) determine the equilibrium in the market for health care resources by first calculating each individual's WTP for private insurance assuming that individuals are expected‐payoff maximizers 6 . At the time an individual decides whether to purchase private insurance, she does not know her severity of illness or the probability of receiving health care in the public system.…”

Section: Theoretical Modelmentioning

confidence: 99%

“…The purpose of this paper is twofold: (i) using a controlled randomized laboratory experiment, we test predictions about people's willingness‐to‐pay for private parallel insurance based on a theoretical model (Cuff et al 2010); and (ii) on the basis of the experimental evidence from (i) we draw implications for the policy debate on parallel private health insurance in Canada.…”

Section: Introductionmentioning

confidence: 99%

“…The paper is organized as follows. Section 2 provides a summary of the Cuff et al (2010) model of parallel public and private health care finance, section 3 discusses the laboratory implementation of the theoretical model, section 4 presents our experimental results, section 5 introduces a calibration of the model using behavioural estimates, and section 6 discusses these results and their policy implications.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Willingness‐to‐pay for parallel private health insurance: evidence from a laboratory experiment

Buckley¹,

Cuff²,

Hurley³

et al. 2012

Canadian J of Economics

Self Cite

View full text Add to dashboard Cite

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Debate over the effects of public versus private health care financing has been, and continues to be, active in both academic outlets and policy circles. Theoretical literature on parallel health care financing is often built on untested behavioural assumptions and the empirical evidence generally depends upon the institutional details of the specific health care systems under analysis. This paper contributes to the literature on parallel health care finance by developing and executing a revealed preference laboratory experiment based on the theoretical model of parallel health care finance in Cuff et al. (2008). The theoretical model involves individuals with varying severities of illness who demand health care from a limited supply of health care resources. Health care resources are purchased by the public sector and rationed free of charge to individuals, or purchased by individuals through a private insurance market. The general theoretical model is converted into a discrete experimental representation of a large-scale economy where individuals are price takers, the probability of receiving public health care is exogenous and the willingness-to-pay (WTP) for private health insurance is elicited from subjects. The experimental design includes two within-subject factors based on the theoretical model: the public sector rationing rule (rationing based on need or severity versus rationing based on a random allocation) and the probability of being publicly treated (high versus low). The experimental design also includes two between-subjects treatments based on the frame of the experiment (neutral frame versus health frame) and on the distribution of private health insurance prices (high prices versus low prices). The results show the public system's allocation rule and the probability of receiving health care from the public system both significantly affect an individual's WTP for private health insurance in the predicted direction, although the WTP values tend to be above the actual theoretical predictions. When the public system allocates health care based on need, the average WTP is lower than under random allocation. A higher probability of receiving health care from the public system elicits a lower WTP regardless of how the public system allocates health care. It is also found that when the public system allocates health care based on need, the WTPs are significantly higher under a neutral frame than a health frame. Terms of use: Documents in

show abstract

Section: Theoretical Modelmentioning

confidence: 99%

Section: Theoretical Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Willingness‐to‐pay for parallel private health insurance: evidence from a laboratory experiment

Buckley¹,

Cuff²,

Hurley³

et al. 2012

Canadian J of Economics

Self Cite

View full text Add to dashboard Cite

show abstract

“…13 It has been suggested that the preferential treatment of workers through expediting investigations, assessments, and surgery may create unequal access to care for patients with non–work-related injuries, who have to wait longer due to limited available resources. 5,6,12 However, parallel insurance helps improve quality standards, accountability, and innovation for injured workers without taking away resources from the public health by using the excess underutilized capacity of the surgeons and operating theaters of the public system.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery

Razmjou

Boljanovic

Lincoln

et al. 2017

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background:Work-related rotator cuff injuries are a common cause of disability and employee time loss.Purpose:To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery.Study Design:Case series; Level of evidence, 4.Methods:Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status.Results:One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) (P < .0001). Eighty-four percent (n = 122) of patients exceeded the MCID of 17 points. Individual factors that affected patient overall disability were preoperative ASES, work status prior to surgery, access to care, and autonomy at work. Achieving a minimal clinically meaningful change was influenced by perceived access to care, autonomy and stress at work, and overall satisfaction with the job.Conclusion:Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.

show abstract

Truncal varicose vein diameter and patient-reported outcome measures

Lane

Varatharajan

Fiorentino

et al. 2017

British Journal of Surgery

View full text Add to dashboard Cite

Background Varicose veins and chronic venous disease are common, and some funding bodies ration treatment based on a minimum diameter of the incompetent truncal vein. This study assessed the effect of maximum vein diameter on clinical status and patient symptoms. Methods A prospective observational cohort study of patients presenting with symptomatic varicose veins to a tertiary referral public hospital vascular clinic between January 2011 and July 2012. Patients underwent standardized assessment with venous duplex ultrasonography, and completed questionnaires assessing quality of life (QoL) and symptoms (Aberdeen Varicose Vein Questionnaire, EuroQol Five Domain QoL assessment and EuroQol visual analogue scale). Clinical scores (Venous Clinical Severity Score (VCSS) and Clinical Etiologic Anatomic Pathophysiologic (CEAP) class) were also calculated. Regression analysis was used to investigate the relationship between QoL, symptoms and vein diameter. Results Some 330 patients were assessed before surgery. The median maximum vein diameter was 7·0 (i.q.r. 5·3–9·2) mm overall, 7·9 (6·0–9·8) mm for great saphenous vein and 6·0 (5·2–8·9) mm for small saphenous vein. In linear regression analysis, vein diameter was shown to have a significant association with VCSS (P = 0·041). For every 1‐mm increase in vein diameter, there was a 2·75‐fold increase in risk of being in CEAP class C4 compared with C2. No other QoL or symptom measures were related to vein diameter. Conclusion Incompetent truncal vein diameter was associated with increasing VCSS, but not a variety of other varicose vein disease‐specific and generic patient‐reported outcome measures.

show abstract

Public and private health‐care financing with alternate public rationing rules

Cited by 19 publications

References 28 publications

Willingness‐to‐pay for parallel private health insurance: evidence from a laboratory experiment

Willingness‐to‐pay for parallel private health insurance: evidence from a laboratory experiment

Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery

Truncal varicose vein diameter and patient-reported outcome measures

Contact Info

Product

Resources

About