You are currently browsing the monthly archive for May 2009.
Tags: Swine Flu
For individuals who have recently lost their job, Carolyn’s Blog advises them how to get health insurance coverage.
“Unless you have a pre-existing condition you should only stick with COBRA until you find a private health insurance plan. Believe it or not, if you go with a High Deductible Health Care Plan (HDHP) for a middle aged guy of 35, private health insurance can be around $75 a month — even with such well known companies as Humana and Blue Cross Blue Sheild when you live in the city of Chicago (very expensive health insurance here!)”
Healthy people sort to the less generous HDHP, sick people choose to the more generous COBRA.
Tags: Adverse Selection
Four months ago, I wrote that the health care sector added jobs despite the overwhelming job losses in the rest of the economy. Looks like the health care sector has not been fully insulated against the economic woes:
“ Six out of ten hospitals nationally are seeing a greater proportion of patients without insurance coming through their emergency departments, according to a new survey from the American Hospital Association (AHA). At the same time, nearly half of hospitals reported they have cut staff. Recent employment information from the Bureau of Labor Statistics confirms that hospital employment is no longer growing and that the number of mass layoffs for hospitals reported in February was more than double what it was a year ago.”
You can view the results of the AHA survey here.
Tags: Hospitals
The Incidental Economist has a concise, easy-to-understand three-part series of posts on Traditional Medicare, Medicare Advantage, and Medicare Prescription Drug Plans. It will help you answer all these questions and more. You can also see my prior posts on the ‘Genesis and Development of Medicare‘ and ‘How to Pick a Medicare Plan.’
Tags: Medicare
New drugs are (typically) more expensive than old drugs. If a hospital decides to use the latest drug technology, this will increase costs…right?
This may not always be the case. If new drugs are more effective than old drugs, then giving patients the new expensive drug may cuts costs in other areas (such as decreased hospitalizations). Lichtenberg (2009) examines whether utilizing new cardiovascular drugs has cut costs for 20 OECD countries between 1995 and 2003.
Methods
Lichtenberg uses a diference in difference framework as follows:
The dependent variable, Yit, measures either hospital use or mortality due to cardiovascular disease. The vector Z represents a host of variables which could explain cardiovascular related morality or hospital admission. The variables αi, δt are country and year dummy variables effects.
The variable of interest is the RxVintage. This variable is the weighted average of the launch year of the cardiovascular drugs used. For instance, let us assume that drug A was launched in 1996 and drug B was launched in 2002. If the U.S. used 2/3 drug B and 1/3 drug A, then RxVintage =1998. If on the other hand, they used 1/3 drug A and 2/3 drug B, then RxVintage=2000. [Lichtenberg actually uses a simpler technique where a drug gets a value of 1 if it was launched after 1995 and a value of 0 otherwise.]
In essence, this specification compares changes in hospitalization rates among countries that increased RxVintage over time with those who did not.
Results
Of all the countries, Australia, Canada and Norway were mostly likely to use newer vintage drugs. The U.S. placed 5th. The Czech Republic, Poland, Hungary, and the Slovak Republic were lease likely to use newer drugs among OECD countries.
“Countries with larger increases in the share of cardiovascular drug SUs [standard units] that were post-1995 SUs had smaller increases in the cardiovascular disease hospital discharge rate, controlling for the quantity of cardiovascular medications consumed per person, the use of other medical innovations (CT scanners and MRI units), consumption of calories, tobacco, and alcohol, and demographic variables (population size and age structure, income, and educational attainment)...The estimates indicate that if drug vintage had not increased during 1995–2004, hospitalization and mortality would have been higher in 2004. We estimate that per capita expenditure on cardiovascular hospital stays would have been 70% ($89) higher in 2004 had the drug vintage not increased during 1995–2004.“
For cardiovascular drugs, it looks like new drugs win the day.
Watch the relationship between GDP/capita and Life Expectancy evolve over time: Gapminder World.
Tags: GDP, Life Expectancy
Marketplace discusses the uptick in Health IT investment. One reason for the surge is the $19 billion in the Obama stimulus package to encourage doctors to get up to speed using electronic medical records.
Will this money be spent effectively? Who knows. I did note last week that 60% of Indian hospitals have HIT compared to only 20% in the U.S.
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