Economics of Health Care Financing, Second Edition The Visible Hand

by Donaldson, Cam; Gerard, Karen; Mitton, Craig; Wiseman, Virginia; Jan, Stephen

• ISBN13: 9780333984314
• ISBN10: 0333984315
• Edition: 2nd
• Format: Paperback
• Copyright: 2004-10-27
• Publisher: Red Globe Pr

Summary

This new edition examines the economics of health care systems in a non-technical manner, highly accessible for economists and non-economists alike. It is very timely and includes the latest evidence of health care reforms and their implications from a number of countries with different systems.

Author Biography

Cam Donalson is Health Foundation Chair in Health Economics and ESRC Advanced Institute of Management Research (AIM) Public Service Fellow, Centre for Health Services Research, School of Population & Health Sciences and Business School (Economics), University of Newcastle upon Tyne.

Karen Gerard is Senior Lecturer University of Southampton and Senior Visiting Fellow, Health Economics Research Centre, Institute of Health Sciences, University of Oxford.

Craig Mitton is a Research Scientist in the Centre for Healthcare Innovation and Improvement in the British Columbia Research Institute for Children's and Women's Health and Assistant Professor, University of British Columbia.

Stephen Jan is Lecturer, London School of Hygiene and Tropical Medicine.

Virginia Wiseman is Lecturer, London School of Hygiene and Tropical Medicine.

Table of Contents

List of figures and tables	vi
Notes on authors	viii
Acknowledgements	x
I MARKETS AND MARKET FAILURE IN HEALTH CARE	1	(52)
1 Health Care Financing Reforms: Moving into the New Millenium	3	(12)
Introduction	3	(1)
The changing world of health care financing	4	(8)
Outline of the book	12	(3)
2 Markets and Health Care: Introducing the Invisible Hand	15	(14)
Introduction	15	(1)
What is a market and how does it work?	16	(7)
Markets: the panacea for health care ills?	23	(1)
The crucial assumptions	24	(3)
Consumer is sovereign?	27	(1)
Conclusions	28	(1)
3 Market Failure In Health Care: Justifying the Visible Hand	29	(24)
Introduction	29	(2)
Market failure and the UK NHS: Williams' tale of the duck-billed platypus	31	(1)
Risk, uncertainty and the failure of voluntary health care insurance	32	(9)
Externalities	41	(2)
Licensure and asymmetry of information	43	(4)
Relevance of economics to government intervention	47	(3)
Conclusions	50	(3)
II HEALTH CARE SYSTEMS AND THEIR OBJECTIVES	53	(36)
4 Methods of Funding Health Care	55	(18)
Introduction	55	(2)
Public/private mix in finance and provision	57	(1)
Rewarding the providers	58	(2)
Private health care insurance	60	(4)
Direct tax system	64	(3)
Public health care insurance	67	(2)
Other financing mechanisms	69	(1)
Conclusions	70	(3)
5 ECONOMIC OBJECTIVES OF HEALTH CARE	73	(16)
Introduction	73	(1)
Efficiency	73	(3)
Equity	76	(1)
Confronting the confusion: what do we mean by equity?	77	(8)
The economics and philosophy interface - theories of equity	85	(1)
Towards some operational equity goals	86	(1)
Interaction between equity and efficiency	87	(1)
Conclusions	88	(1)
III A REVIEW OF EMPIRICAL FINDINGS	89	(110)
6 Countering Consumer Moral Hazard	91	(25)
Introduction	91	(1)
Policy responses to consumer moral hazard	92	(1)
Evidence on countering consumer moral hazard	93	(21)
Conclusions	114	(2)
7 Countering Doctor Moral Hazard	116	(27)
Introduction	116	(1)
Methods of paying doctors	117	(1)
Fee for service: does supplier inducement really exist?	118	(7)
Alternatives to fee for service	125	(16)
Conclusions	141	(2)
8 Countering Moral Hazard in the Hospital Sector	143	(28)
Introduction	143	(1)
Theoretical perspectives	144	(3)
Methods of reimbursing hospitals: a case of minding our Ps and Qs?	147	(5)
Empirical evidence on reimbursing hospitals	152	(13)
Does ownership make a difference?	165	(2)
Towards a solution: back to budgeting?	167	(2)
Conclusions	169	(2)
9 Achieving Equity	171	(28)
Introduction	171	(1)
The role of government in health care financing	172
Evidence on vertical equity	171	(9)
Evidence on equity as access	180	(15)
Conclusions	195	(4)
IV FUTURE CHALLENGES	199	(29)
10 Future Considerations: Setting the Health Care Budget	201	(18)
Introduction	201	(1)
What are the determinants of total health care spending?	202	(6)
What is the appropriate level of spending?	208	(3)
Moving forward: from QALY league tables to programme budgeting and marginal analysis	211	(3)
Social determinants of health	214	(4)
Conclusions	218	(1)
11 Health Care Financing Reforms: Where Now for the Visible Hand?	219	(9)
Introduction	219	(1)
The contribution of economic theory	220	(1)
Empirical findings - how health services should be financed	221	(5)
Determining the size of the budget	226	(1)
Conclusions	226	(2)
Notes	228	(4)
References	232	(40)
Index	272