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9780192632531

Distributing Health Care Economic and Ethical Issues

by ;
  • ISBN13:

    9780192632531

  • ISBN10:

    0192632531

  • Format: Paperback
  • Copyright: 2003-01-09
  • Publisher: Oxford University Press

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Summary

This is a new health economics textbook with a difference. It is based firmly in the discipline of economics and, as such, it fills a gap in the health economics market. But, unlike other texts in the area, it is very explicit about the distributive implications of economic models and it provides clear rathionale for public involvement in the market for health care. It separatesthe efficiency reasons for public involvement(based on notions of 'market failure') from the equity reasons(based on the views of society that health care should be distributed according to the notion of health needs rather than according to ability to pay). The book illustrates the distributional aspects of money flows in the financing and provision of health care, and discusses who are the gainers and who are the losers under different financing arrangements. A central part of the book contains a discussion of those techniques that are increasingly being used to aid decisions about how to distribute health care. Beyond the parameters included in economic evaluation techniques such as cost- benefit analysis and cost-effectiveness analysis, the book discusses some key ethical issues that are relevant for decision-makers when setting health care priorities.

Table of Contents

Health care and health
1(12)
What is health care?
1(2)
What is health?
3(2)
What does health care---and health---do for people?
5(2)
The determinants of (ill) health
7(2)
The health of nations
9(2)
Conclusion
11(2)
Suggested reading
12(1)
Economics and efficiency
13(18)
Microeconomics---studying markets and their actors
15(15)
More in means more out---but at a diminishing rate
16(3)
Substitution---`there is more than one way to skin a cat'
19(4)
Scarcity: a dismal reality for the dismal science
23(4)
Supply and demand---and the magic equilibrium
27(3)
Conclusion
30(1)
Suggested reading
30(1)
Justice and fairness
31(18)
What is to be distributed?
32(3)
Utility
32(2)
Primary goods
34(1)
Basic capabilities
35(1)
How is it to be distributed?
35(3)
Sum-ranking
36(1)
Maximin
36(1)
Egalitarianism
37(1)
Choosing a preferred distribution
38(4)
Choosing a point on the utility possibility frontier
38(2)
The social welfare function
40(2)
Alternatives to distributive justice
42(5)
Rights
42(2)
Procedural justice
44(1)
Medical ethics: different principles at the bedside?
45(2)
Conclusion
47(2)
Suggested reading
48(1)
Efficiency-motivated responses to market failures
49(23)
The perfect market model and the imperfect market for health care
49(4)
Uncertainty and insurance
53(4)
The welfare gain from insurance
53(2)
The probability and the loss
55(1)
Actuarially fair insurance
56(1)
Adverse selection
57(2)
Moral hazard
59(1)
Asymmetric information and the agency relationship
60(6)
The doctor--patient relationship
61(1)
Supplier-induced demand
62(3)
The agency relationship and social welfare
65(1)
Externalities---selfishly motivated
66(4)
Contagion
67(2)
Productivity
69(1)
Conclusion
70(2)
Suggested reading
71(1)
Equity-motivated responses to market failures
72(10)
Reasons for caring---defining altruism
73(2)
Transfers in cash or in kind
75(3)
Concerns for more than one individual
78(1)
Concerns for the community
79(1)
Conclusion
80(2)
Suggested reading
81(1)
Providing health care: finance and regulation
82(16)
Flows of money: the `revenue--expenditure--income' identity
83(3)
Limited revenue
84(1)
Keeping expenditures in line with revenues
85(1)
Earning incomes from the expenditures
86(1)
Disaggregation: a closer look at gainers and losers
86(2)
Shifting the financial burdens
87(1)
Making a living from expenditure
88(1)
The split between purchasers and providers
88(4)
Labour supply
92(4)
Conclusion
96(2)
Suggested reading
97(1)
Economic evaluation techniques
98(23)
Different techniques with some basic similarities
98(3)
Valuing benefits in monetary terms
101(7)
Non-preference-based measures of monetary benefits
101(4)
Preference-based measures of monetary benefits
105(3)
Valuing benefits in health terms
108(4)
Non-preference-based health benefits
108(1)
Quality-adjusted life-years
109(1)
Measuring health-related quality of life
110(2)
Estimating costs---some key principles
112(2)
Marginal costs
112(1)
Social costs
113(1)
Discounting---a preference for the present
114(4)
The reasons for discounting
115(1)
Some formulae and examples
115(1)
Some views on discounting
116(2)
Conclusion
118(3)
Suggested reading
120(1)
The ethics of economic evaluation in priority setting
121(14)
Aggregation issues
122(2)
Aggregation in monetary terms
122(1)
The distribution of health benefits
123(1)
The importance of different health streams
124(2)
The no-treatment health stream
124(1)
Age and the previous stream of health
125(1)
The importance of non-health characteristics
126(2)
The causes of ill health
127(1)
The consequences of improved health
128(1)
Quantifying preferences
128(3)
The type of preferences required
128(2)
The nature of individual preferences
130(1)
Quantifying rights and procedures
131(2)
Conclusion
133(2)
Suggested reading
134(1)
Towards a new health economics?
135(11)
The boundaries of health economics
135(2)
The demand for curves
137(2)
Justice and fairness: societal judgements
139(1)
The market fails---but so may the government
140(1)
Caring for others
140(1)
Purchasing and providing health care
141(1)
Economic evaluation
142(1)
Beyond health benefits
143(1)
A new normative health economics?
144(2)
References 146(5)
Index 151

Supplemental Materials

What is included with this book?

The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

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