Mark V. Pauly | |
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Nationality | American |
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Mark V. Pauly is an American economist whose work focuses on healthcare management and business economics. He is currently the Bendheim Professor in the Department of Health Care Management at the Wharton School of the University of Pennsylvania. Pauly is a former commissioner on the Physician Payment Review Commission, and has been a consultant to the Congressional Budget Office, the Office of the Secretary of the U.S. Department of Health and Human Services, [1] the American Enterprise Institute, [2] and served on the Medicare Technical Advisory Panel. He is also the Co-Editor-in-Chief of the Springer journal International Journal of Health Care Finance and Economics, and was formerly the Robert D. Eilers Professor from 1984 to 1989. [3] [4]
Pauly received his AB from Xavier University in 1963, his MA from the University of Delaware in 1965, and a PhD in economics from the University of Virginia in 1967. [5]
Pauly is a co-editor-in-chief of the International Journal of Health Care Finance and Economics and an associate editor of the Journal of Risk and Uncertainty . He has served on Institute of Medicine panels on public accountability for health insurers under Medicare and on improving the financing of vaccines. Pauly is a former member of the advisory committee to the Agency for Health Care Research and Quality, and most recently a member of the Medicare Technical Advisory Panel. [6]
Pauly is a former commissioner of the Physician Payment Review Commission and an active member of the Institute of Medicine. He is Professor of Health Care Systems, Insurance and Risk Management, and Business and Public Policy at the Wharton School and Professor of Economics in the School of Arts and Sciences at the University of Pennsylvania. [7] In 2005, he and Philip A. Rea co-founded the Roy and Diana Vagelos Program in Life Sciences and Management [8] and continues to serve as Emeritus Faculty Co-Director. [9]
One of the nation's leading health economists, Pauly has made significant contributions to the fields of medical economics and health insurance. He is considered to be one of the key architects of the individual mandate, which he and a team of economists proposed to George H. W. Bush in the late 1980s. [10] His classic study on the economics of moral hazard was the first to point out how health insurance coverage may affect patients' use of medical services. Subsequent work, both theoretical and empirical, has explored the impact of conventional insurance coverage on preventive care, outpatient care, and prescription drug use in managed care.
In addition, he has explored the influences that determine whether insurance coverage is available and, by several cost-effectiveness studies, the influence of medical care and health practices on health outcomes and cost. His interests in health policy deal with ways to reduce the number of uninsured through tax credits for public and private insurance and the appropriate design for Medicare in a budget-constrained environment.
He is currently studying the effect of poor health on worker productivity. [11]
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.
Mark Barr McClellan is the director of the Robert J Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University. Formerly, he was a senior fellow and director of the Health Care Innovation and Value Initiative at the Engelberg Center for Health Care Reform at The Brookings Institution, in Washington, D.C. McClellan served as commissioner of the United States Food and Drug Administration under President George W. Bush from 2002 through 2004, and subsequently as administrator of the Centers for Medicare and Medicaid Services from 2004 through 2006.
John C. Goodman is president and CEO of the Goodman institute for Public Policy Research, a think tank focused on public policy issues. He was the founding chief executive of the National Center for Policy Analysis, which operated from 1982 to 2017. He is a senior fellow at the Independent Institute. The Wall Street Journal and The National Journal have called Goodman the "father of Health Savings Accounts."
Uwe Ernst Reinhardt was a professor of political economy at Princeton University and held several positions in the healthcare industry. Reinhardt was a prominent scholar in health care economics and a frequent speaker and author on subjects ranging from the war in Iraq to the future of Medicare.
Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.
In the United States, health insurance coverage is provided by several public and private sources. During 2019, the U.S. population overall was approximately 330 million, with 59 million people 65 years of age and over covered by the federal Medicare program. The 273 million non-institutionalized persons under age 65 either obtained their coverage from employer-based or non-employer based sources, or were uninsured. During the year 2019, 89% of the non-institutionalized population had health insurance coverage. Separately, approximately 12 million military personnel received coverage through the Veteran's Administration and Military Health System.
Healthcare rationing in the United States exists in various forms. Access to private health insurance is rationed on price and ability to pay. Those unable to afford a health insurance policy are unable to acquire a private plan except by employer-provided and other job-attached coverage, and insurance companies sometimes pre-screen applicants for pre-existing medical conditions. Applicants with such conditions may be declined cover or pay higher premiums and/or have extra conditions imposed such as a waiting period.
The Leonard Davis Institute of Health Economics (LDI) is the center for health services research, health policy, and health care management education at the University of Pennsylvania. It is based in the Colonial Penn Center on Locust Walk, at the heart of Penn's campus.
Lawton R. Burns is an American business theorist, Professor of Management and the Chairperson of the Health Care Management Department of The Wharton School of The University of Pennsylvania, and a Faculty Co-director for the Roy and Diana Vagelos Program in Life Sciences and Management.
There were a number of different health care reforms proposed during the Obama administration. Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs. hospice, fraud, and use of imaging technology, among others.
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965.
Karen Davis is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. Davis is an economist, with a career in public policy and research. Before joining The Commonwealth Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977–1980, becoming the first woman to head a U.S. public health service agency.
In the United States, the chargemaster, also known as charge master, or charge description master (CDM), is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital. The chargemaster typically serves as the starting point for negotiations with patients and health insurance providers of what amount of money will actually be paid to the hospital. It is described as "the central mechanism of the revenue cycle" of a hospital.
Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.
Rashi Fein was an American health economist termed "a father of Medicare" in the United States and "an architect of Medicare", was Professor of Economics of Medicine, Emeritus, in the Department of Global Health and Social Medicine at Harvard Medical School, and the author of the book Medical Care, Medical Costs: The Search for a Health Insurance Policy.
Stephen T. Parente is an American health economist. He currently serves as a Professor of Finance and the Minnesota Insurance Industry Chair at the Carlson School of Management and Finance at the University of Minnesota. In April 2017, President Donald Trump nominated Parente to be Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services.
Ilyana Kuziemko is a professor of economics at Princeton University, where she has taught since 2014. She previously served as the David W. Zalaznick Associate Professor of Business at Columbia Business School from July 2013 to June 2014 and as associate professor from July 2012 to June 2013. From 2007 to 2012, she was an assistant professor of economics and public affairs at Princeton University and Woodrow Wilson School. She also served as a Deputy Assistant Secretary for Economic Policy at the U.S. Department of the Treasury from 2009 to 2010 under The Office of Microeconomic Analysis. During her tenure, she worked primarily on the development and early implementation of the Affordable Care Act.
Rinad S. Beidas is an American clinical child psychologist and implementation scientist. She is currently the chair and Ralph Seal Paffenbarger Professor of the department of Medical Social Sciences at the Northwestern University Feinberg School of Medicine. She was formerly professor of Psychiatry and Medical Ethics and Health Policy at the Perelman School of Medicine at the University of Pennsylvania; Director of the Penn Implementation Science Center (PISCE@LDI); and Director of the Penn Medicine Nudge Unit. She is currently an Associate Director at the University of Pennsylvania's Center for Health Incentives and Behavioral Economics.
Rachel Michele Werner is an American physician-economist. She is the first woman and first physician-economist executive director of the Leonard Davis Institute of Health Economics. In 2018, Werner was elected a Member of the National Academy of Medicine for her investigation into the unintended consequences of quality improvement incentives.
Kevin G. Volpp is an American behavioral economist and Mark V. Pauly President's Distinguished Professor at the University of Pennsylvania’s Perelman School of Medicine and the Wharton School. He is the Director of the Penn Center for Health Incentives & Behavioral Economics (CHIBE).