Paying on the Margin for Medical Care: Evidence from Breast Cancer Treatments

• 成果类型: Article
• 署名作者: Einav, Liran; Finkelstein, Amy; Williams, Heidi
• 署名单位: Stanford University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT)
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20140293
• 发表日期: 2016
• 页码: 52-79
• 关键词: comparing total mastectomy; health-insurance; radiation-therapy; travel distance; Managed care; follow-up; CHOICE; irradiation; lumpectomy; welfare

摘要

We present a simple graphical framework to illustrate the potential welfare gains from a top-up health insurance policy requiring patients to pay the incremental price for more expensive treatment options. We apply this framework to breast cancer treatments, where lumpectomy with radiation therapy is more expensive than mastectomy but generates similar average health benefits. We estimate the relative demand for lumpectomy using variation in distance to the nearest radiation facility, and estimate that the top-up policy increases social welfare by $700-2,500 per patient relative to two common alternatives. We briefly discuss additional tradeoffs that arise from an ex ante perspective.