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Record W2945622429 · doi:10.1177/0043820019841436

Moral Hazard: It's the Supply Side, Stupid!

2019· article· en· W2945622429 on OpenAlexaboutno aff
Rachel Kreier

Bibliographic record

VenueWorld Affairs · 2019
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsnot available
Fundersnot available
KeywordsMoral hazardDemand sideHealth careBlamePer capitaIncentivePaymentBusinessEconomicsActuarial sciencePublic economicsMarket economyFinanceMicroeconomicsEconomic growthPopulationMedicine

Abstract

fetched live from OpenAlex

In health care markets, moral hazard is conventionally viewed as a demand‐side phenomenon in which insurance causes patients to use more care because it reduces the price they have to pay for care. However, demand‐side moral hazard cannot explain why U.S. per capita health care costs are much higher than those of countries with universal coverage and lower out‐of‐pocket charges. Instead, blame rests with a phenomenon that may be called supply‐side moral hazard, which occurs when third‐party payment removes the constraints the demand curve would otherwise exert over the prices providers charge, and the quantity of expensive services they can sell. Public institutions are better positioned than private entities to address supply‐side moral hazard. This helps explain why the other wealthy democracies—both those with single‐payer systems, like Canada, and those with multipayer systems and all‐payer procedures for setting provider rates, like Germany and Switzerland—spend much less per capita than the United States. Although managed care achieved some success in controlling U.S. provider prices in the 1990s, in the longer term, it motivated increasing market concentration among providers, which vitiated cost control. Furthermore, managed care exacerbates inequity and complexity, problems that public price regulation avoids.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesInsufficient payload (model declined to judge)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.939
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.007

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.038
GPT teacher head0.250
Teacher spread0.212 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations9
Published2019
Admission routes1
Has abstractyes

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