Miriam Laugesen, PhD

Fixing Medical Prices: Global Lessons (expected completion 2021), France, Germany, Japan: International Evidence from Better Health Systems (2016-): Accurate healthcare pricing of physician services is fundamental for creating the right incentives in a healthcare system. Our paper (2020) in Health Affairs provided an overview of the mechanisms other countries use to set prices. Our book manuscript addresses fee-for-service reimbursement, alternative payment models, and the use of incentive payments in a selected number of high-income countries to evaluate the advantages and disadvantages of different payment methods. The project also aims to identify strategies countries use to balance prices, utilization and expenditure suitable for adoption in the US by private and public payers. PI: Miriam Laugesen with Michael Gusmano (Rutgers), Lawrence Brown (Columbia), Victor Rodwin (NYU)

Insurance coverage and health care across borders (Completed), Mexico: Previously, most analyses of insurance coverage and healthcare across borders explored specific countries or regions. European analyses often focused on treatment for specialty or high-cost services. In contrast, the high cost of US healthcare and the lack of basic coverage motivates some people to travel to Mexico for routine health care services. With Professor Arturo Vargas-Bustamante (UCLA), Dr. Laugesen sought to develop a more universal conceptual framework that would ""travel"" across a variety of health care system types, and reflect differences in insurance coverage and health care costs. The authors presented the framework at a European Consortium for Political Research workshop in 2009, and the paper was published in Health Policy in 2010. Next, with colleagues from the University of Texas, Dr. Laugesen and Dr. Vargas Bustamante researched how Medicare could potentially cover US retirees living in Mexico at a lower cost than in the US, and how uninsured Mexican nationals in the US could receive coverage through public programs sponsored by Mexico, or through private insurance plans operating in California. This analysis was published in Revista Panamericana de Salud/Pan American Journal of Public Health (with M. Caban, & P. Rosenau) in 2012.

Democratic Governance and Health [book] (Completed 2012), New Zealand: Governments in many countries are interested in increasing public participation in health care policy decision-making. One option is to create elected health boards of citizen representatives serving specific geographic areas. New Zealand is the only country in the world where elected health boards are a core and enduring feature of the governance of its health system. Elected boards have survived health system reform attempts by governments on the left and right. One attempt in the 1990s succeeded--for a time-- hospitals were depoliticized and required to operate as profitable businesses. That effort ran aground, due to voter resistance (see Laugesen, ""Why Some Market Reforms Lack Legitimacy"" Journal of Health Politics, Policy and Law, 2005). Democratic Governance in Health, coauthored by Miriam J. Laugesen and Robin Gauld was published by Otago University Press in 2012. It critically surveys the origins and endurance of elected boards in New Zealand, drawing on original archival research as well as recent survey data. The authors dispassionately consider the boards in the context of changing priorities of a regionalized, quality-oriented health care system in New Zealand.