Health economics and sexual dysfunction. Based on a presentation by Cyril F. Chang, PhD.
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Erectile dysfunction (ED) and the results of its treatment are two separate issues, centering on how outcomes of the disorder affect the economy and the impact its treatment has on quality of life. The treatment of ED has been an $800-million-a-year business in the United States alone. The recent introduction of the drug sildenafil raises the possibility that revenues from its sale could reap billions of dollars for the pharmaceutical industry, with much of that cost being borne by the managed care industry. The introduction of sildenatil raises new cost-effectiveness concerns about all available treatment options. Both the National Institutes of Health and the American Urological Association have identified the need for better studies whose outcomes could be used to analyze the problem of ED. (+info)
Simulating the impact of medical savings accounts on small business.
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OBJECTIVE: To simulate whether allowing small businesses to offer employer-funded medical savings accounts (MSAs) would change the amount or type of insurance coverage. STUDY SETTING: Economic policy evaluation using a national probability sample of nonelderly non-institutionalized Americans from the 1993 Current Population Survey (CPS). STUDY DESIGN: We used a behavioral simulation model to predict the effect of MSAs on the insurance choices of employees of small businesses (and their families). The model predicts spending by each family in a FFS plan, an HMO plan, an MSA, and no insurance. These predictions allow us to compute community-rated premiums for each plan, but with firm-specific load fees. Within each firm, employees then evaluate each option, and the firm decides whether to offer insurance-and what type-based on these evaluations. If firms offer insurance, we consider two scenarios: (1) all workers elect coverage; and (2) workers can decline the coverage in return for a wage increase. PRINCIPAL FINDINGS: In the long run, under simulated conditions, tax-advantaged MSAs could attract 56 percent of all employees offered a plan by small businesses. However, the fraction of small-business employees offered insurance increases only from 41 percent to 43 percent when MSAs become an option. Many employees now signing up for a FFS plan would switch to MSAs if they were universally available. CONCLUSIONS: Our simulations suggest that MSAs will provide a limited impetus to businesses that do not currently cover insurance. However, MSAs could be desirable to workers in firms that already offer HMOs or standard FFS plans. As a result, expanding MSA availability could make it a major form of insurance for covered workers in small businesses. Overall welfare would increase slightly. (+info)
What would happen if large firms offered MSAs?
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This paper reports the results of a survey of more than 500 health benefit specialists about the advice they would give to medium-size and large employers on offering a tax-advantaged medical savings account (MSA). About 42 percent of respondents would recommend an MSA combined with a catastrophic health plan, while a third would advise against such a plan. When presented with a specific example of an MSA package that would be attractive to a large fraction of workers, the percentage of benefit specialists favoring adding an MSA option rose to 74 percent. However, respondents generally did not believe that most workers would choose the MSA, especially if the alternative were a health maintenance organization (HMO). (+info)
Prefunding Medicare without individual accounts.
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It has recently been proposed that Medicare be prefunded through the creation of individual medical retirement accounts. There is a strong case for prefunding Medicare in anticipation of the retirement of the numerous baby boomers. But the creation of individual accounts would involve a new departure for Medicare with serious potential shortcomings. This paper shows how Medicare can be prefunded without the creation of individual accounts--through a Medicare trust fund reform. (+info)
Movement toward individual health benefit accounts.
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There are strong pressures for employers to pursue defined contribution health benefits with individual health benefit accounts such as Medical Savings Accounts (MSAs), Health Care Reimbursement Accounts (HCRAs), and Comprehensive Individual Medical Accounts (CIMAs). Health care consumers are becoming more assertive. The political backlash against managed care is eroding provider-based cost control mechanisms. Health insurance premium inflation is intensifying. Advocates of the movement toward individual health benefit accounts view them as a means of restoring autonomy to the physician-patient relationship and controlling costs. Opponents are concerned that individual health benefit accounts of any type will segment insurance markets, benefiting the healthy and wealthy at the expense of the chronically ill and the poor. Can these accounts be designed so as to achieve their positive effects and minimize negative effects? (+info)
Pretax allotments for health insurance premiums. Final rule.
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The Office of Personnel Management (OPM) is issuing final regulations dealing with the use of OPM's allotment authority to allow for Federal Employees Health Benefits (FEHB) employee premium payments to be deducted on a pretax basis under section 125 of the Internal Revenue Code. The allotment regulations work in tandem with related FEHB regulations dealing with this premium conversion. (+info)
Defined-contribution health insurance products: development and prospects.
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Defined-contribution health insurance products have received considerable recent attention, stimulated by double-digit increases in health plan premiums and employers' desire to get their employees more involved in health care purchasing decisions. Existing products typically feature a consumer health spending account, a major medical or other insurance policy, and the use of the Internet to support consumer decision making. They vary in their use of provider networks, provider payment approaches, the specific design of spending accounts, marketing strategies, and infrastructure investment. The companies producing these products are now at a critical juncture. They could grow rapidly over the next few years, be acquired by existing health plans, or fail if they do not deliver on their promises. (+info)
Medical Savings Accounts: will they reduce costs?
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BACKGROUND: Medical Savings Accounts are an attempt to reduce health care costs by transferring responsibility for expenditures to patients, while providing them with state-supported base amounts to cover some of the costs. We wondered whether such a system would actually be effective, given the fact that medical care expenditures (and illness) are unequally distributed across the population. METHODS: We used the Manitoba Population Health Research Data Respository to assess costs incurred by individual residents of Manitoba for all physician visits and admissions to hospital between 1997 and 1999, and we calculated an average expenditure per person per year over the 3 years. RESULTS: During fiscal years 1997-1999, physician and hospital costs that could be attributed to individual Manitoba residents averaged $730 each year. Most users accounted for very little expenditure. About 40% of the entire population of Manitoba used less than $100 each, and 80% used less than $600. The highest-using 1% of the Manitoba population accounted for 26% of all spending on hospital and physician care, whereas the lowest-using 50% accounted for 4%. When examined by age category, the results were similar. Even in the highest age category, most of the population falls into the low-usage category. If the entitlement under a Medical Savings Account scheme was set at the current average cost of $730 per year, then total spending by government on health care for this healthy group would increase (by $505 million) rather than decrease. If the "catastrophic threshold," above which the insurer would pay costs, was set at $1,000 per year, then the sickest 20% of Manitoba residents would become personally responsible for just over $60 million of current health care costs. The net result is a 54% increase in spending on hospital and physician costs that can be allocated to individuals. INTERPRETATION: Medical Savings Accounts will not save money but will instead, under most formulations, lead to an increase in spending on the healthiest members of the population. (+info)