IDEAS home Printed from https://ideas.repec.org/p/oec/ecoaaa/665-en.html
   My bibliography  Save this paper

Health Care Reform in the United States

Author

Listed:
  • David Carey

    (OECD)

  • Bradley Herring

    (Johns Hopkins University)

  • Patrick Lenain

    (OECD)

Abstract

In spite of improvements, on various measures of health outcomes the United States appears to rank relatively poorly among OECD countries. Health expenditures, in contrast, are significantly higher than in any other OECD country. While there are factors beyond the health-care system itself that contribute to this gap in performance, there is also likely to be scope to improve the health of Americans while reducing, or at least not increasing spending. This paper focuses on two factors that contribute to this discrepancy between health outcomes and health expenditures in the United States: inequitable access to medical services and subsidized private insurance policies; and inefficiencies in public health insurance. It then suggests two sets of reforms likely to improve the US health-care system. The first is a package of reforms to achieve close to universal health insurance coverage. The second set of reforms relates to payment methods and coverage decisions within the Medicare programme to realign incentives and increase the extent of economic evaluation of different medical procedures. Réforme du système de santé aux États Unis Malgré certains progrès, les États-Unis ne sont pas très bien placés parmi les pays de l’OCDE pour ce qui est de diverses mesures des résultats de la santé. Or, les dépenses de santé y sont sensiblement plus élevées que dans tout autre pays de l’OCDE. Cette situation contradictoire amène à penser qu’il est possible d’améliorer le système de santé du pays tout en réduisant, ou du moins en n’augmentant pas, les dépenses. Le présent papier examine plus particulièrement deux facteurs qui contribuent à la divergence entre les résultats et les dépenses en matière de santé aux États-Unis : accès inéquitable aux services médicaux et inefficience des subventions pour la souscription de polices d’assurance privées ; et manque d’efficacité de l’assurance de santé publique. Il propose ensuite deux séries de réformes propres à améliorer le système de santé des États-Unis. La première est un ensemble de mesures destinées à assurer la couverture universelle de l’assurance-maladie. La deuxième concerne les méthodes de paiement et les décisions de prise en charge au sein du programme Medicare et vise à réaligner les incitations et à renforcer l’évaluation économique des différents actes médicaux.

Suggested Citation

  • David Carey & Bradley Herring & Patrick Lenain, 2009. "Health Care Reform in the United States," OECD Economics Department Working Papers 665, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:665-en
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1787/227104360465
    Download Restriction: no

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pauline Vaillancourt Rosenau, 2009. "Health Policy and Healthy Populations: An Introduction to a Special Issue of the "Social Science Quarterly"," Social Science Quarterly, Southwestern Social Science Association, vol. 90(5), pages 1039-1050.

    More about this item

    Keywords

    adverse selection; aléa moral; assurance santé; avantage Medicare; comparaison de l’efficacité; comparative effectiveness; coûts de santé; dépenses de santé; espérance de vie; exonération fiscale; health costs; health expenditure; health oucomes; health status; health subsidies; individual market; life expectancy; mandat; mandate; marché individuel; Medicare; Medicare advantage; moral hazard; pooling; regroupement de risque; résultats de la santé; subventions pour l’achat des polices d’assurance santé; sélection adverse; tax exclusion;

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O57 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Comparative Studies of Countries

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oec:ecoaaa:665-en. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (). General contact details of provider: http://edirc.repec.org/data/edoecfr.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.