Health Economics and Financing, 3rd Edition

by Thomas E. Getzen (Temple Univ.)

• ISBN13: 9780471772590
• ISBN10: 0471772593
• Edition: 3rd
• Format: Hardcover
• Copyright: 2006-12-01
• Publisher: Wiley

Summary

A practical primer to the dynamic field of health economics. Written by Thomas Getzen, a leading academic and practitioner, and currently Director of the International Health Economics Association, this complete, accessible text introduces students to the economic analysis of medical markets and the production of health. Updated and revised with new cases and the latest developments in the field, the new Second Edition traces the economic rationale and development of the medical care organization. It thoroughly introduces students to the principles and concepts of health economics without requiring prolonged preparatory work or extensive mathematical manipulation. * Cases illustrate practical uses of economic theory in each chapter. * More streamlined presentation of macro and historical materials. * Covers the relationship of marketing to marginal cost.

Author Biography

Thomas E. Getzen is Professor ofRisk, Insurance andHealthManagement atTempleUniversity and the founder and Executive Director of iHEA, the International Health Economics Association. After receiving an undergraduate degree in literature from Yale University, he worked for the U.S.P.H.S. Centers for Disease Control Venereal Disease program in New York and Los Angeles, and then obtained an MHA degree in Medical Care Organization and Ph.D. in Economics from the University of Washington. Dr. Getzen’s main research contributions have been in the areas of contracting, price indexes and forecasting of health care spending. His consulting work has included employee benefit negotiations, laboratory diagnostics, risk assessment, and capital financing for managed care. Dr. Getzen has been a visiting professor at the University of York (U.K.), theWharton School of the University of Pennsylvania, and the Center for Health and Wellbeing of the Woodrow Wilson School at Princeton University. He has served on the boards of Covenant House, a local community health center in Northwest Philadelphia, MSI Inc, a venture-capital financed managed behavioral health care corporation, Catholic Health East (CHE), a multi-institutional health provider system with over 60 hospitals and nursing homes. Dr. Getzen has written more than 80 papers in the field and serves on the editorial board of the journal Health Economics.

Table of Contents

Preface

Acknowledgments

About the Author

Foreword

Terms of Trade: The Flow of Funds Through the Health Care System

What is Economics?

The Flow of Funds

Quality

Public or Private Choices

Research

Time

Economic Principles as Conceptual Tools

Health Principles

Health and The Economy

Demand and Supply

Need Versus Demand

The Demand Curve

Marginal Revenue

Is Money the Only Price?

Supply: Inputs and Production Functions

Markets

The Production of Health

Efficiency

Cost-Benefit and Cost-Effectiveness Analysis

Cost-Benefit Analysis is about Making Choices

Maximization: Finding the Optimum

Measuring Benefits

Measuring Costs

Evidence-Based Medicine

The Value of Life

Quality-Adjusted Life Years (QALYs)

Perspectives: Patient, Payer, Government, Provider, Society

Health Insurance: Financing Medical Care

Methods for Covering Risks

Insurance: Third-Party Payment

Risk Aversion

Adverse Selection

Moral Hazard

Tax Benefits

Effects of Health Insurance on Labor Markets

History of Health Insurance

Financing Health Care: Insurance as a Funding Mechanism

Insurance Contracts and Managed Care

Types of Insurance Plans

HSA's, Medical Savings Accounts and "Consumer-Driven Health Plans."

A Range of Risk Bearing: Fixed Premiums, Administered Services Only, and Self-Insurance

Managed Care Plans

The Range of Managed Care Plans

Is Managed Care The Solution to Rising Costs?

Managed Competition: The Enthoven Plan

Incentives-To Patients, To Payers, and To Providers

Physicians

Financing Physician Services: Revenues

Physician Incomes

Physician Financing: Expenses

The Transaction Between Doctor And Patient

Uncertainty

Licensure: Quality or Profits?

Medical Education, Organization, and Business Practices

Medical Education

The Origins of Licensure and Linkage to Medical Education

Adjusting Physician Supply

Group Practice: How Organization and Technology affect Transactions

Kickbacks, Self-Dealing, and Side Payments

Price Discrimination

Practice Variations

Insurance, Price Competition, and The Structure of Medical Markets

Hospitals

From Charitable Institutions to Corporate Chains: Development of the Modern Hospital

Hospital Financing: Revenues

Hospital Financing: Expenses

Financial Management and Cost Shifting

How do Hospitals Compete?

Organization: Who Controls The Hospital and for What Ends?

Management and Regulation of Hospital Costs

Why do some Hospitals Cost more than Others?

How Management Controls Costs

Conflict Between Economic Theory and Accounting Measures of Per Unit Cost

Economies of Scale

Quality and Cost

Controlling Hospital Costs Through Regulation

Long-Term Care

Development of The Long-Term Care Market

Defining Ltc: Types of Care

Medicaid: Nursing Homes as A Two-Part Market

Certificate of Need: Whose Needs?

Case-Mix Reimbursement

Substitution

Financial Reimbursement Cycles

Continuing Care Retirement Communities and The Wealthy Elderly

The Effects of aging on Cost and Utilization

Pharmaceuticals

Pharmaceutical Revenues: Sourceso Of FI

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