《健康经济学》教学课件(英文版)—Chapter18.pptxVIP

CHAPTER 18THE AMERICAN MODEL

The American modelBhattacharya,HydeandTu–HealthEconomi Unlikeeveryotherdevelopedcountry,theUnitStateslacksuniversalguaranteedinsurancefocitizens. Nevertheless,mostAmericansfindinsurancecoveragethroughoneofthesethreeavenues:employer-basedinsurance,MedicareandMedicaThismixofprivateandpublicinsuranceisahallmoftheAmericanmodel.

The American modelBhattacharya,HydeandTu–HealthEconomiMajorcharacteristics:Privatehealthinsurancemarkets:Thenon-elderlyandnon-poorseekinsuranceontheprivatemarkwhichiscenteredaroundemployer-basedhealthinsurancepools.Partialuniversalhealthinsurance:Subsidizeduniversalhealthinsuranceisprovidedtotwovulnersubpopulations:theelderly(throughMedicare)andthepoor(throMedicaid).Privatehealthcareprovision:Mosthospitalsanddoctor’sclinicsareprivate.Whilethereiantitrustregulation,therearefewlegalrestrictionsonwheredcanpracticeandhospitalscanopen.Therearealsonodirectpriccontrolsenforcedbythegovernment.

TheAmericanmodelBhattacharya,HydeandTu–HealthEconomi TheAmericanmodelreflectsapoliticalprefereforlibertyandfreechoice.Patients(usually)havefreechoiceof:DoctorHospitalInsuranceplanDoctors(usually)havefreechoiceof:PricestochargeWheretopracticeWhomtotreat

Ch18|TheAmericanmodelEMPLOYER-SPONSOREDHEALTHINSURANCE

Employer-sponsoredhealthinsuranceBhattacharya,HydeandTu–HealthEconomiMostinsurednon-elderlyAmericansreceivecoveragthroughemployer-sponsoredplans. Thisinsuranceisnot“free”,sinceitisactuapartoftheworker’stotalcompensationpackageThecostofpremiumsaretakenoutoftheworker’swages. Thefactthatthecostsofinsuranceeffectivelycomeoutoftheworker’swagesisknownaswagepass-through.Soforthesametypeofjobandskill-level,jobswitemployer-sponsoredinsuranceplansmayofferhigherwagesthanjobswiththem.

Employer-