Skeleton Notes 3 Flashcards
What is the key idea in health economics thinking about physician labor markets?
Physicians respond to incentives that may not always be in the patient’s best interest
The labor market is plagued by a number of difficult ______ and ________, which lead to ____ prices of healthcare and ____ quality of care
Tradeoffs
market failures
higher
lower
More regulation should lead to higher quality but makes it harder to become a physician (lowering quantity/supply) (FAILURE)
Quality vs. Quantity tradeoff
Government regulation through licensure and self-regulation by the _______________ essentially create a _________ in the labor market (FAILURE)
American Medical Association
Monopoly
Regulations attempt to correct the market failure in information. It difficult for regular people to differentiate between _________ and a ________
A high quality physician
quack
____________ are intended to create better doctors but also create the need for physician to make more post-training to pay back loans. (FAILURE)
Higher costs and barriers
Empirical studies suggest that experience is related to more errors (FAILURE)
July effect
The need for physicians, nurses, and staff to take breaks to avoid errors vs. giving the patient consistent care throughout their hospital stay
The work-hour tradeoff
Patients have a principal interest in their own health but lack information on how to best address specific health problems or diagnose specific conditions
Principal-agent problem
Financial pressures may induce physicians to encourage patients to undergo costlier treatments than are necessary or aligned with standard-of-care. May over-prescribe, or dissuade to protect reputation.
Physician Induced Demand
If physicians are fearful of litigation for being negligent or malpractice, then they may over- utilize testing and services or recommend unnecessary procedures
Patient litigation vs. defensive medicine
What percent of physicians in PA reported practicing defensive medicine
93
The economic term for discrimination stemming from prejudice, stereotypes, cultural biases, or dislikes for a given group. Inefficient, group based disparities, increasing costs for society
Taste-based discrimination (Becker)
Based on scientific evidence that different optimal treatments and interventions should be applied to different groups
Statistical discrimination
Is physician pay the problem with his healthcare expenditures in the U.S. or their influence on other costs? Explain Fuchs argument
No, it is the physicians decisions that effect expenditures, quality, type of care.
Do physicians make the same treatment decisions across the U.S. based strictly on the latest medical science?
no
What are some reasons Fuchs says drives differences in treatment decisions in the US
Regional differences in pay structures (prepaid group practices vs. fee for service)
Institutional differences due to insurance, training, medical schools, hospital management
What are 4 incentives Fuchs says physicians respond to other than income
Peer approval
Patient approval
Instinct of workmanship
Family/life style
Is it just that the free market for physician services has not be tried or are their fundamental differences about medical care?
Uncertainty
Has the physician-to-population ration in the US increased since the 1970s? Is it expected to rise or fall?
Increased
Fall due to aging workforce
Is there expected to be a surplus or shortage of surgeons and what are the most problematic fields?
Shortage; cardiothoracic, orthopedic, OBGYN, urology, general surgery
Does the fee-for-service model align physician economic incentives with best practice for the patient
No it leads to induced demand and defensive medicine
About how much more are C-sections performed than what is medically necessary
About double than nessessary
What are hospital incentives for more c-sections. So c-section rates vary across hospitals very much
longer recovery, lots of variation
