Nurse practitioners can prescribe drugs in Wyoming but not New York.

What explanation did we discuss in class for this fact? Wyoming has a harder time attracting doctors so they allow nurse practitioners do some of the things that doctors traditionally do.

The fact that military doctors often see diabetic patients monthly illustrates what point? Military doctors get fixed salaries so dont have an incentive to work hard. By arranging easy patient visits they lighten the work load.

Multi-specialty firms might have trouble attracting enough business for some specialties. Because of this, what is frequently true of the most extensive multi-specialty firms? They might be affiliated with an insurance organization that directs a lot of patients to the multispecialty firm.

How did Dranove and Wehner show that the standard techniques of proving inducement of medical care were inadequate? They showed that the same techniques could be used to prove the silly notion that doctors induce child birth.

What factor dramatically increases how much imaging a doctor orders? When the doctor has ownership in a company that performs imaging work. According to Hickson, Altmeier, and Perrin, what types of doctors scheduled visits that exceeded pediatric guidelines? What type of doctors scheduled fewer than recommended visits? Doctors paid a fixed salary were more likely to skip recommended visits. Doctors paid fee-forservice were more likely to exceed pediatric guidelines.

How do hospitalists differ from most doctors who work in the typical not-for-profit hospital?

They are employees of the hospital.

If doctors are the residual claimant of a not-for-profit hospital, why wouldnt they want to own the hospital outright? Not-for-profit hospitals enjoy a lot of tax benefits. All the patients from hospital A come from PA. The patients from hospital B come from all over the country. Which hospital likely has higher per patient costs and why? Hospital B will have higher costs since patients willing to travel far distances are more likely to be sicker than average.

Name 2 factors that reduce costs at VA hospitals versus other hospitals? Immunity from malpractice. They pay doctors less.

Name at least one reason why it hurt Colorado hospitals financially when payment for car accidents switched from automobile insurers to health insurers? Health insurers were better at negotiating lower fees.

Why did Medicare Advantage initially cost more money than traditional Medicare? Medicare Advantage attracted healthier than normal patients but Medicare was paying insurance companies a rate representative of the normal Medicare population.

What marketplace distortion did the introduction of Medicare Part D fix? When prescription drugs werent covered, people might have an incentive to forego using drugs even if using a drug might prevent an expensive hospital stay (because the hospital stay is covered by Medicare)

A woman signs up for health insurance after learning that she is pregnant. This is an example of what? (correct answer is a 2 word phrase) Adverse selection

What is a non-cynical reason why rescission usually occurs after large claims occur?

Investigating fraud is expensive so it doesnt make sense for insurance companies to investigate every applicant for fraud.

How might community rating lead to fewer people being insured?

When sick people can afford insurance, the average cost of people in the risk pool will increase. This increases the premium which means that healthy people might drop insurance

Why do COBRA participants have higher medical costs than the average employee? Since COBRA participants typically pay the full price of insurance, the healthier people might try to save money by going without insurance.

Why might consultants give more impartial advice than brokers? Brokers are paid by the insurance company whereas consultants are paid by the employer.

What 2 reasons would make it difficult to institute a prospective payment system for doctors? A patient might see multiple doctors. A doctor might treat multiple conditions for a single patient.

What is the purpose of "look-back" rules? To discourage people from giving away all their assets so that they can qualify for free nursing care from Medicaid.

In any given area there are only a few different companies that sell malpractice insurance. Why might this be? If there are too many insurance companies it is harder for any company to have a reputation for defending against blackmail claims.

Why might the Learned Hand Rule imply that malpractice premiums should be high for obstetricians? Because obstetricians treat babies, mistakes can be extremely costly. This means that obstetricians need to exercise high levels of care.

What fact about medical malpractice premiums might be indirect evidence that specialization is good?

Premiums are negatively correlated with the number of doctors in an area.

What contributes to Workman's Compensation having low overhead? No money is spent determining who is at fault.

How does coinsurance impact the level of moral hazard created by insurance? When patients pay more of the cost out of pocket, they are less likely to get expensive treatments that offer little value.

How did health care reform politicize the U.S. Preventive Services Task Force? The decisions of the U.S. Preventive Services Task Force are used to decide whether or not insurance companies must pay for preventive services.

What sector of the population did SCHIP target? children from families that are too rich to qualify for medicare but too poor to choose to buy medical insurance

As the income threshold to qualify for Medicaid is raised, what happens to the level of crowding out? Why? It increases. As people with higher incomes qualify for Medicaid they would have been more likely to purchase insurance even without Medicaid.

Why do Medigap plans have "open enrollment" periods? This means that people cant wait to sign up the day before they go to the hospital and still get the same rate as everybody else.

What happened in the bond market after the prospective payment system was instituted? Why?

Bond ratings for hospitals worsened for hospitals. The rating agencies forecasted that the prospective payment system was bad financial news for hospitals.

What regulatory changes meant that Empire was no longer necessary as the insurer of last resort? New York enacted community rating. It also mandated that employers in the large group market had to offer guarantee issue in the individual market.

When Empire was born in 1934, it was created to serve whose interests? Hospitals.