The Economics of U.S. Health Care Policy: The Role of Market Forces: The Role of Market Forces

201 Pages·2005·9.281 MB·English

by  Frank W. Musgrave

The
Economics of
U.S. Health
Care Policy
Dr. Frank W. Musgrave is a professor of economics at Ithaca College where
he has taught for thirty-eight years. Previously, he had taught social studies,
including economics, at Lakewood Junior-Senior High School in Lakewood,
New Jersey, for ten years. He is also the director of the Southern Tier (NY)
Center for Economic Education at Ithaca College. He did his undergraduate
study at Muhlenberg College; his graduate degrees (MBA, Ph.D.) are from
Rutgers University, where he was a Walter Russell Scholar. Professor Musgrave
is a distinguished fellow of the New York State Economics Association. He is a
member of the International Honor Society in Economics, Omicron Delta Ep
silon, and Phi Kappa Phi Honor Society. He has presented and published in the
fields of health, labor, and education. Musgrave is married to Eva Mae Gifford
Musgrave; they have two children, Marcia and Scott, and two grandchildren,
Devon and Dylan. Eva Mae operates the Edge of Thyme Bed and Breakfast Inn
in Candor, New York, where high tea is served upon appointment. Musgrave
loves to travel and enjoys classical and jazz music as well as baseball. His bas
set hound, Winston, is a constant and loyal companion.
The
Economics of
U.S. Health
Care Policy
The Role of
Market Forces
Frank W. Musgrave
I~ ~~o~;~;n~~;up
LONDON AND NEW YORK
First published 2006 by M.E. Sharpe
Published 2015 by Routledge
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Library of Congress Cataloging-in-Publication Data
Musgrave, Frank W., 1932-
The economics of U.S. health care policy : the role of market forces I
Frank W. Musgrave.
p.cm.
Includes bibliographical references and index.
ISBN 0-7656-1255-0 (hardcover: alk. paper)-ISBN 0-7656-1256-9 (pbk. : alk. paper)
1. Medical policy. 2. Medical economics. 3. Medical care. I. Title:
Economics of US health care policy. II. Title.
RA395.A3M87 2006
362.1'0425--dc22 2005021725
ISBN 13: 9780765612564 (pbk)
ISBN 13: 9780765612557 (hbk)
To Eva Mae Gifford Musgrave, my love and real life line
and
Monroe Berkowitz, my mentor and academic life line.
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Contents
List of Tables and Figures IX
Preface XI
Acknowledgments
Xlll
1. Introduction: Health Care Choices, Trade-Offs, and
Ownership of Health Care Resources 3
2. The Mix of Health Services: More Market and More
Government? 15
3. The Pricing of Drugs: Who Benefits and Who Pays? 39
4. Managed Care: Revolution, Evolution, or Devolution? 59
5. The Four "Cs" of the Uninsured: Causes, Characteristics,
Consequences, and Corrections/Choices 92
6. Medical and Health Savings Accounts: Schemes That You
Can Love! 115
7. The Medicare Reform School: Who Pays for the
Rehabilitation? 135
8. Conclusions and Policy Implications 155
Bibliography 167
Index 181
vii
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List of Tables and Figures
Tables
1.1 Health Care Expenditures and Public Funding 8
4.1 Per Diem Reimbursement and Hospital Costs 70
4.2 Annual Percentage Change in Selected Components of the
Consumer Price Index for All Urban Consumers, 1960-2002 80
4.3 Percentage of Total Physician Expenditures 84
5.1 Health Insurance Coverage by Type of Insurance and
Demographic Characteristics for People Under Age 65, 2002 98
5.2 Health Insurance Coverage by Employment Characteristics
for People Under Age 64, 2002 100
7.1 Current Medicare and Sample Federal Employee Cost-
Sharing Requirements for In-patient Hospital Care 149
Figures
5.1 Characteristics of the Uninsured Population Under Age 65,
2002 (age and race/ethnicity) 96
5.2 Characteristics of the Uninsured Population Under Age 65,
2002 (citizenship and firm size) 99
7.1 Medicare Outlays vs. Medicare Tax Receipts and
Premiums 147
7.2 The Aging of Society Makes Reform Urgent 148
7.3 Percentage of Medicare Beneficiaries with Drug
Coverage, by Source of Coverage (2002 projection) 150
ix