Thesis (M.Phil.)--Hong Kong University of Science and Technology, 2006. / Includes bibliographical references (leaves 96-100). Also available in electronic version.

Zugl.: Freiburg (Breisgau), Universiẗat, Diss., 2006.

Thesis (M.S. Eco.)--Baylor University, 2006. / Includes bibliographical references (p. 48-50).

abstract: This work is driven by two facts. First, the majority of households in the U.S. obtain health insurance through their employer. Second, around 20% of working age households choose not to purchase health insurance. The link between employment and health insurance has potentially large implications for household selection into employment and participation in public health insurance programs. In these two essays, I address the role of public and private provisions of health insurance on household employment and insurance decisions, the distribution of welfare, and the aggregate economy. In the first essay, I quantify the effects of key parts of the 2010 health care reform legislation. I construct a lifecycle incomplete markets model with an endogenous choice of health insurance coverage and calibrate it to U.S. data. I find that the reform decreases the fraction of uninsured households by 94% and increases ex-ante household welfare by 2.3% in consumption equivalence. The main driving force behind the reduction in the uninsured population is the health insurance mandate, although I find no significant welfare loss associated with the elimination of the mandatory health insurance provision. In the second essay, I provide a quantitative analysis of the role of medical expenditure risk in the employment and insurance decisions of households approaching retirement. I construct a dynamic general equilibrium model of the household that allows for self-selection into employment and health insurance coverage. I find that the welfare cost of medical expenditure risk is large at 5% of lifetime consumption equivalence for the non-institutionalized population. In addition, the provision of health insurance through the employer accounts for 20% of hours worked for households ages 60-64. Finally, I provide an quantitative analysis of changes in Medicare minimum eligibility age in a series of policy experiments. / Dissertation/Thesis / Ph.D. Economics 2011

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Health care systems are complex organizations. Multiple agents interact in different settings to provide health care, each one of them with different objectives and information. How markets are organized and which actions are allowed, has a direct impact on the incentives agents face when making health care choices. In this dissertation, I study the determinants and effects of these choices on market outcomes, focusing on private health insurance markets. The first chapter provides insights about health insurance markets in which workers, rather than firms , choose insurance plans in an imperfect competition setting. Using a unique dataset that includes every person enrolled in private plans in Chile in 2009, I estimate underlying preference parameters over health insurance features. I find large heterogeneity in the valuation of t hese features across age-sex-groups and individual types. Individual characteristics play an important role on health plan choices and therefore, can be used by insurers to design plans targeted to specific groups and for patient selection. The second chapter presents a theoretical model where private insurers compete with a free public alternative to attract clients. Using a two-type model I show that if private insurance companies offer a non-rationing alternative and the public system rationing is done through random selection, an efficiency trap may exist. A marginal increase in the budget allocated to the public system can potentially reduce the expected welfare for all types. This result extends to a model with multiple types, but the negative welfare impact is offset by a crowding-in effect among the rich. Finally, the third chapter provides a general analytical framework that can be used to evaluate risk selection under different health care models. The model is based on the interactions between the four key agents present in every health care system: sponsors, health plans, providers and customers. This framework is used to review risk selection in four countries in the Americas - Canada, Chile, Colombia, and the U.S.-, showing how regulatory policies both create and ameliorate it, and in some cases are as important as risk adjustment, risk sharing and risk selection strategies for reducing risk selection. / 2031-01-01

No description available.

abstract: This dissertation consists of two chapters. Chapter one studies distortionary effects of tax exemption of employer-sponsored health insurance (ESHI) premiums. First, I argue that, in the competitive labor market, tax deductibility of ESHI premiums generates an implicit labor cost subsidy to the employers sponsoring health insurance (HI) which distorts the allocation of labor across employers. Second, I quantify the extent of this misallocation measured as output loss in a general equilibrium model of firm dynamics extended to incorporate tax exemption of ESHI premiums and endogenous provision of HI by the employers. The calibrated model shows that elimination of tax exemption increases aggregate output by 1.73%. About two-thirds of this effect comes from removing the misallocation of labor across existing establishments, and the remaining one-third comes from the increase in the number of operating establishments. Third, I use the model to analyze how tax exemption interacts with the employer mandate of the Affordable Care Act imposing a tax on large employers not sponsoring HI. Quantitative results show that implementing the employer mandate when the tax exemption is present reduces output by 0.13%. Chapter two studies macroeconomic implications of a higher cost of health services faced by the unemployed which arise because 1) workers lose access to ESHI when they leave their jobs and 2) the uninsured face inflated health care prices. First, I provide evidence suggesting that the cost of health services for the privately insured is about 50% lower than for the uninsured. Second, I quantify the effects of higher cost of health services for the unemployed in the Lucas and Prescott (1974) island model extended to allow the workers to pay an extra cost of health services contingent on their employment status. Calibration procedure uses the differences between costs of health services for the privately insured and uninsured inferred from the data as a gap between costs of health services for the employed and unemployed. Quantitative results show that equalizing these costs across workers increases labor productivity by 1.2% and unemployment rate by 1.5 percentage points. The increased unemployment dominates quantitatively leading to a decrease in aggregate output by 0.26%. / Dissertation/Thesis / Doctoral Dissertation Economics 2017

Orientador: Orlando Saliba / Banca: Eduardo Daruge Júnior / Banca: Eliel Soares Orenha / Resumo: O setor de saúde suplementar atualmente representa a porta de entrada de cerca de 42 milhões de brasileiros a serviços de saúde. Passaram-se anos até que finalmente surge a regulamentação do setor. O objetivo deste trabalho foi realizar uma análise da representação da classe odontológica frente a Agência Nacional de Saúde Suplementar - ANS, responsável pela regulamentação e fiscalização do setor. Por meio de uma investigação do conteúdo das Atas de reuniões da ANS no período de 1998 a 2006 realizou-se a identificação e classificação das citações relativas à odontologia, tentando traçar um perfil da representação da classe junto ao setor. A odontologia foi referenciada 135 vezes nos documentos examinados, os representantes da classe odontológica foram responsáveis por 77 citações (57%), destas 19 trataram sobre a cobertura e rol de procedimentos sendo 7 de caráter reivindicatório; outras 35 colocações trataram do gerenciamento e padronização dos serviços e contratos oferecidos pelos planos odontológicos, sendo que 5 foram de caráter reivindicatório; outras 3 reivindicações foram pleiteadas pelos representantes em relação à política de reajustes e taxas e totalizaram 10 citações a respeito dos prestadores de serviços. Concluímos que a classe odontológica parece estar bem representada, sendo imprescindível a continuidade dos trabalhos executados por nossos representantes junto a ANS. / Abstract: The sector of health insurance is the entrance of 42 millions Brazilian people for health services. Passed a lot of years until regulations appears. The objective of this article was made an analysis of dental institutions participation at the national agenc y of health insurance - ANS, response for regulation and investigation in Brazil. Through an documental analysis of texts described in meeting registration of ANS, from 1998 to 2006, was made an identification of dental citations, try to describe a standard of dental representation in the meetings. The dentistry was present in 135 citations, the dentistry representatives institutional made 77 citations (57%), 19 was about dentistry proceeds and 7 of those was to ask resolutions; others 35 citations was about manager and standard of services offer by insurance companies, 5 was ask resolutions; others 3 asks was about taxes and fees, and 10 others was about relationship between companies and employs. The results show that dentistry has a good presence by their institutional representatives in ANS meetings. / Mestre

Thesis (MTech (Public Management)--Cape Peninsula University of Technology, 2011 / In South Africa’s two-tiered health system, some enjoy health care based on ability to pay and others utilize services in an under-funded sector. The rift in the two, public and private sectors, primarily exists because income categories either curb or allow the necessary contributions. This thesis reports on the various contributing mechanisms, through which health care can be ensured universally, without causing impoverishment. The framework or criteria selected for this study includes feasibility, equity, efficiency and sustainability of a contributing mechanism. Furthermore, the contributing mechanisms – tax-funded, NHI, voluntary health insurance and out-ofpocket – are resident within four health care models namely, Beveridge, Bismarck, NHI and Out-of-pocket. These models are discussed as well as relevant country examples are provided. In the pursuit of answering whether the NHI scheme is suitable for South Africa, the study shows that government or tax-funding and NHI provides the contributing mechanisms that are applicable to the South African situation within the context of different challenges. It is recommended that, in the government’s discussions about health care reform, prepayment, universalism and health care expenditure, amongst others, be considered.

Três modelos teóricos de negociação entre seguradores e provedores privados são desenvolvidos e seus resultados simulados e analisados. Os modelos procuram captar o que seria o encontro entre um segurador e um provedor vinculados entre si por um contrato de parceria e sentados à mesa para negociarem os preços do seguro-saúde e do bem/serviço médico. Na estrutura dos modelos está presente o problema de agente-principal característico da relação entre os dois atores, dadas as assimetrias informacionais inerentes ao campo da saúde. Tanto o segurador quanto o provedor estão restritos por considerações junto a seus consumidores. O processo de negociação em si baseia-se no modelo de Stackelberg para oligopólios, o que produz dois cenários: num primeiro cenário o líder da negociação é o provedor e num segundo cenário o líder da negociação é o segurador. / Three theoretical models about negotiation between private insurers and providers are developed and their results are simulated and analyzed. The models try to catch what would be a meeting between an insurer and a provider tied each other by an association contract bargaining the health insurance price and the medical good/service price. The main problem is the agent-principal relationship in an environment with asymmetric information. Both agents are restricted by consumer behavior. The basis for the bargain process is the Stackelberg model for oligopolies, which gives two scenes: one with insurer leadership and other with provider leadership.