Aha Insurance Essay

4. Methods Data and Study Sample This study examined whether the two health system formations analyzed in the previous essay, Health System A and Health System B, can pass the antitrust safety zone test for horizontal hospital mergers and acquisitions. The main data source for this essay is MarketScan® Commercial Claims and Encounters Database, which is a unique private insurance claims database that includes 23 million employees, dependents and retirees from around 100 large private employers (Adamson

This essay contributes to health economics and antitrust literature as follows. First, this essay investigates change in transaction price for cardiac surgery. Instead of using list or average prices, this analysis adopted the transaction price of care, which is a much more accurate measure for price of care (Brooks, Dor & Wong, 1997; Capps & Dranove, 2004; Dor, Grossman & Koroukian, 2004; Dor, Koroukian & Grossman, 2004; Dor et al., 2012; Moriya, Vogt & Gaynor, 2010). Second, this essay applies

reduction of Medicare reimbursement rates (Shi and Singh, 2015. p238). Payers that have employment-based insurance are charged extra to cover the remaining balance. This process is called cost shifting. In some healthcare systems, the relationship between reimbursement reduction and cost shifting is correlated in an inversely proportional trend. As the decrease in reimbursement from public insurance such as Medicare and Medicaid, the method of cost shifting would increase. The Balanced Budget Act (BBA)

United States of America is the only advanced nation that does not provide their citizens with some sort of health coverage. Americans go on with health care if they can afford it and those who are not able to afford health care have trouble dealing with health care coverage or poor treatment. In fact, thirty- two million Americans deal with no health care. This being true, President Obama followed through with the Health Care and Education Reconciliation Act of 2010. Ever since then, there has

Chapter 3 The Evolution of Health Services in the United States Learning Objectives To discover historical developments that have shaped the nature of the US health care delivery system To evaluate why the system has been resistant to national health insurance reforms To explore developments associated with the corporatization of health care To speculate on whether the era of socialized medicine has dawned in the United States “Where’s the market?” 81 26501_CH03_FINAL.indd 81 7/27/11 10:31:29 AM 82

E SSAYS ON TWENTIETH-C ENTURY H ISTORY In the series Critical Perspectives on the Past, edited by Susan Porter Benson, Stephen Brier, and Roy Rosenzweig Also in this series: Paula Hamilton and Linda Shopes, eds., Oral History and Public Memories Tiffany Ruby Patterson, Zora Neale Hurston and a History of Southern Life Lisa M. Fine, The Story of Reo Joe: Work, Kin, and Community in Autotown, U.S.A. Van Gosse and Richard Moser, eds., The World the Sixties Made: Politics and Culture in