Økonomiske mekanismer bag sundhedssystemerne i Danmark og USA: Herunder asymmetrisk information

Mirela Ducic

Student thesis: Master thesis


The purpose of this paper is to give an insight into the healthcare systems in Denmark and US, where a growing interest over the past few years is awakened due to their differences in organi-zations and immense criticism. The healthcare systems in these two countries is characterized as being completely opposite of each other, due to the organization and political goals. The Danish government has a purpose of providing universal coverage, which can be characterized as free and equal healthcare access to the total population. The US government however has based their political goals on choice of freedom, where approximately 40 mill. Americans (free riders) has no insurance and thereby minimum access to healthcare. The Danish healthcare system is rigid in the sense, that supply and demand for healthcare is con-trolled by the government with small private healthcare suppliers. However the US healthcare system is characterized by the opposite, where the majority of the healthcare market is represented by private suppliers that can be categorized as not-for-profit (NFP) organizations and for-profit (FP). The governments own healthcare programs are Medicaid and Medicare, and the part of the population covered by these programs is poor people and pensioners/disabled people. The insurance plans can be split into the following HMO, POS, PPO categorized as ma-naged care plans and the traditionally FFS plan. Under managed care plans the provider and the insurance companies is defined as an organization, where the goal is to minimize healthcare con-sumption and maximize profits. The reimbursement model in managed care plans is based on a fixed rate pr. patient, where more volume means less profit, therefore the suppliers are aware of the cost containment. Under the FFS plan the supplier is reimbursed by the total amount, where the supplier doesn’t care about cost containment. Even though the healthcare systems in these two countries are different, they battle the same problems in their contract design relating to asymmetric information in the form of moral hazard and adverse selection. These types of market failure lead to inefficiency primarily due to rising competition in the supplier market, where competition helps improving welfare. The disadvan-tages come in the form of neglected patient care, repel the sick that increase costs or seek to treat only healthy patient, which is known as adverse selection. Moral hazard relates to overconsump-tion of healthcare from healthy people, which also deteriorates the welfare in the society, due to wasting of resources. None of the healthcare systems are perfect and there can be made adjust-ments in both countries. In US by introducing universal healthcare that can eliminate the free riders and in Denmark overconsumption can be minimized by introducing a patient fee.

EducationsMSc in Business Administration and Management Science, (Graduate Programme) Final Thesis
Publication date2009
Number of pages81