Health Economics

by Phelps, Charles E.

• ISBN13: 9780673993984
• ISBN10: 0673993981
• Edition: 2nd
• Format: Hardcover
• Copyright: 1997-05-01
• Publisher: Taylor & Francis

Summary

Phelps combines current economic thinking and research in health economics with real health policy problems. Early chapters develop necessary methodological foundations supported with concrete empirical studies. Later chapters focus on major policy areas such as the structure and effects of Medicare reform, competition and regulation in health care, and international comparisons of health care systems, building on the conceptual material developed earlier in the book.

Table of Contents

Preface	xiii
CHAPTER 1 Why Health Economics?	1	(29)
Important (If Not Unique) Aspects of Health Care Economics	2	(8)
How to Think About Health and Health Care (or...How Health Economics?)	10	(5)
The Production of Health	15	(4)
Health Through the Life Cycle	19	(1)
Lifestyle and Health	20	(6)
Summary	26	(1)
Problems	27	(2)
Appendix to Chapter 1 A Formal Model of Utility Maximization	29	(1)
CHAPTER 2 An Overview of How Markets Interrelate in Medical Care and Health Insurance	30	(31)
Medical Care Markets with Fixed Technology	31	(12)
Dynamic Issues--Changes Through Time	43	(16)
Summary	59	(1)
Problems	59	(2)
CHAPTER 3 The Transformation of Medical Care to Health	61	(41)
The Productivity of Medical Care	61	(17)
Confusion About the Production Function: A Policy Dilemma	78	(12)
Physician-specific Variations (Medical Practice Styles)	90	(5)
Extensive and Intensive Margin Differences: Are They Similar?	95	(2)
Summary	97	(1)
Problems	98	(1)
Appendix to Chapter 3 Marginal, Average, and Total Productivity	99	(3)
CHAPTER 4 The Demand for Medical Care: Conceptual Framework	102	(36)
Indifference Curves for Health and Other Goods	103	(7)
From Indifference Curves to Demand Curves	110	(2)
How Demand Curves Depend on Illness Events	112	(1)
Demand Curves for Many Medical Services	113	(2)
The Demand Curve for a Society: Adding Up Individual Demands	115	(1)
Using the Demand Curve to Measure Value of Care	116	(2)
How Insurance Affects a Demand Curve for Medical Care	118	(11)
Time Costs and Travel Costs	129	(1)
The Role of Quality in the Demand for Care	130	(3)
Summary	133	(1)
Problems	134	(2)
Appendix to Chapter 4 Demand Curves and Demand Elasticities	136	(2)
CHAPTER 5 Empirical Studies of Medical Care Demand and Applications	138	(44)
Studies of Demand Curves	139	(13)
Effects of Age and Gender on Demand	152	(2)
The Effects of Illness on Demand	154	(1)
Lifestyle and Its Effects on Demand	154	(1)
The Demand for Quality: Choice of Provider Specialization	155	(3)
Other Studies of Demand for Medical Care	158	(1)
Natural Experiments I: The Demand for Physician Care	159	(1)
Natural Experiments II: The Demand for Drugs	160	(1)
Time Series Information: The Demand for Drugs Yet Again	161	(1)
Natural Experiments III: The Role of Time in Demand for Care	162	(1)
More on the Role of Time in the Demand for Care	162	(3)
Applications and Extensions of Demand Theory	165	(5)
Decision Theory: Deriving the "Right" Demand Curve for Medical Care	170	(1)
Cost-Effectiveness Ratios and Demand Curves	171	(1)
Why Variations in Medical Practice?	172	(1)
Summary	173	(1)
Problems	174	(2)
Appendix to Chapter 5 An Example of Medical Decision Theory	176	(6)
CHAPTER 6 The Physician	182	(37)
The "Firm"--Inputs, Output, and Cost	183	(1)
The Physician as Entrepreneur	184	(1)
The Physician-Firm and Its Production Function	185	(10)
Nonphysician Primary-Care Providers	195	(2)
The Size of the Firm--Group Practice of Medicine	197	(7)
The Physician as Labor	204	(8)
The Aggregate Supply Curve: Entry and Exit	212	(1)
The Open Economy: United States- and Foreign-trained Physicians	213	(2)
Summary	215	(1)
Problems	215	(2)
Appendix to Chapter 6 Cost Passthrough	217	(2)
CHAPTER 7 Physicians in the Marketplace	219	(39)
Physician Location Decisions	220	(7)
Consumer Search and Market Equilibrium	227	(11)
Actual Search by Patients	238	(1)
Advertising and the Costs of Information	238	(3)
The Role of Licensure	241	(2)
Estimates of the Demand Curve Facing Physician-Firms	243	(2)
Induced Demand	245	(9)
The Role of Payment Schemes	254	(1)
Summary	255	(1)
Problems	256	(2)
CHAPTER 8 The Hospital as a Supplier of Medical Care	258	(32)
The Hospital Organization	258	(7)
Who Is the Residual Claimant?	265	(9)
Hospital Costs	274	(6)
Long-Run Versus Short-Run Costs	280	(1)
The Hospital's "Cost Curve"	281	(2)
Another Complication: Outpatient Surgery	283	(1)
The Demand Curve Facing a Single Hospital	284	(2)
Revisiting the Utility-Maximizing Hospital Manager	286	(1)
Summary	287	(1)
Problems	288	(2)
CHAPTER 9 Hospitals in the Marketplace	290	(40)
Hospitals and the Market for Medical Staff	290	(6)
Hospitals and Patients	296	(3)
A Model of Equilibrium Quality and Price	299	(4)
Insurance and Competition in the Hospital's Decision	303	(3)
How Doctors and Hospitals Interact: "Goodies" for the Doctor	306	(2)
How Doctors and Hospitals Interact: Patients for the Hospital	308	(1)
Competition--"Old Style" Versus "New Style"	309	(2)
Entry and Exit: The Pivotal Role of For-Profit Hospitals	311	(1)
The Hospital in Labor Markets	312	(7)
Nursing "Shortages"	319	(4)
Summary	323	(1)
Problems	324	(2)
Appendix to Chapter 9 The Hospital's Quality and Quantity Decision	326	(4)
CHAPTER 10 The Demand for Health Insurance	330	(36)
The Source of Uncertainty	331	(1)
Why People Dislike Risky Events	332	(1)
The Risk-Averse Decision Maker	333	(3)
Choosing the Insurance Policy	336	(6)
Patterns of Insurance Coverage	342	(2)
How the Price of Insurance Differs for Different People	344	(3)
Group Demand Versus Individual Demand for Insurance	347	(1)
Insurance Purchases Through Time	348	(1)
How Income Taxes Subsidize Health Insurance	349	(5)
Empirical Estimates of Demand for Insurance	354	(2)
The Overall Effect of the Tax Subsidy on the Health Sector	356	(1)
"Optimal" Insurance	357	(1)
Other Models of Demand for Insurance	358	(1)
Summary	359	(1)
Problems	359	(5)
Appendix to Chapter 10 A Detailed Calculation of Welfare Loss	364	(2)
CHAPTER 11 Health Insurance in the Marketplace	366	(37)
The Supply of Insurance	366	(1)
The Production Function of Health Insurers	367	(11)
Cost-Controlling Health Insurance Plans	378	(8)
How Common Are Cost-Control Measures?	386	(1)
How Popular Are Cost-Controlling Health Plans?	387	(2)
How Effective Are Cost-Controlling Health Plans?	389	(3)
Evolution in Private Cost Control--Vertical Integration and "Integrated Delivery Systems"	392	(7)
Pluralistic Provision of Health Care	399	(1)
Summary	400	(1)
Problems	401	(1)
Appendix to Chapter 11 The Statistics of an Insurance Pool	402	(1)
CHAPTER 12 Government Provision of Health Insurance: Medicare and Its Revisions	403	(37)
The Medicare Program	404	(4)
Economic Consequences of Medicare's Structure	408	(4)
Changes in Medicare	412	(25)
Summary	437	(1)
Problems	437	(3)
CHAPTER 13 Other Government Health Care Programs	440	(28)
The Medicaid Program	440	(5)
Economic Policy Issues in Medicaid	445	(14)
Military Health Care Systems	459	(4)
Other Government Programs	463	(2)
Summary	465	(1)
Problems	466	(2)
CHAPTER 14 Medical Malpractice	468	(34)
Background on the Legal System in the United States	468	(7)
The Economic Logic of Negligence Law	475	(4)
Judicial Error, Defensive Medicine, and "Tough Guys"	479	(2)
Medical Malpractice Insurance	481	(1)
Evidence on Actual Deterrence	482	(12)
Malpractice Awards: "Lightning" or a "Broom Sweeping Clean"?	494	(1)
Tort Reform	495	(4)
Tort Reform Writ Large	499	(1)
Summary	500	(1)
Problems	500	(2)
CHAPTER 15 Externalities in Health and Medical Care	502	(37)
Externalities, Property Rights, and the Control of Externalities	503	(2)
Externalities of Contagion	505	(7)
Health-Affecting Externalities: The Example of Alcohol	512	(8)
Externalities from Tobacco	520	(3)
"Financial" Externalities--Transfers Between People	523	(1)
Information as an Externality	524	(3)
Research as an Externality	527	(2)
Why So Little Research on Medical Effectiveness?	529	(1)
Transfusion-induced AIDS and Hepatitis	530	(5)
Summary	535	(1)
Problems	535	(2)
Appendix to Chapter 15 Value of Life	537	(2)
CHAPTER 16 Regulation in the U.S. Health Care Sector	539	(42)
Licensure	540	(8)
Drug and Medical Device Regulation	548	(10)
"Certificate of Need" (CON) Laws	558	(11)
Price Controls	569	(7)
Quality Control	576	(2)
Summary	578	(1)
Problems	579	(2)
CHAPTER 17 Universal Insurance Issues and International Comparisons of Health Care Systems	581	(42)
General Considerations for a National Health Policy	584	(8)
Review of Health Policy and Systems in Selected Countries	592	(1)
Snapshots of Four Countries	593	(12)
Aggregate International Comparisons	605	(11)
Growth in Costs and Health Outcomes	616	(4)
Summary	620	(1)
Problems	621	(2)
Author's Postscript	623	(4)
Answers to Selected Problems	627	(16)
Bibliography	643	(28)
Acknowledgments	671	(2)
Index	673