Health economics

Ali Palali, Jan van Ours, 30 September 2017

Despite decades-long efforts to deter its consumption, tobacco continues to be one of the world’s biggest health threats. Studies of tobacco control policies show they have had little impact on overall smoking rates. This column assesses the impact of such policies – from bans to advertising controls – on rates of smoking initiation across Europe. Control policies have no significant effect on the age of onset of smoking, and do not seem to discourage young individuals from starting to smoke. To prevent take-up of smoking, policies must address this directly.

Joan Costa-i-Font, Edward C. Norton, Luigi Siciliani, 12 September 2017

Long-term care services are at the forefront of a new wave of reforms extending public intervention into healthcare, but it is unclear how the government should intervene to fund and organise such services. This column suggests some strengths and weaknesses of public financing and organisation of long-term care, including its weak financial sustainability and some potential knock-on effects on saving behaviour. However, publicly funded systems deliver better equity of access. Non for profit and autonomous organisations provide better care.

Laurent Gobillon, Carine Milcent, 21 July 2017

It is widely believed that the goal of keeping health expenditures under control while increasing the quality of the healthcare system can best be achieved by giving a greater role to market forces. This column evaluates the effect of a pro-competition reform implemented in France over 2004-2008 on hospital quality. It finds that the impact on quality depends on the managerial autonomy of hospitals. And due to the French healthcare market structure, the overall effect of the reform has been limited.

Thomas Buchmueller, Helen Levy, 11 June 2017

The Affordable Care Act (ACA), enacted in 2010, was intended to address long- standing problems with the American system of health care and health insurance. This column, taken from a new VoxEU eBook, reviews the main provisions of the ACA related to insurance coverage and healthcare costs, including what is known so far about their impact. It also discusses the recent Republican attempt to ‘repeal and replace’ the law.

Margaret Kyle, Heidi Williams, 22 May 2017

Despite higher per capita healthcare spending, US health outcomes compare poorly with other developed nations. One potential reason is that the US healthcare system creates incentives that promote the faster adoption of medical technologies with minimal benefits. This column tests this claim using data on the quality and diffusion of new pharmaceuticals in the US and four other countries. The results suggest that compared to Australia, Canada, Switzerland, and the UK, low-quality drugs diffuse more quickly in the US relative to high-quality drugs.

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