This chapter reviews the literature on payment schemes for government purchases of health services. It focuses on four themes: (1) the tension between obtaining appropriate quality of services and keeping the cost of those services at an acceptable level; (2) the role of cost sharing by the...

In the 1990s many countries have chosen to use prospective payment arrangements for health plans (e.g., health insurers, sickness funds or HMOs) together with health plan competition, as a means of creating incentives to be cost conscious, while preserving quality, innovation and responsiveness...

By 1993, over 70 of all Americans with health insurance were enrolled in some form of managed care plan. The term managed care encompasses a diverse array of institutional arrangements, which combine various sets of mechanisms, that, in turn, have changed over time. The chapter reviews these...

A distinctive feature of the health insurance market in the US is the restriction of group insurance availability to the workplace. This has a number of important implications for the functioning of the labor market, through mobility from job-to-job or in and out of the labor force, wage...

This article describes the anatomy of health insurance. It begins by considering the optimal design of health insurance policies. Such policies must make tradeoffs appropriately between risk sharing on the one hand and agency problems such as moral hazard (the incentive of people to seek more...

This paper discusses theoretical and empirical findings concerning insurance reimbursement of patients or providers by insurers operating in private markets or in mixed public and private systems. Most insurances other than health insurance do not reimburse; instead they pay cash to insureds...

This chapter reviews the theory and empirical literature on physician market power, behavior, and motives, referred to collectively as the issue of physician agency. The chapter is organized around an increasingly complex view of the demand conditions facing a physician, beginning with the most...

Consumer incentives are reflected in a wide range of choices, many of which occur in both insurance- and tax-financed health care systems. However, health insurance and sick leave pay cause consumer incentives to be reflected in moral hazard effects of several types. Theoretically, ex ante moral...

This chapter contains a detailed treatment of the human capital model of the demand for health which was originally developed in 1972. Theoretical predictions are discussed, and theoretical extensions of the model are reviewed. Empirical research that tests the predictions of the model or...