Health Care.

• Position: Brief Article

The NBER's Program on Health Care met on November 17 at the Bureau's headquarters in Cambridge. Program Director Alan M. Garber of Stanford University presided over a day-long discussion of these topics:

"Economic Consequences of Health Insurance Reform"--Presentations and Roundtable Discussion

David M. Cutler, NBER and Harvard University; Jonathan Gruber, NBER and MIT; and Mark B. McClellan, NBER and Stanford University

"Is Health Insurance Affordable for the Uninsured?"

M. Kate Bundorf, NBER and Stanford University, and Mark V. Pauly, NBER and University of Pennsylvania

"Incentives in HMOs"

Martin S. Gaynor, NBER and Carnegie Mellon University; James B. Rebitzer, NBER and Case Western Reserve; and Lowell J. Taylor; Carnegie Mellon University

"Association between Intensity of Treatment and Mortality in Cohorts of Medicare Beneficiaries"

Elliott S. Fisher and Therese A. Stukel, Dartmouth College, and David E. Wennberg, Maine Medical Center

In the first of the day's discussions, Gruber analyzed the economic consequences of a national health insurance plan based on a structured approach to competition among private health plans, tax credits to subsidize health insurance purchase among low-income Americans, and other features to promote near-universal coverage. McClellan presented an analysis of a similar plan, and Cutler led a discussion of several issues in the valuation and costs of national health insurance financing proposals that incorporate competition among private insurance plans.

In their paper, Bundorf and Pauly investigate the meaning of the term "affordability" in the context of the purchase of health insurance. After proposing a definition and estimating the proportion of those currently uninsured who, by this definition, are unable to afford coverage, they find that health insurance actually was affordable for anywhere from 24 to 55 percent of the uninsured in 1998.

Gaynor, Rebitzer, and Taylor use...