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Biomedical subjects

Uwe E Reinhardt

Publications and source records attributed to Uwe E Reinhardt.

At least 19 recordsLinked to original sources
PubMedDate not supplied

Cross-national comparisons of health systems using OECD data, 1999.

This paper presents selected components of the most recent (1999) Organization for Economic Cooperation and Development (OECD) Health Data. Previous trends in spending for health care, supply and use of health care resources, and health status are updated for the thirty industrialized countries in the OECD. In 1999 the United States spent 53 percent more on health care than any other OECD country spent. The paper reviews two possible reasons for the difference: economic development and population aging. It discusses spending, supply, and utilization for specific categories of health care services: pharmaceuticals, physicians, hospitals, and high-technology services. The paper concludes with a consideration of the strengths and weaknesses of using OECD data to compare health systems.

Actuarial Analysis↗
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It's the prices, stupid: why the United States is so different from other countries.

This paper uses the latest data from the Organization for Economic Cooperation and Development (OECD) to compare the health systems of the thirty member countries in 2000. Total health spending--the distribution of public and private health spending in the OECD countries--is presented and discussed. U.S. public spending as a percentage of GDP (5.8 percent) is virtually identical to public spending in the United Kingdom, Italy, and Japan (5.9 percent each) and not much smaller than in Canada (6.5 percent). The paper also compares pharmaceutical spending, health system capacity, and use of medical services. The data show that the United States spends more on health care than any other country. However, on most measures of health services use, the United States is below the OECD median. These facts suggest that the difference in spending is caused mostly by higher prices for health care goods and services in the United States.

Data Collection↗
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Does the aging of the population really drive the demand for health care?

In the debate on health policy, it is widely believed that the aging of the U.S. population is a major driver of the annual growth in the demand for health care and in national health spending. This essay draws on the research literature and on data from the Medical Expenditure Panel Surveys (MEPS) to debunk that myth. Although in any year per capita health spending for people age sixty-five or older tends to average three to five times that for younger Americans, the aging of the population is too gradual a process to rank as a major cost driver in health care.

Adolescent↗
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An information infrastructure for the pharmaceutical market.

The primary contribution of Joseph Newhouse's paper is to make the point that it is impossible to devise a drug pricing policy that satisfies either the conditions for economic efficiency or prevailing standards of "fairness." Not specifically mentioned by Newhouse is a rule for the socially efficient outlays on selling and marketing by the pharmaceutical industry. In fact, it is not clear that the current allocation of the industry's revenue dollars to marketing and R&D is efficient from society's point of view. This paper explores this question and proposes an independent, publicly funded information infrastructure to study and disseminate results on pharmaceutical cost-effectiveness.

Cost-Benefit Analysis↗
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U.S. health care spending in an international context.

Using the most recent data on health spending published by the Organization for Economic Cooperation and Development (OECD), we explore reasons why U.S. health spending towers over that of other countries with much older populations. Prominent among the reasons are higher U.S. per capita gross domestic product (GDP) as well as a highly complex and fragmented payment system that weakens the demand side of the health sector and entails high administrative costs. We examine the economic burden that health spending places on the U.S. economy. We comment on attempts by U.S. policymakers to increase the prices foreign health systems pay for U.S. prescription drugs.

Delivery of Health Care↗
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The pricing of U.S. hospital services: chaos behind a veil of secrecy.

Although Americans and foreigners alike tend to think of the U.S. health care system as being a "market-driven" system, the prices actually paid for health care goods and services in that system have remained remarkably opaque. This paper describes how U.S. hospitals now price their services to the various third-party payers and self-paying patients, and how that system would have to be changed to accommodate the increasingly popular concept of "consumer-directed health care."

Confidentiality↗
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Health care spending and use of information technology in OECD countries.

In 2003, the United States had fewer practicing physicians, practicing nurses, and acute care bed days per capita than the median country in the Organization for Economic Cooperation and Development (OECD). Nevertheless, U.S. health spending per capita was almost two and a half times the per capita health spending of the median OECD country. One proposal for both lowering health spending and improving quality is the adoption of health information technology (HIT). The United States lags as much as a dozen years behind other industrialized countries in HIT adoption--countries where national governments have played major roles in establishing the rule, and health insurers have paid most of the costs.

Attitude of Health Personnel↗
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Is there hope for the uninsured?

In an anecdote popular on the conference circuit, an American health policy analyst who has ascended to heaven asks God, "Will there ever be universal health insurance coverage in the United States?" "Perhaps," sighs God, "but not in my lifetime." This paper argues that this tale accurately describes the prospect of covering the uninsured in this country. Neither moral sentiments among a majority of U.S. political leaders, economic self-interest among those who would have to pay for universal health insurance, nor political pressure from the uninsured and likely-to-be-uninsured will provide a sufficiently strong imperative to move this country toward universal coverage soon, if ever.

Humans↗