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9780324260007

Health Economics and Policy with Economic Applications

by
  • ISBN13:

    9780324260007

  • ISBN10:

    0324260008

  • Edition: 3rd
  • Format: Hardcover
  • Copyright: 2004-03-08
  • Publisher: South-Western College Pub
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Supplemental Materials

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Summary

Health Economics and Policy is a basic introduction to the microeconomics of health, health care, and health policy. This edition demonstrates how economic principles apply to health-related issues. It explains the social, political, and economic contexts of health care delivery and explores the changing nature of health care. Students learn to analyze public policy from an economic perspective. While the text was written for non-economics majors, it includes enough economic content to challenge majors.

Table of Contents

PART 1 THE RELEVANCE OF ECONOMICS IN HEALTH AND MEDICAL CARE
U.S. Medical Care: Crisis or Conundrum
1(21)
Historical Developments in the Delivery of Medical Care
2(7)
Post-War Experience
3(1)
The Question of High and Rising Spending
4(2)
Changes in Medical Care Delivery
6(3)
The Nature of Medical Care as a Commodity
9(2)
Health Economics Defined
11(1)
Ten Key Economic Concepts
12(2)
Summary and Conclusions
14(1)
Questions and Problems
15(1)
References
16(1)
Appendix 1A: The Medical Care Price Index
17(5)
Measuring Price Changes with Index Numbers
17(1)
Medical Care Price Index
17(2)
Problems with Using a Fixed-Weight Index as a Measure of Inflation
19(1)
Alternative Methods to Measure Medical Care Inflation
20(2)
Using Economics to Study Health Issues
22(36)
The Relevance of Economics in Health Care
22(3)
Critical Assumptions in Economics
23(1)
The Scientific Method
24(1)
Model Building
25(1)
Problem Solving
25(1)
Economic Optimization
25(3)
Supply and Demand
28(11)
The Law of Demand
28(2)
Price Elasticity of Demand
30(3)
The Law of Supply
33(5)
Equilibrium
38(1)
The Competitive Model
39(6)
The Theory of Firm Behavior
39(1)
Welfare Implications
40(1)
Imperfect Competition
41(4)
Summary and Conclusions
45(1)
Questions and Problems
45(2)
References
47(1)
Appendix 2A: Graphing Data
48(4)
Some Basics of Graphing
48(1)
Functional Relationships
49(1)
Time-Series Graphs
50(1)
Cross-Section Graphs
51(1)
Appendix 2B: Statistical Tools
52(6)
Descriptive Statistics
52(1)
Correlation
53(1)
Regression
54(4)
Analyzing Medical Care Markets
58(43)
The Medical Care Marketplace
58(7)
Cost of Care
59(2)
Access to Care
61(1)
Medial Outcomes
62(3)
The Competitive Market Model
65(1)
Market Failure
66(7)
Market Power
66(2)
Externalities
68(3)
Public Goods
71(2)
Market Failure in Medical Markets
73(8)
Traditional Sources of Market Failure
73(5)
Imperfections in Medical Markets
78(3)
Government Intervention in Medical Markets
81(6)
Regulation
81(2)
Tax Policy
83(1)
Government Failure
83(4)
Summary and Conclusions
87(1)
Questions and Problems
87(1)
References
88(1)
Appendix A3: The Economics of Consumer Choice
89(4)
Consumer Preferences: Indifference Curves
89(1)
Consumer Constraints: The Budget Line
90(1)
Consumer Choice: The Concept of Equilibrium
90(2)
Implications of the Model
92(1)
Appendix 3B: Production and Cost in the For-Profit Sector
93(8)
Production with Two Variable Inputs
93(3)
Optimal Input Use
96(1)
Extensions of the Model
97(1)
Estimating Production Functions
97(1)
Production to Cost
98(1)
Long-Run Costs
99(2)
Economic Evaluation in Health Care
101(26)
Importance of Economic Evaluation
101(2)
Meaning of Economic Evaluation
103(1)
Types of Economic Evaluation
103(10)
Cost-of-Illness Studies
103(1)
Cost-Benefit Analysis
104(3)
Cost-Effectiveness Analysis
107(6)
Approaches to Modeling in Economic Evaluation
113(5)
Decision Trees
113(2)
Markov Models
115(1)
Markov Decision Models
116(1)
Sensitivity Analysis
117(1)
Standardization of Economic Evaluation Techniques
118(1)
Case Studies
118(4)
Lung Cancer Screening
118(2)
Cervical Cancer Screening
120(1)
Drug Treatment for Alzheimer's Disease
120(2)
Summary and Conclusions
122(1)
Questions and Problems
122(3)
References
125(2)
PART 2 DEMAND-SIDE CONSIDERATIONS
Demand for Health and Medical Care
127(27)
The Demand for Health
127(10)
The Production of Health
128(2)
Measures of Health Status
130(2)
Determinants of Health Status
132(4)
The Role of Public Health and Nutrition
136(1)
The Demand for Medical Care
137(12)
Medical Care as an Investment
137(1)
Factors Influencing Demand
137(9)
Measure Demand
146(3)
Summary and Conclusions
149(2)
Questions and Problems
151(1)
References
151(3)
The Market for Health Insurance
154(27)
Historical Setting
154(4)
Types of Insurance
156(2)
Health Insurance Providers
158(1)
Private Insurance Demand
158(9)
The Theory of Risk and Insurance
159(3)
Health Insurance and Market Failure
162(1)
Information Problems
163(4)
The Provision of Health Insurance in the United States
167(2)
The Practice of Self-Insurance
168(1)
Medical Care for the Uninsured
169(6)
How Many Americans Are Uninsured?
170(1)
Who Are the Uninsured?
171(2)
Why Are They Uninsured?
173(1)
Does Lack of Insurance Mean Poor Health?
174(1)
The Safety Net for the Uninsured
174(1)
Summary and Conclusions
175(3)
Questions and Problems
178(1)
References
179(2)
PART 3 SUPPLY-SIDE CONSIDERATIONS
Managed Care
181(18)
History of Managed Care
181(2)
Types of Managed Care Plans
183(4)
Health Maintenance Organizations (HMOs)
184(1)
Preferred Provider Organizations (PPOs)
184(2)
Point-of-Service Plan (POS)
186(1)
Hybrid Varieties
186(1)
The Theory of Managed Care Cost Saving
187(3)
Selection of Providers
187(1)
Cost-Sharing Arrangements
187(2)
Practice Guidelines and Utilization Review
189(1)
Evidence of Managed Care Cost Savings
190(2)
Evidence of Quality Differences Between Managed Care and Fee-for-Service Care
192(1)
Managed Care and Its Public Image
193(1)
The Future of Managed Care
194(1)
Summary and Conclusions
195(2)
Questions and Problems
197(1)
References
197(2)
The Market for Health Care Professionals
199(29)
The Theory of Labor Markets
199(3)
Input Pricing
199(1)
Demand for Inputs
200(1)
Human Capital Investments
201(1)
The Market for Physicians' Services
202(12)
Specialty Distribution
205(1)
Geographic Distribution
206(2)
Physician Compensation
208(2)
Pricing of Physicians' Services
210(1)
Organization of Physicians' Practices
211(1)
Variations in Practice Patterns
212(2)
Models of Physician Behavior
214(1)
The Physician as Monopolistic Competitor
214(1)
The Physician as Imperfect Agent
215(1)
Controlling Physician Behavior
215(4)
Do Physicians Respond to Incentives?
217(1)
Empirical Evidence on the Impact of Financial Incentives
218(1)
The Market for Nursing Services
219(1)
The Market for Dental Services
220(3)
Summary and Conclusions
223(2)
Questions and Problems
225(1)
References
226(2)
The Market for Hospital Services
228(23)
A Brief History of American Hospitals
228(3)
The U.S. Institutional Setting
231(10)
Hospital Classification
231(3)
Hospital Spending
234(1)
Structure of the Hospital Market
235(4)
Hospital Pricing
239(2)
The Role of the Not-for-Profit Organization in the Hospital Industry
241(2)
The Not-for-Profit Organizational Form
241(1)
Nature of Competition in the Not-for-Profit Sector
241(2)
Alternative Models of Hospital Behavior
243(2)
Utility Maximizing Models
243(2)
Physician-Control Models
245(1)
The Trend toward Multihospital Systems
245(3)
The Theory of Consolidation
246(1)
The Empirical Evidence on Consolidation
246(2)
Summary and Conclusions
248(1)
Questions and Problems
249(1)
References
249(2)
PART 4 CONFOUNDING FACTORS--SALT
Sociocultural Considerations
251(26)
The Nature of Social Problems
251(1)
AIDS in America
252(5)
The Extent of AIDS in the United States
252(1)
Risk to the Population
253(1)
Medical Care Issues
254(1)
The Worldwide Impact
255(2)
Consequence of Drug Abuse
257(3)
The Nature and Extent of Drug Abuse
258(1)
The Costs to Society
259(1)
Intervention Strategies
260(1)
The Economic Impact of Tobacco and Alcohol Use
260(6)
Tobacco Use
260(4)
Alcohol Use
264(2)
Social Pathology
266(7)
Violence in America
266(1)
Teen Pregnancy
267(3)
Sexually Transmitted Disease
270(1)
Obesity
271(2)
Summary and Conclusions
273(1)
Questions and Problems
273(2)
References
275(2)
The Aging of the Population
277(15)
The Aging Population
277(3)
Life Expectancies
278(2)
Medical Care Costs for the Elderly
280(7)
Quality of Services
281(1)
Increased Intensity of Services
281(1)
The Challenge of Treating Chronic Diseases
282(3)
The Cost of Long-Term Care
285(1)
The High Cost of Dying
285(2)
Summary and Conclusions
287(3)
Questions and Problems
290(1)
References
290(2)
The Legal System and Medical Malpractice
292(25)
Tort Law in the United States
293(1)
The Function of Medical Malpractice Law
293(2)
Compensation
294(1)
Deterrence
294(1)
Retribution
294(1)
The Growth in Medical Malpractice Claims
295(6)
Claims Frequency
295(1)
Claims Security
296(3)
International Differences
299(2)
Tort Reform
301(10)
Cost of Malpractice
301(2)
Causes of Increased Litigation
303(1)
Suggestions for Reform
303(8)
Summary and Conclusion
311(1)
Questions and Problems
311(1)
References
312(2)
Appendix 12A: Valuing Life in the Case of Wrongful Death
314(3)
Methodological Considerations
314(1)
Value in Litigation
315(2)
Technology in Medicine
317(28)
The Diffusion of New Technology
317(4)
The Economics of Technological Change
318(1)
The Levels of Technology
319(2)
The Role of Insurance in the Diffusion of Technology
321(1)
The Case of Organ Transplantation
321(8)
History of the Organ Transplantation
321(2)
Current Organ Transplant Policy
323(3)
Why Is There a Shortage of Donable Organs?
326(3)
The Pharmaceutical Industry
329(10)
The Structure of the Industry
329(1)
The Role of Research in the Age of Technology
330(5)
Advertising and Promotion
335(1)
The Role of Government
336(2)
Future Directions for the Industry
338(1)
Summary and Conclusion
339(4)
Questions and Problems
343(1)
References
343(2)
PART 5 PUBLIC POLICY IN MEDICAL CARE DELIVERY
Policies that Enhance Access
345(22)
Medicare: Medical Care for the Elderly
345(6)
Institutional Features
346(1)
Who Pays?
347(2)
Who Benefits?
349(1)
Economic Consequences
350(1)
Medicaid: Medical Care for the Poor
351(8)
Institutional Features
351(3)
State Children's Health Insurance Program
354(1)
Economic Consequences
355(2)
Other Economic Issues
357(2)
Other Government Programs
359(3)
Department of Defense
359(1)
Veterans' Administration Medical Care Program
359(3)
Summary and Conclusions
362(1)
Questions and Problems
363(1)
References
363(2)
Appendix 14A: A Note on ``Projections''
365(2)
Policies to Contain Costs
367(17)
Policy Options
367(5)
Mandated Fee Schedules
367(2)
Global Budgeting
369(2)
Resource Rationing
371(1)
Cost-Containment Strategies in the United States
372(8)
Diagnosis Related Groups
372(5)
Setting Physicians' Fees: Resource-Based Relative Value Scale (RBRVS)
377(3)
Managed Care Strategies
380(1)
Market Alternatives
380(2)
Summary and Conclusions
382(1)
Questions and Problems
383(1)
References
383(1)
Medical Care Systems Worldwide
384(36)
International Comparisons
384(6)
Expenditures Across OECD Countries
386(1)
International Comparison of Medical Outcomes
387(3)
Canadian National Health Insurance: Medicare
390(5)
France: Equality, Liberty, Fraternity
395(3)
Germany: Sickness Funds
398(4)
Japan: The Company Is People
402(5)
United Kingdom: National Health Service
407(5)
Summary and Conclusions
412(5)
Questions and Problems
417(1)
References
417(3)
Medical Care Reform in the United States
420(32)
The Push for Reform
420(1)
The Moral Issues---Is Medical Care a ``Right''?
421(1)
The Goals of Reform
422(4)
Who's Covered?
423(1)
What's Covered?
424(1)
Who Pays and How Much?
424(2)
Individual State Initiatives
426(4)
Universal Coverage in Hawaii
426(1)
Oregon Health Plan
427(2)
Other State Reforms
429(1)
Health Insurance Mandates
430(4)
The Economics of Mandates
430(2)
The States' Approach to Mandates
432(2)
U.S. Policy Alternatives
434(10)
Single-Payer National Health Insurance
434(2)
Employer-Based Health Insurance
436(1)
Market-Based Alternatives
437(5)
Managed Competition
442(2)
Market Response to Uncertainty
444(1)
Summary and Conclusions
445(5)
Questions and Problems
450(1)
References
450(2)
Lessons for Public Policy
452(7)
Scarcity and Choice
452(1)
Opportunity Cost
452(1)
Marginal Analysis
452(1)
Self-Interest
453(1)
Markets and Pricing
454(1)
Supply and Demand
454(1)
Competition
455(1)
Efficiency
455(1)
Market Failure
456(1)
Comparative Advantage
456(1)
Final Reflections
456(3)
Glossary 459(8)
Index 467

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