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Essays on Health Economics: Optimal Incentives for Physicians’ Diagnostic and Treatment Choice and Empirical Evidence on Physicians’ Provision of Advanced Diagnostic Tests
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Die private Krankenversicherung in Chile: Vollversicherung oder Zusatzversicherung für ambulante Leistungen?
Full text linkSeit 1981 besteht in Chile ein privates Krankenversicherungssystem, dem 1995 über ein Viertel der Bevölkerung angehörte. Diese Arbeit untersucht dieses System aus ökonomischer Sicht. Im Mittelpunkt der Analyse stehen die Anreizwirkungen staatlicher Vorschriften für die Gestaltung privater Krankenversicherungsverträge und das Verhältnis zum staatlichen Gesundheitsdienst. Die asymmetrischen Kündigungsrechte und die unbeschränkte Wechselmöglichkeit zum staatlichen System erweisen sich als zentrale Funktionsmerkmale. Es wird die These vertreten, daß das private System entgegen seiner offiziellen Zielsetzung für viele Versicherte keine Vollversicherung sondern eine Zusatzversicherung für ambulante Leistungen darstellt.In 1981 a private health insurance System was introduced in Chile which covered over a quarter of the population by 1995. This paper portrays the System and provides an economic analysis which focuses on the effects of regulation of contract design and the interaction with the State health System. The assymmetry of rights in ending the contract and the unrestricted possibility to return to the State health System prove to be essential characteristics. It is argued that although the private System is officially designed to provide füll coverage, in reality, for large numbers of the privately insured it constitutes a supplementary insurance for out-patient Services
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
To commit or not to commit: A health insurance monopoly with variable quality and uncertain types of individuals
Full text linkThis paper examines the trade-off between risk allocation and quality supply for an insurance monopolist when individuals face two kinds of risk related to health. First, they may suffer an ordinary monetary loss. Second, they are subject to uncertain premiums because their type may change. We assume that neither quality of insurance service,nor the individual type is verifiable in front of a court. We show that no-commitment is a necessary condition for the efficient supply of unverifiable quality while the insurance of premium risk requires commitment. Profit-maximizing contracts may involve full, partial or no- commitment. Risk allocation or quality supply is inefficient
The design of pension pay out options when the health status during retirement is uncertain
Full text linkThis paper examines the optimal design of pension plans when the health status during retirement is uncertain. Assuming that the health status affects both life expectancy and the marginal utility of consumption, choice between a lump-sum payment and an annuity can be welfare-enhancing if the health status is not observable by pension plans. This result holds if the marginal utility of consumption and life expectancy are negatively correlated. On equity grounds, a lump-sum option can be justified even if the marginal utility of consumption is independent of life expectancy
Indikationsspezifische Kosten-Nutzen-Bewertung auf Grundlage eines sozialen Gesundheitsindexes
Full text linkDieser Beitrag entwickelt einen Vorschlag zur indikationsspezifischen Kosten-Nutzen-Bewertung. Zentrales Konzept ist ein sozialer Gesundheitsindex, der die Leistung des Gesundheitswesens misst. Er berücksichtigt nicht nur das Niveau der Gesundheit in der Bevölkerung, sondern auch deren Verteilung. Wird der Gesundheitsindex mit einer gesellschaftlichen Zahlungsbereitschaft bewertet, dann kann die optimale Therapie für jeden Indikationsbereich bestimmt werden. Für neue Medikamente, die wirksamer, aber teurer sind, lässt sich eine Höchsterstattungsgrenze ermitteln. Diese fällt umso höher aus, je geringer das bisherige Nutzenniveau in einer Indikation ist.This paper proposes a method to evaluate health technologies in a given therapeutic area. The key concept is a social health index which measures the performance of the health system. It considers both the level and the distribution of health in the population. If improvements in the social health index are valued with a social willingness to pay, it is possible to determine the optimal therapy for each therapeutic area. A maximum price can be assigned to medications which are more effective but more expensive. This price is higher, the lower the present health level in a therapeutic area
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