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Health Economics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Economics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
National Health Expenditures Copyright ©2008 by Project HOPE, all rights reserved. Sean Keehan, Andrea Sisko, Christopher Truffer, Sheila Smith, Cathy Cowan, John Poisal, M. Kent Clemens  the National Health Expenditure Accounts Projections Team,  Health Spending Projections Through 2017: The Baby-Boom Generation Is Coming To Medicare,  Health Affairs, Vol 27, Issue 2, w145-155w
Example of Type of Research Using 1996 MEPS DATA Resource Use by Income Quintile Actual Use
Example of Type of Research Using 1996 MEPS DATA Resource Use by Income Quintile Standardized Use
1996 Sample Means by Income Quintile
1996 Sample Means by Income Quintile Hispanic MCO 0.19 0.13 0.11 0.07 0.04 0.097 FFS 0.19 0.10 0.06 0.06 0.05 0.088 Black MCO 0.26 0.16 0.11 0.10 0.08 0.128 Non-Hispanic FFS 0.23 0.13 0.08 0.06 0.05 0.112 Female  MCO 0.55 0.55 0.50 0.51 0.49 0.520 FFS 0.59 0.54 0.50 0.50 0.47 0.520 Health ExcellentMCO 0.30 0.36 0.40 0.40 0.42 0.390 FFS 0.24 0.30 0.37 0.38 0.44 0.340 Health Good MCO 0.27 0.23 0.21 0.19 0.19 0.210 FFS 0.25 0.23 0.20 0.19 0.17 0.210 Health Fair MCO 0.11 0.07 0.05 0.05 0.04 0.060 FFS 0.17 0.09 0.07 0.06 0.05 0.090 Health Poor MCO 0.06 0.03 0.02 0.01 0.01 0.020 FFS 0.07 0.05 0.03 0.02 0.01 0.040
1996 Sample Means by Income Quintile
Basic Questions of any Economic System ,[object Object],[object Object],[object Object],[object Object],With given endowment of scarce resources:
Basic Questions of Health Economics ,[object Object],[object Object],[object Object],[object Object]
The Production Possibilities Frontier ,[object Object]
Question of Distribution ,[object Object],[object Object],[object Object]
Distribution ,[object Object],[object Object],[object Object]
The Consumer Determined by regulators Availability of substitutes/complements Yes (for most goods and services) OOP does not reflect full price of service Pays price Yes Weak direct knowledge; based on trust Knows Quality Yes Weak knowledge Knows Price Yes Health Care Generic Industry
The Producer Mixed MD’s : other motivations Non-profits: no Pharmaceutical cos.: yes Profit maximizer yes Yes: licensing, certification, etc. restricts competition Regulation To address externalities; Taken into account in market models Less certainty: efficacy of treatment; scale: very certain to very vague Known Production Function Yes Health Care Generic Industry
Demand for Medical Care ,[object Object],[object Object],[object Object]
Demand for Medical Care ,[object Object],[object Object],[object Object]
Utility ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Utility
Utility
 
Demand for Medical Care - Influences ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Demand for Medical Care - Influences ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Demand for Health Care ,[object Object],[object Object],[object Object]
[object Object],Budget constraint & indifference curves to Demand ,[object Object],[object Object]
Fuzzy Demand ,[object Object],[object Object],[object Object]
Fuzzy Demand for HC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Severity of Disease and Demand
Demand for HC and Insurance
Effect of Insurance on Demand for Medical Care ,[object Object],[object Object],[object Object],[object Object]
Rand Health Insurance Experiment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rand Health Insurance Experiment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Rand Health Insurance Experiment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Demand, Insurance and Moral Hazard ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Welfare loss and Insurance
Producing Health ,[object Object],[object Object],[object Object],[object Object],[object Object]
Producing Health ,[object Object],[object Object],[object Object]
Producing Health ,[object Object],[object Object],[object Object],[object Object]
Production Function
Production Function ,[object Object],[object Object],[object Object],[object Object]
Disease Specific Production Functions
Medical Care at the Margin Breast Cancer Screening ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Care at the Margin Breast Cancer Screening ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Externalities and the Need for Policy ,[object Object],[object Object]
Public Health, Externalities and Policy ,[object Object],[object Object],[object Object]
Conclusion of Brief Overview of Health Economics Theory ,[object Object],[object Object],[object Object]

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Basics of Health Economics

  • 1.
  • 2.
  • 3. National Health Expenditures Copyright ©2008 by Project HOPE, all rights reserved. Sean Keehan, Andrea Sisko, Christopher Truffer, Sheila Smith, Cathy Cowan, John Poisal, M. Kent Clemens the National Health Expenditure Accounts Projections Team, Health Spending Projections Through 2017: The Baby-Boom Generation Is Coming To Medicare, Health Affairs, Vol 27, Issue 2, w145-155w
  • 4. Example of Type of Research Using 1996 MEPS DATA Resource Use by Income Quintile Actual Use
  • 5. Example of Type of Research Using 1996 MEPS DATA Resource Use by Income Quintile Standardized Use
  • 6. 1996 Sample Means by Income Quintile
  • 7. 1996 Sample Means by Income Quintile Hispanic MCO 0.19 0.13 0.11 0.07 0.04 0.097 FFS 0.19 0.10 0.06 0.06 0.05 0.088 Black MCO 0.26 0.16 0.11 0.10 0.08 0.128 Non-Hispanic FFS 0.23 0.13 0.08 0.06 0.05 0.112 Female MCO 0.55 0.55 0.50 0.51 0.49 0.520 FFS 0.59 0.54 0.50 0.50 0.47 0.520 Health ExcellentMCO 0.30 0.36 0.40 0.40 0.42 0.390 FFS 0.24 0.30 0.37 0.38 0.44 0.340 Health Good MCO 0.27 0.23 0.21 0.19 0.19 0.210 FFS 0.25 0.23 0.20 0.19 0.17 0.210 Health Fair MCO 0.11 0.07 0.05 0.05 0.04 0.060 FFS 0.17 0.09 0.07 0.06 0.05 0.090 Health Poor MCO 0.06 0.03 0.02 0.01 0.01 0.020 FFS 0.07 0.05 0.03 0.02 0.01 0.040
  • 8. 1996 Sample Means by Income Quintile
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. The Consumer Determined by regulators Availability of substitutes/complements Yes (for most goods and services) OOP does not reflect full price of service Pays price Yes Weak direct knowledge; based on trust Knows Quality Yes Weak knowledge Knows Price Yes Health Care Generic Industry
  • 15. The Producer Mixed MD’s : other motivations Non-profits: no Pharmaceutical cos.: yes Profit maximizer yes Yes: licensing, certification, etc. restricts competition Regulation To address externalities; Taken into account in market models Less certainty: efficacy of treatment; scale: very certain to very vague Known Production Function Yes Health Care Generic Industry
  • 16.
  • 17.
  • 18.
  • 21.  
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28. Severity of Disease and Demand
  • 29. Demand for HC and Insurance
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35. Welfare loss and Insurance
  • 36.
  • 37.
  • 38.
  • 40.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.

Editor's Notes

  1. HC is not a perfectly competitive market -- so need more insight. If it were perf, comp, then all allocations would be optimal
  2. Note: some goods can be bad for you!
  3. Different combinations of X and H lead to different levels of utility. Assuming that as x and h increase, U increases. Fix X at x1 and increase H, then U increases At
  4. Many combinations of X and H; unlikely to hold one constant; rather, consider combinations of X and H for given levels of Utility. Then, given a set of constraints (Budget), will maximize utility. Now, do the same for higher and lower levels of utility.
  5. Healthy -- low demand, lower prices willing to pay; more inelastic as less healthy
  6. Say there is a $1000 deductible and that office visits for a procedure cost $200. Once that deductible is met, go back to verticle demand -- no price sensitivity.
  7. Very inelastic demand - smaller welfare loss when insured; the more price sensitive the demand for medical care, the less desirable it is to insure against that risk with health insurance ; a market equilibrium would be a lower quantity demanded and higher price. Because of market intervention, there is a loss to society in “overproduction”
  8. Quality: structure - facilites, training, management; process quality: access-waiting time, data collection, communication with paitent, diagnosis and treatment; outcome quality: impact of care -- pt satisfaction, lost work time, post care mortality/mornbidity
  9. Curve is called Total Product; exhibuts law of diminishing marginal productivity; health increases at a decreasing rate as Medical Care is added; Can even exhibit negative returns: iatrogenic disease (e.g. catch something inpt, wrong medicine, wrong procedure. Note -- “catch up effect” consider poor countries with little access to health care, clean water, etc.
  10. Disease II: start with better health; treatment is more effective Disease I: start with worse health, treatment not as effective, but not worthless
  11. Example: Breast Cancer scrreing
  12. Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1.2 externality: unintended side effect of market activity or any later version published by the Free Software Foundation; with no Invariant Sections, no Front-Cover Texts, and no Back-Cover Texts. A copy of the license is included in the section entitled "GNU Free Documentation License".