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1、Chapter10-GovernmentandtheMarketforHealthCare1.Oneexplanationdiscussedinthechapteristhattheshifttowardmanagedcareledtoaone-timedecreaseinexpenditures,butadvancesinmedicaltechnologycontinued,resultinginconcomitantgrowthinexpenditures.ThisexplanationimpliesthatHMOshelp
2、edpreventrisinghealthcarecostsduringthe1990s,buthavebeenunabletokeepcostslowduetorapidadvancesintechnology•ThestructureofHMOscreatesincentivesforhealthcareproviderstoskimponthequalityofcare.HMOsused“gagrules^thatprohibitedphysiciansfromdiscussingtreatmentoptionsthatw
3、erenotcoveredbytheplan,butgovernmentregulationhassincebannedthesegagrules,allowingpatientsgreateraccesstoinformation.Medicaltechnologycreatesnew,andoftenmoreexpensive,treatmentoptions,whichmanypatientsbelievetheyshouldhave.IthasbecomeincreasinglydifficultforHMOstokee
4、pcostsdownbydenyingmoreexpensivetreatmentoptions,especiallysincetheycannolongerpreventphysiciansfrominformingpatientsoftheseoptions.2.Medicarecoversnearlytheentirepopulationaged65andolderandisnotmeanstested.About99percentoftheeligiblepopulationchoosestoenrollinsupple
5、mentarymedicalinsurance(SMI),orPartBofMedicare,whichpaysforphysiciansandservicesrenderedoutsidethehospital.Patientspayamonthlypremium,asmallannualdeductible,anda20percentcoinsurancerate.TheMedicareprogramhasnotimprovedthehealthstatusoftheelderlyverymuch,butishasledto
6、significantbenefitsintheformofreducingtheriskoffacingmajorreductionsinconsumptionduetomedicalexpenses.3.AllowingindividualstojointheMedicareprescriptiondrugbenefitplanatanytimewouldlikeleadtoanadverseselectionproblem.Asindividualsageandtheirhealthdeteriorates,thelike
7、lihoodthattheywillneedexpensiveprescriptiondrugsincreases.IfindividualswaituntilseveralyearsafterbecomingeligibleforMedicaretoaddtheprescriptiondrugbenefitplan,theypaylessinpremiums,whichaddstothealreadyenormousexpenseoftheMedicaredrugbenefit.5.0001.Thebudgetconstrai
8、ntinitiallyhasunitsofMedigaponthex-axis,andothergoodsonthey-axis.Giveninitialpricesof$1perunitforeachgood,and$30,000ofincome,thebud
