The effects of health insurance on the choice of medical procedures: Evidence from heart attacks and childbirths

Abstract

This paper investigates the effect of health insurance on the use of alternative procedures to treat a given medical condition. In particular, we estimate the effect of health insurance on the use of bypass surgery after a heart attack and on the use of a C-section after a normal pregnancy.These procedures are the most expensive, compared to the alternatives. Theoretically, the demand for some procedures like bypass surgery is likely to be inelastic. In this situation, health insurance should have no effect on the use of the procedure. For other procedures such as C-section, demand may be more elastic, especially after a normal pregnancy without complications. We use a nationally representative dataset of inpatient hospital admissions from the United States and control for individual and hospital characteristics. The results from our empirical analysis support our predictions. For patients admitted to a hospital because of a heart attack, being uninsured has no effect on the probability of bypass surgery. However, for patients admitted for childbirth, the uninsured have a substantially lower probability of a C-section delivery.

The Impact of Unexpected Billing in Spine Surgery and How the Price Calculator Can Improve Patient Care

“…Patients undergoing elective surgery often have greater choice when seeking care compared with urgent or emergent medical episodes and may desire to reduce their individual out-of-pocket costs. 12,13 A discrete choice model found evaluating patient and provider priorities found that both populations valued low out-of-pocket costs the most when deciding where to obtain/administer care for knee or hip osteoarthritis. 14 Dekhne et al 1 reviewed a database of 216,263 collective arthroscopic meniscal repair, lumbar discectomy, total knee arthroplasty, and total hip arthroplasty patients and demonstrated that 1 in 6 patients are at risk for a surprise bill despite seeking care at an in-network facility.…”

“…Patients undergoing elective surgery often have greater choice when seeking care compared with urgent or emergent medical episodes and may desire to reduce their individual out-of-pocket costs 12,13 . A discrete choice model found evaluating patient and provider priorities found that both populations valued low out-of-pocket costs the most when deciding where to obtain/administer care for knee or hip osteoarthritis 14 .…”