财政学课本习题答案（第8版）Chapter_10.docVIP

Chapter 10 – Government and the Market for Health Care 1. One explanation discussed in the chapter is that the shift toward managed care led to a one-time decrease in expenditures, but advances in medical technology continued, resulting in concomitant growth in expenditures. This explanation implies that HMOs helped prevent rising health care costs during the 1990s, but have been unable to keep costs low due to rapid advances in technology. The structure of HMOs creates incentives for health care providers to skimp on the quality of care. HMOs used “gag rules” that prohibited physicians from discussing treatment options that were not covered by the plan, but government regulation has since banned these gag rules, allowing patients greater access to information. Medical technology creates new, and often more expensive, treatment options, which many patients believe they should have. It has become increasingly difficult for HMOs to keep costs down by denying more expensive treatment options, especially since they can no longer prevent physicians from informing patients of these options. 2. Medicare covers nearly the entire population aged 65 and older and is not means tested. About 99 percent of the eligible population chooses to enroll in supplementary medical insurance (SMI), or Part B of Medicare, which pays for physicians and services rendered outside the hospital. Patients pay a monthly premium, a small annual deductible, and a 20 percent coinsurance rate. The Medicare program has not improved the health status of the elderly very much, but is has led to significant benefits in the form of reducing the risk of facing major reductions in consumption due to medical expenses. 3. Allowing individuals to join the Medicare prescription drug benefit plan at any time would like lead to an adverse selection problem. As individuals age and their health deteriorates, the likelihood that they will need expensive prescription drugs increases. If individuals w