The health care industry differs from most other industries in that medical pricing is primarily administered by the government and private insurers and in that it uses several types of contracts. Providers may receive a fixed sum for all necessary ...
services within a given period of time, for the necessary services to treat a given condition, or for each specific service. Medical providers may also be reimbursed on the basis of cost. The industry is changing dramatically, offering many natural experiments to aid understanding of the economics of pricing for health care. In "Pricing the Priceless", Joseph Newhouse explains the different pricing systems and how they affect resource allocation and efficiency. All pricing arrangements, he explains, involve trade-offs. The advantages of more inclusive bases of payment, for example, may be offset by incentives for providers to select good risks or to stint on the delivery of services. Newhouse focuses on the efficiency of pricing. He also discusses large issues of equity, fair distribution of burden, and social justice. Although most of the examples are American-based, the same issues arise in all medical care financing and delivery systems, and the theories and models are general enough to apply to many institutional contexts. The topics include Medicare, managed care, the contemporary integration of health insurance and medical care, the management of moral hazard and stinting, uncertainty and risk aversion, the demand for health insurance, agency relationship, information disparities, regulation and supply-side and demand-side selection.