We present a simple graphical framework to illustrate the potential welfare gains from a "top-up" health insurance policy requiring patients to pay the incremental price for more expensive treatment options. We apply this framework to breast cancer treatments, where lumpectomy with radiation therapy is more expensive than mastectomy but generates similar average health benefits. We estimate the relative demand for lumpectomy using variation in distance to the nearest radiation facility, and estimate that the "top-up" policy increases social welfare by $700-2,500 per patient relative to two common alternatives. We briefly discuss additional tradeoffs that arise from an ex-ante perspective.

中文翻译：

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支付医疗费用：乳腺癌治疗的证据


我们提出了一个简单的图形框架来说明“补充”健康保险政策的潜在福利收益，该政策要求患者为更昂贵的治疗选择支付增量价格。我们将此框架应用于乳腺癌治疗，其中肿瘤切除术联合放射治疗比乳房切除术更昂贵，但产生相似的平均健康益处。我们利用距最近放射设施的距离变化来估计肿瘤切除术的相对需求，并估计相对于两种常见的替代方案，“补充”政策使每位患者的社会福利增加了 700-2,500 美元。我们简要讨论从事前角度产生的额外权衡。