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u 3. Emanuel also looks at particular procedures, such as knee replacements and coronary bypass surgeries, and at imaging, and he concludes that higher spending
u 3. Emanuel also looks at particular procedures, such as knee replacements and coronary bypass surgeries, and at imaging, and he concludes that higher spending on these things in the US. reflects a combination of high prices and high volumes. Papanicolas et al. put more emphasis on high prices, as does Reinhardt (he is famous for a paper with the title \"It's the Prices, Stupid\"). Briefly explain how Emanuel reaches his conclusion. Where does Cutler come down on this issue? 4. According to the numbers in Emanuel's table, about what percentage of total health care spending in the U.S. is accounted for by administration? How does this compare with what Reinhardt and Cutler suggest, and with Drum's conclusion about the share of healthcare employment that is engaged in administration? What accounts for the difference between what Emanuel and the others find? (Hint: Emanuel's numbers for administration come from Papanicolas et al., and count only administrative costs incurred by government and private insurers (and insurer profits).) Could the administrative costs not counted by Emanuel be a partial explanation for why prices of many medical services are much higher in the U.S. than in other countries? Explain. Assignment Guidelines It is well known that the US. spends far more on health care, by any measure, than any other country. The paper by Irene Papanicolas et al. (2018) is a major study of the differences in healthcare spending across high-income countries. It concludes that \"Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries.\" In a commentary on that paper, Ezekiel Emanuel (2018) analyzes much of the same data and concludes \"it is unlikely that prices alone drive excessive health care costs in the United States.\" The same issues are addressed in Chapter 1 of Uwe Reinhardt's Priced Out(2019), and in an interview with economist David Cutler. This assignment will focus primarily on the Emanuel piece, making reference to these other sources, as well as an article by Kevin Drum (2019). We will not discuss prescription drug spending. It is generally agreed that the higher prices that the US. pays for drugs accounts for a significant portion of our excess spending compared with other countries, even though drug spending is only about 15 percent of total U.S. health care spending, according to the Papanicolas et al. numbers. Questions 1. Emanuel agrees that doctors are typically paid much more in the US. than in other countries, but argues that this is not an important explanation for why we spend more on health care in total. Briefly explain his argument. 2. According to the numbers in Emanuel's table, about what percentage of total healthcare spending is accounted for by physicians' salaries? If there are about 18 million people employed in healthcare (Drum's number, including those in the insurance industry), about what percentage of those workers are physicians (use the information in Drum's article)
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