Health Economics
U.S. Health Care: Facts about Cost, Access, and Quality
The U.S. spends approximately 15 percent of its gross domestic product on health care, making health care the largest single sector of the U.S. economy. Despite these levels of expenditure, Americans are not healthier and do not live longer than citizens in many other nations. American adults receive just half of recommended health care services, and quality does not vary much by socioeconomic factors. Focusing on the nation as a whole, this chart book provides an overview of key health care policy issues in the areas of cost, access, and quality.
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The RAND Corporation is at the forefront of research on health insurance and managed care, conducting high-profile studies on a variety of topics, including the influence of insurance coverage on access to health care and on health outcomes. RAND's 15-year Health Insurance Experiment, which began in 1971, is considered the most important study of health insurance ever conducted, laying the groundwork for future research on health care quality and coverage and on managed care. Our current studies on health care financing and organization are highlighted below.
Profiles of Current Research
Health Insurance, Quality of Care, and Outcomes
Employer-Sponsored Health Insurance and Care for the Uninsured
Highlights of Recent Studies & News
Modeling the Health and Medical Care Spending of the Future Elderly.
This study, which modeled the likely influence of health innovations and projected health status on health spending, found that health technologies are likely to increase, not decrease, spending; that elimination of disease (with the exception of obesity) would not reduce health spending; and that prevention care might decrease spending, but only under particular conditions.
State Insurance Mandates and Consumer-Directed Health Plans: Are They Helping Small Business Provide Health Insurance to Employees?
This study found no evidence that state-health insurance mandates or consumer-directed health plans have improved access to or affordability of insurance for small businesses; that they may have had unintended consequences; and that monitoring and alternative solutions are needed
Consumer Decisionmaking in the Insurance Market
This study of the individual insurance market in California finds that only 7 percent of non-elderly adults purchase their own insurance; those with chronic illnesses pay slightly more than healthier adults; large subsidies would be needed to spur those without insurance to purchase it; purchasers would be willing to pay higher premiums to lower their deductibles; and premium costs will need to be controlled to maintain the market.
Consumer-Directed Health Care: Early Evidence Shows Lower Costs, Mixed Effects on Quality of Care
This study of the effects of enrollment in consumer-directed health plans on use, costs, and quality of health care also found that beneficiaries believed they lacked adequate information with which to make choices.
The Public Spends Little to Provide Health Care for Undocumented Immigrants
This study found that undocumented immigrants use fewer health care services than native-born residents, in large part because they are healthier than native-born residents.
The Health Insurance Experiment: A Classic RAND Study Speaks to the Current Health Care Reform Debate— 2006
A reexamination shows that the main findings of this classic study—that cost sharing affects the use of highly effective as well as less effective health care services and that free care led to some health improvements—are still relevant today.
Related Web Sites
Healthcare for Communities
http://www.hsrcenter.ucla.edu/research/hcc.shtml
HIV Cost and Services Utilization Study (HCSUS)
Bing Center for Health Economics
www.rand.org/health/centers/bing/
RAND Roybal Center for Health Policy Simulation
UCLA/RAND NIMH Center for Research on Quality in Managed Care
Working with Congress
RAND's Washington Office of Congressional Relations (OCR) furthers RAND's mission to provide objective analysis and effective solutions by disseminating research results to Congress and federal agencies. The OCR publishes a monthly electronic newsletter featuring current work on health policy. Contact: Shirley Ruhe (Shirley_Ruhe@rand.org) or Kristy Anderson (kristy@rand.org).
The RAND Health Congressional Newsletter
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