The Truth About Moral Hazard and Adverse Selection

Pauly, Mark V.

doi:10.2139/ssrn.1822442

Cited by 9 publications

(8 citation statements)

References 2 publications

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“…A different view has been taken by others, following authors such as Pauly (2007). Pauly argues that governments should leave the majority of people (i.e.…”

Section: Targeting Vs Universalitymentioning

confidence: 99%

“…Pauly concluded that poor, sick people should not be subject to cost sharing in general, and that for the rest, ideally, cost sharing should be applied in such a way as to discourage care with low marginal benefit and to encourage use of high marginal benefit care that tends to be underused (e.g. beta blockers; Pauly, 2007).…”

Section: Future Issues In Relation To the Payment Systemmentioning

confidence: 99%

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New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges

Cumming

Mays

2009

HEPL

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: Since 2001, implementation of a New Zealand's Primary Health CareStrategy (the Strategy) has led to an increase in the proportion of primary health care services which are publicly funded, the development of 82 primary health organisations (PHOs) to oversee primary health care services and universal public capitation funding of PHOs. This approach has replaced the previous system of fee-for service targeted public subsidies paid to individual general practitioners (GPs). Patient copayments, although at a reduced level but still set by individual practitioners, have remained a core feature of the system. This paper focuses on the implementation and impact of key policy changes over the first five years of the Strategy. Although patient copayments have fallen and consultation rates have increased, the new funding and payment system has raised a number of unresolved issues -whether to retain the new universal funding system or revert to the former targeted approach; how to achieve the potential gains from capitation when GPs continue to receive their income from a variety of sources and in a variety of different ways; and how to manage the potential for 'cream skimming'.Recent improvements in access may, in time, improve health status and reduce inequalities in health, but there is no guarantee that a universal system will necessarily improve average health or reduce inequalities. Much depends on the services being delivered and the populations that are benefiting mostsomething New Zealand needs better evidence on before determining future policy directions in primary health care.

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“…A different view has been taken by others, following authors such as Pauly (2007). Pauly argues that governments should leave the majority of people (i.e.…”

Section: Targeting Vs Universalitymentioning

confidence: 99%

Section: Future Issues In Relation To the Payment Systemmentioning

confidence: 99%

New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges

Cumming

Mays

2009

HEPL

View full text Add to dashboard Cite

show abstract

“…Much of the discussion about cost sharing centers on economic theory and the results of the most sophisticated effort to test theories about cost sharing, the Rand Health Insurance Experiment. Syntheses and reviews of the existing research on cost sharing, including recent work by CBO (2006) Davis (2004), Gruber (2006), Pauly (2007), and Braithwaite and Rosen (2007), generally come to similar conclusions, following Gruber's presentation, as follows:…”

Section: Boxmentioning

confidence: 70%

“…At the simplest level, coinsurance or copayments are supposed to do two things: increase the percentage of insurance costs paid by the insured person, and counter "moral hazard." As defined colloquially by Mark Pauly, moral hazard manifests itself when patients show up in the doctor's office saying "That's OK, doc, the insurance will pay for it" (Pauly, 2007). 16 Nominal fees, such as $10 per visit to a health plan primary care provider, are not (at least in the United States 17 ) commonly viewed an effective means of dealing with moral hazard.…”

Section: Copayments and Coinsurancementioning

confidence: 99%