Economist and Professor at HBS and HKS @Harvard. Tweets about food, dogs, piano, affogatos, cars, #GoT, India, hippies, and occasionally, health care.
Feb 9, 2021 • 4 tweets • 1 min read
Our findings on the large mortality effects from patient cost-sharing are from Medicare, but let's be clear that the largest proponents of consumerism ("skin in game", "price shopping") are employers, their HR departments, and their benefits consultants.
nber.org/papers/w28439
Employers insure half of Americans (over 150 million) and do a great job in some areas, but also embrace a variety of snake oils-- like wellness and prevention saving 💰, price shopping saving $, high deductible plans and cost-sharing increasing value.
Feb 8, 2021 • 5 tweets • 1 min read
Thinking of patients as 'rational' has lead to policies like cost-sharing and consumerism in health care.
But when faced with small amounts of cost-sharing-- even $10-- patients back on valuable medicines, some drop all their medicines, and many die.
nber.org/papers/w28439
At the root of the problem is the constant desire to view reductions in health care spending, especially Rx spending, as desirable-- yet cost-sharing saves money but it does not save lives. Most research measures the $$ savings and ignores the lives bc they're hard to measure.
