Econ 6370 Paper Instructions
Book Assessment (Expected length of the body (doesn’t include references or abstract) : 6 pages double spaced; Maximum length: 8 pages). This is more than enough room if you are concise.
When finished you will upload the paper to the Turnitin drop box labeled Paper Drop Box under the Lessons tab on WTClass. See the bottom of this document for a brief description of how this paper will be graded.
1. For this paper, you will be required to compare and contrast two books. The paper should include:
a. a brief comprehensive summary of the Gruber book and parts III and IV of the Goodman book (I encourage you to read parts I and II of the Goodman book, but I am not going to require that you write about it)
b. a section where you analyze and critique each book (the whole Gruber book and parts III and IV of the Goodman book) separately using solid economic theory.
i. This section should include an evaluation of the authors’ arguments, being sure to cite the strengths and weaknesses you find; that is, what did the authors do well (and why is it right), what didn’t they do well (and why isn’t it the best approach), what could they have done differently, etc…
c. a section where you compare and contrast each book jointly (the whole Gruber book and parts III and IV of the Goodman book) using solid economic theory.
i. This section should compare and contrast the primary ideas of each author (don’t get bogged down in the details, which can be a trap). What are the main differences? What are the main similarities?
ii. If given the opportunity, how would you improve upon what Goodman and Gruber advocate? Would you emphasize one author’s primary approach over another? Blend the two approaches? Why or why not?
2. NOTE: Your paper should conform to and follow APA 6th Edition style and formatting guidelines. The only guideline you can skip is the inclusion of an abstract. To be clear, your paper does not need to have an abstract. Please follow all of the other guidelines. See http://owl.english.purdue.edu/owl/resource/560/01/. Your font must be Times New Roman size 12.
3. Do not simply give me your opinion. Do your research, and back your statements up with resources, making sure to cite those references.
a. Your paper should have at least five references (in addition to the Gruber and Goodman books), which should be formatted according to APA style. Be sure to cite these references and the Gruber and Goodman books, both in the text and in the bibliography. Furthermore, these should be references that have not been cited by the author of either book. If you use any course material from lectures or the textbook, you should also cite it in the text and in the bibliography. You need to cite everything.
4. Below are a few sources containing information about writing a critical review. Take a look at
these prior to writing your paper.
http://www.unc.edu/depts/wcweb/handouts/review.ht
ml http://www.lc.unsw.edu.au/onlib/critrev.html
http://www.hccfl.edu/adjunct/darren_smith/bbsgwcr.
htm
Please do not quote unless absolutely necessary. It is generally better to provide the information
in your own words and cite the source.
Finally, please be sure to proofread your paper, and if possible, have someone else proofread it,
as it is often difficult to catch your own mistakes after having spent so much time with it.
5. You will be scored according to how well you follow the instructions above. Your grade will be
broken down as follows:
a. Summary of the books (all of the Gruber book and only sections III and IV for the Goodman
book) – 25%
b. Evaluating the strengths and weaknesses of the authors’ arguments separately – 25%
c. Comparing and contrasting each book jointly (all of the Gruber book and only sections III and
IV of the Goodman book); your improvements – 25%
d. Overall read (includes: citations, grammar, sentence structure, etc…) – 25%
i. Note: this also includes plagiarism, which will be assessed using Turnitin. Serious
plagiarism will result in serious consequences.
6. Before submitting your paper, you must complete the pre-test and post-test from the University of
Southern Mississippi’s plagiarism tutorial available at
http://www.lib.usm.edu/legacy/plag/plagiarismtutorial.php. You will need to include my email address
when submitting your pre-test and post-test so that I will receive notification that you completed the tests.
If you do not complete the pre-test and post-test by the deadline for paper submission, then you will
receive a score of 0 for your paper.
7. To be clear, your paper must have at least 5 references to 5 separate sources. Our course textbook, the
Goodman book, the Gruber book, and any citations found in these three resources do not cut toward the 5
references. Each reference needs to be cited within the paper. It is not enough to just throw 5 references
into a reference list at the end of your paper and never mention the 5 references or never cite them within
the body of your paper. The 5 references need to be actively included in the body of your paper.
this is what I have written
Healthcare system continues to poses a significant threat to the US economy. According to Goodman, health cost per capita has been rising at the rate of per capita income for the past forty years. It is estimated that healthcare consume over 17.2 percent of the total gross DP and to make matters worse, about 32 million people lack access to affordable healthcare. It is public knowledge that increase in insurance premium can be directly linked to the number of the uninsured receiving care and if there is no intervention, it will consume about 40% of the country GDP in the upcoming years.
The affordable Care Act was enacted with the goals of increasing affordability of health insurance and increasing the quality of care while decreasing cost. Many individuals believe that newly enacted legislation will do little to effect the change needed to cut cost while others believe otherwise. Jonathan Gruber and Goodman are such individuals with different opinion on the newly enacted legislation (ACA).
In the book healthcare reform by Dr. Jonathan Gruber, he used an easily understood cartoon book to discuss the new legislation, it’s necessity and how it works". He pointed out the biggest problem affecting our current healthcare system and how the law addresses most of them. He depicts the landscape of healthcare by profiling different types of individuals that found in the healthcare system. These include those individuals with employers sponsored insurance coverage, Medicare beneficiaries, the working class without coverage who tends to use the nongroup insurance coverage and those with no coverage at all. According to Gruber, the biggest American health care finance is the rising cost of insurance coverage and the rising number of American without coverage. He associated the rising healthcare cost to the dwindling health insurance coverage by employers. He also pointed out that waste and inefficiencies which is affecting Medicare ability to cover cost and its effect on physician reimbursement.
Mr Gruber went further to explained the benefit of reform which includes the affordable insurance through the health insurance exchanges, Medicaid expansion for qualifying for individuals, subsidies for qualifying families, removal of pre-existing conditions and help for Medicare beneficiaries with 50% payments for their prescription drugs, if they fall into the “donut hole”. The reform also added preventative care to everyone, coverage for children under 26 through their parents whether they are working or in school, single or married, and living on their own or with their parents; coverage for babies born with birth defects and removal of lifetime limitation. Small businesses with less than 25 employees will get tax credits to help offset insurance premiums.
In response to his critics, he presented Massachusetts care which is similar with ACA in some way as example of ACA will work. He pointed the advantage of the Massachusetts care which insured 98% of its resident and has a high approval rate.
He emphasized why the individual “mandate” is necessary to pay for coverage by increasing the number of people in the insurance pool which will help to keep rates down for everyone. He also predicts that under the new law, many healthy people may refused to buy coverage until they are sick since there is a little penalty associated with purchase at a later time. He noted that this type of behavior can increase the rate for everyone.
Though Mr. Gruber did not know the full effect of the new health reform , he concluded by informing the readers on how the new law will increase the number of the uninsured, reduce deficit through spending cuts and increasing revenue through taxation and waste elimination.
On the other hand, Goodman viewed the ACA care as a radical transformation of the US healthcare system that needs to be repealed. In his book priceless, he wrote about different factors affecting the healthcare system such as quality and access problems of our system; the new health care reform which he believes does little to address the problem of US healthcare and the reform of malpractice insurance, Medicare and Medicaid among others. Gruber believes that "system of third-party payment encourages over consumption and insulates patients from the cost of their care and discourages health care providers from innovating in ways that lower the costs of care while improving its quality."
He mentioned some of the major benefit of the new reform which includes insurance affordability by some individuals, removal of preexisting conditions, no annual limitation, no copay or deductible for most of the preventative screening and the insurability of the 32 million individuals as estimated by CBO.
He went on to describe major cost of ACA reform such as Medicare spending cut that will be used to pay for the reform, the new taxes on drugs and medical device, higher premium and low benefit for Medicare beneficiaries, loss of employer drug coverage for nearly 6 million retirees, tax cost on business, 40% tax increase on the Cadillac plan, tax on medical savings account, increased premium for everyone especially the younger population, reduction in wages and job loss that is estimated to be about 700,000 by 2019 according to CBO. He also reports Job loss in the millions that can occurs with the new health insurance and the effect on wages as employers try to implement the new health reform.
According to Goodman, true reform can be achieved by implementing the following:
Health savings account which will allow individuals to have control over their health care funds and give ‘patients and their physicians control to decide on their care instead of third party bureaucracies such as government, HMOs, and insurance companies’. This will cause individual to spend their money wisely by demanding for better quality and better price.
"Replacing Medicaid with health stamps depending on their health conditions and allowing them to add their own money and pay the market prices for the services that they desire. Because they pay the full market value, they have more accessibility to providers"
"Management of chronic care accounts by individuals or other mechanism which will allow them to become unrestricted consumers in the medical marketplace".
"Increasing accessibility for Medicare/Medicaid consumer by allowing them to participate in low cost clinics"
‘Allowing reimbursement for other types of consultation such as email and telephone’
Allowing competition on the supply side of the market ‘based on price and convenience instead of providing only those services approved by the third payer party which does not reflect the true cost of treating a patient.’
"Loosening medical practice statutes to allow a broader array of providers into the market for direct care". ‘This should include the health retail outlet like Minute care which are known to provide high quality care that are evidence based and allowing paramedical personal to provide services that do not require a physicians level of expertise"
‘Making insurance portable for individuals as the move in and out of the labor market" Portable insurance will allow long term relationship with the insurance company and provide continuity of care with their physicians. In the case of serious illness, people would be able to transfer to other health plans at market price paid by the current insurers. As a result, insurers would actively compete for sick people including the chronically ill and providers would compete to deliver quality care’
He devoted some sections on the effect of malpractice insurance and liability on healthcare cost and offered some suggestions for Medicare and Medicaid reform and concluded with these simple fact:, that "patients should pay a price for care equal to the marginal social cost, providers should receive a price equal to the marginal value of their care and these prices should be determined in competitive market"
Similarities
They both agreed that cost is rising and that waste and inefficiencies exist.
That ACA will only work if both healthy and sick people alike buy insurance.
Goodman basically rejects the basic landscape of the new reform and offered his comprehensive ideas which includes the following:
He demanded that individual mandate be removed as well as free preventative care. He argued that the individual mandate would increase ‘the price of insurance and prevent the healthcare industry from feeling the normal consumer reaction to a rising premium’. He notes that this mandate could cause employers to pay fewer wages in order to cover insurance premium which may lead to job loss. He also wants removal of preventative care "without deductible or copay which would lead to over consumption of care as individual will not have any incentive to compare prices in effort to minimize cost"..
He believes the ACO which Gruber promoted as part of cost and quality improvement is incompetent and harmful according to the comprehensive review of all the studies. He noted that "ACO will cut innovation and entrepreneurship on the supply side and may cause them to leave the industry altogether". Instead, he proposes that healthcare providers to be compensated based on waste and inefficiencies elimination without increase in cost or decrease quality of care.
Goodman recommended that the federal government give individual the same tax relief that is offered to employers and give subsidies that is independent of income while Gruber supports giving subsidies to only qualified individuals
Goodman worries that the new law will negatively affect small business by increasing their tax penalty when they can’t afford coverage or decide to hire only part time in order to avoid coverage while Gruber believes that the new law will help small business cover insurance premium if they qualify.
Goodman argued for a fair market in which the insurance company is allowed to charge the sick a higher premium at an attractive rate just as it will charge the lower rate for the health but Gruber promote an insurance exchange that will charge the same price for everyone in the insurance pool
Goodman ridiculed the Massachusetts care as a place where people continue to use the system due to weakly enforced mandate while Gruber delineate it success rate and popularity.
Analyzing both authors
Given the level of difficult associated with predicting an event, many individuals decide to self-insure because of the high price of health insurance relative to the benefits they expect to receive. According to Natree and Neu, the pooling arrangement help to mitigate some risk associated with pooling and replaces individual loss with the average loss distribution of the group. Due to asymmetry of information, people buying individual health insurance plans may lack the technical information needed to accurately assess the true value of a health insurance policy and may pay higher prices or receive lower quality as a result. In that case, government gets involved by making policies in an attempt to distribute the medical resources equitably and fairly.
There are 3 dimension of care as identified by Goodman which are quality, quantity and amenities and "explaining that the time cost of care is the single largest factor determining true cost." According to Mr. Goodman the quality dimension is effectively hidden because the third-party payer system negotiates the direct price and amenities, and the patient experiences effectively only the time price and not the cost. Therefore, eliminating the third party payer will help decrease cost in the long run.
The newly enacted legislation with the individual mandate will drive the price of health insurance as the influx of high risk patient becomes apparent. As premium goes up, enrollment in the insurance pool will reduce. Recall that any increase in price will decrease the quantity demanded by consumers if the marginal benefit of new coverage are more than marginal cost of the coverage. Gruber argued that individual mandate will help solve the problem but the tax penalty attached for lack of coverage may not sufficient to force individuals into compliance.. .
Health savings Accounts (HSAs)which is a big part of Goodman crusade on solving the healthcare problem has shown to reduce health cost by 30%. ( ). He want HSAs to be expanded throughout the entire health care sector by giving workers, Medicare and Medicaid beneficiaries freedom to choose HSAs coverage as they see fit. Goodman advocated for health care saving account that gives patient control over their healthcare spending versus current third payer insurance which are usually covered by employer and seen by the federal government as tax credit.” According to Goodman, employers health insurance is tax-free and wages are taxed at the marginal rate, employees have an incentive to put as many dollars of benefits as possible into health insurance thereby making medical care essentially free at the point of delivery.”This encourages patients to consume healthcare until the last amount obtained has a value that approaches zero (N&S)making it unlikely that "patient will shop around for the best buy".”
When patients are not allowed in the healthcare market, healthcare producers will have no economic incentive to keep costs low the way other producers do in an open markets. Currently, the third third-party payment system gives healthcare producers an incentive to maximize against the payment formulas in order to enhance their incomes. "which results in insures controlling at every level. HSAs can be expanded throughout the entire health care sector by giving workers, Medicare and Medicaid beneficiaries freedom to choose HSAs coverage. I agree with Goodman recommends of getting rid of the employer-based tax exclusion for health insurance and replacing it a safety net tax credit for health insurance which will encourage people to purchase health insurance that covers largely catastrophic cost.
The new law includes free preventative care which will increase demand for medical professionals. It will lead to overcrowding given that the current supply of healthcare providers are not adequate for the medical services needed. Again, patient has an incentive to over consume when they are no fees attached. In addition, individuals in high paying plans seeking the same type of services may crowd out access to care for patients in lower paying plan and increase number of physicians going into concierge care could cause greater rationing of healthcare providers.
With expansion of Medicaid comes the problem of crowding out. Studies has shown that previous expansion of Medicaid program gave families who will otherwise be in a private insurance pool the incentive to increase their take home pay by shifting their health care cost to the taxpayers. In other words, "crowding out encourages free ring at the expense of the tax payers and the care is not the same since privately insured patients are known to get better care and coverage".
Medicare should allow provider to propose and obtain different reimbursement rate when they are eliminating waste and inefficiencies, cutting cost and providing quality services such as those that allows patient to be better manager of their care
Finally, we will benefit from a system that offer individuals tax subsidy to everyone regardless of insurance type. We should make it ‘easier to save for health expense by allowing after tax health savings account that can grow tax free and use for other purposes’. This will encourage individuals to be prudent with their spending, allow them to purchase insurance directly by eliminating third party and increase competition and innovation among healthcare producers which will drive down cost just like it would in any other market.
Use the order calculator below and get started! Contact our live support team for any assistance or inquiry.
[order_calculator]