Health Services Accessibility

Publication Title: 
Journal of Health Economics

I investigate how changes in fees paid to Medicaid physicians affect take-up among children in low-income families. The existing literature suggests that the low level of Medicaid fee payments to physicians reduces their willingness to see Medicaid patients, thus creating an access-to-care problem for these patients. For the identical service, current Medicaid reimbursement rates are only about 65 percent of those covered by Medicare. Increasing the relative payments of Medicaid would increase its perceived value, as it would provide better access to health care for Medicaid beneficiaries.

Author(s): 
Hahn, Youjin
Publication Title: 
Health Economics

Medicare adjusts its payments to physicians for geographic differences in the cost of operating a medical practice, but the method it uses is imprecise. We measure the inaccuracy in its geographic adjustment factors and categorize beneficiaries by whether they live where Medicare's formula is favorable or unfavorable to physicians.

Author(s): 
Brunt, Christopher S.
Jensen, Gail A.
Publication Title: 
Health Economics

The introduction of the New Cooperative Medical Scheme (NCMS) in rural China has been the most rapid and dramatic extension of health insurance coverage in the developing world in this millennium. The literature to date has mainly used the uneven rollout of NCMS across counties as a way of identifying its effects on access to care and financial protection. This study exploits the cross-county variation in NCMS generosity in 2006 and 2008 in the Ningxia and Shandong provinces to estimate the effect of coverage generosity on utilization and financial protection.

Author(s): 
Hou, Zhiyuan
Van de Poel, Ellen
van Doorslaer, Eddy
Yu, Baorong
Meng, Qingyue
Publication Title: 
International Journal of Health Care Finance and Economics

Using 2008 physician survey data, we estimate the relationship between the generosity of fees paid to primary care physicians under Medicaid and Medicare and his/her willingness to accept new patients covered by Medicaid, Medicare, or both programs (i.e., dually enrolled patients). Findings reveal physicians are highly responsive to fee generosity under both programs. Also, their willingness to accept patients under either program is affected by the generosity of fees under the other program, i.e., there are significant spillover effects between Medicare and Medicare fee generosity.

Author(s): 
Brunt, Christopher S.
Jensen, Gail A.
Publication Title: 
Journal of Dental Education

If it is not a naÔve expectation for dentists who have been beneficiaries of public generosity to share their good fortune with the public that made it possible, there may be a rational basis for enhancing the role of dental education in improving access to oral health care by promoting-but not requiring-a voluntary service commitment after graduation commensurate with the magnitude of the subsidy received.

Author(s): 
Bertolami, Charles N.
Berne, Robert
Publication Title: 
Health Economics

In this study, the convergent validity of the contingent valuation method (CVM) and travel cost method (TCM) is tested by comparing estimates of the willingness to pay (WTP) for improving access to mammographic screening in rural areas of Australia. It is based on a telephone survey of 458 women in 19 towns, in which they were asked about their recent screening behaviour and their WTP to have a mobile screening unit visit their nearest town.

Author(s): 
Clarke, Philip M.
Publication Title: 
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen

A characteristic feature of transplanting organs from living donors is that not only patients in need for treatment but also healthy individuals are submitted to medical interventions. Ethical considerations in this field have to deal with the question of property attributes of the human body and conflicts with traditional medical principles.

Author(s): 
Nagel, E.
Mayer, J.
Publication Title: 
The Journal of Rheumatology

OBJECTIVE: To delineate the personal, psychosocial, and disease-related factors that may influence rheumatoid arthritis (RA) patients' decisions to participate in clinical trials. METHODS: A total of 191 patients with RA were asked to participate in this survey. The questionnaire collected information on demographics, RA disease-related factors, and the importance of several factors that might influence patients' willingness to participate in clinical trials. Patients were then asked if they would consider participating in a hypothetical study.

Author(s): 
Lee, Susan J.
Lenert, Leslie
Weisman, Stuart
Kavanaugh, Arthur
Publication Title: 
Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC

An exploration of distributive justice in Canadian infertility treatment requires the integration of ethical, clinical, and economic principles. In 1971, American philosopher John Rawls proposed a theoretical model for fair decision-making in which "rational" and "self-interested" citizens are behind a "veil of ignorance" with respect to both their own position and the position of other decision-makers.

Author(s): 
Nisker, Jeff
Publication Title: 
Monash Bioethics Review

If it is so obvious that international participants should share in the spoils of research profits, why isn't it equally obvious that participants who share nationality with the researchers should do so as well? I argue that if one believes that some form of benefit-sharing is morally obligatory in research conducted in developing countries, it is very hard to escape the conclusion that it should at least in some circumstances be thought equally obligatory in research conducted within the borders of developed countries.

Author(s): 
Barclay, Linda

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