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Table of Contents
Cover
Half Title
Title Page
Dedication
Copyright Page
Contents
Preface and acknowledgements
Introduction: approaching health economics
Our approach and structure of the book
Part I Health, healthcare and healthcare systems
1 Understanding "health" in health economics
1.1 Definitions and models of "health" and "disease"
1.2 Pathology and the definition of specific diseases
1.3 Factors influencing health and disease
1.4 Data, data sources and data analysis
1.5 Health and human rights
Further reading
2 From disease to care
2.1 Need and demand for healthcare
2.2 Healthcare systems
2.3 Providing care
2.4 Quality of care
Further reading
3 Ethics, values and the idea of a good life
3.1 Theories of justice
3.2 Governance and the role of social institutions
3.3 Positive and normative health economics
3.4 Disease, incentives and moral convictions: towards a dictatorship of health?
Further reading
4 Healthcare management
4.1 Management: history and terminology
4.2 Management and organizations
4.3 Management activities
Further reading
5 Financing healthcare
5.1 Spending on healthcare
5.2 Describing financial flows: national health accounts
5.3 Who pays for whom? Equity in financing
5.4 Effects of healthcare spending on the household
Further reading
6 The relationship between macroeconomics and health
6.1 The economic consequences of disease
6.2 Investing in health
6.3 The basis for government spending: fiscal space
6.4 Social security, automatic stabilizers and projecting future costs
Further reading
7 Comparing healthcare systems
7.1 Comparative healthcare system analysis: economics, data, history and attitudes
7.2 Social health insurance in Germany
7.3 The Beveridge Report and the UK welfare state.
7.4 Sin taxes to finance national health insurance: the Philippines
7.5 World war and vested interests prevented the creation of a national health insurance: the United States
Further reading
Part II Health economic theory
8 Approaching healthcare from an economic perspective
8.1 Economic thinking in healthcare and the role of health economics
The role of public goods
The role of health economics: providing data and reflecting on goals
8.2 Economics as a field of study and economics as a method
8.3 A very short history of health economics
8.4 The political economy of healthcare systems
8.5 Mathematics, models and causality in health economics
Independent and dependent variables, models, econometrics and mixed methods
Further reading
9 Neoclassical economics: The prevailing approach
9.1 Homo economicus
Utility
Marginal analysis
Efficiency
Rationality
Human capital and investing in people
9.2 Welfare economics
9.3 Two key works: Kenneth Arrow and Michael Grossman
9.4 Game theory
Vaccination
9.5 Criticisms of neoclassical theory
Unrealistic modelling of human behaviour
Neglect of transaction costs
Neglect of institutions
Ignoring alternative modes of distribution
9.6 Responses: historical school, behavioural economics and new institutional economics
Historical school: putting economics in context
Behavioural economics: how do people make decisions?
New institutional economics: understanding markets and institutions
Further reading
Appendix
An example of neoclassical reasoning in health economics: Arrow's calculation of loss of utility
10 Markets, market failure, state intervention and state failure
10.1 Markets
Pareto efficiency and Pareto optimum
10.2 Market failure
10.3 Government intervention and government failure.
10.4 Where markets and governments fail: common goods for health
Further reading
11 Options for financing medical care
11.1 Uncertainty in health and healthcare
11.2 Non-insurance forms of health financing
Out-of-pocket payments
Direct subsidies
Consumer-directed healthcare plans
Health savings accounts
Micro-credit, micro-savings and micro-insurance
Taxation-based funding
11.3 Health insurance
11.4 Overview of insurance types
Social health insurance
Community-based health insurance
Private/employer-based health insurance
Further reading
12 Evaluation methods in health economics
12.1 Why economic evaluation?
12.2 Welfarism, extra-welfarism and different forms of economic evaluation
Cost-benefit analysis
Cost-effectiveness analysis
Cost-utility analysis
Incremental cost-effectiveness ratio (ICER)
Multi-criteria decision-making
12.3 Measuring health and disease
The quality-adjusted life year (QALY)
Disability-adjusted life year (DALY)
12.4 Problems with QALYs
12.5 Comparing neoclassical, QALY-based and medical thinking
12.6 Distributional equity impacts and trade-offs
12.7 Cost measurement and analysis
12.8 Important modelling techniques
Further reading
13 Health technology and health technology assessment
13.1 What is health technology assessment and where can it be applied?
13.2 HTA as a political and technical endeavour
Indonesia: linking HTA to the national health insurance programme
Thailand: a success story based on a private initiative
Malaysia: gradual evolution of comprehensive HTA
13.3 Key elements of an HTA system
13.4 HTA and reimbursement in a changing healthcare system
The UK: using the cost per QALY
Germany: the efficiency frontier
New Zealand: programme budgeting and marginal analysis
Further reading.
14 Paying for medical care: Balancing appropriateness, quality and cost
14.1 Strategic purchasing of healthcare
14.2 Paying for curative care, public healthcare and preventative services
Fee-for-service and per diems
Capitation
Pathology-based systems
Mixed systems
Payment methods for public health and preventative services
Social-impact bonds
14.3 Pay-for-performance
14.4 Co-payments and user fees
14.5 Value-based healthcare
14.6 Context matters
Further reading
Part III From theory to practice: Using medical economics to improve global health
15 Medical economics: An applied interdisciplinary science that looks at evidence, considers complexity and implements what works
15.1 Applying the logic of medicine in medical economics
15.2 The interdisciplinary nature of medical economics and the uses of economic thinking
Transforming concepts into policy
The advantages of rigorous analysis: the health economics of old age
The useful challenges of economic thinking
A word of caution
15.3 Health policy, data and health reform
Health reform
15.4 Managing complexity
The digitalization of medicine
A "theory of everything"?
The (second) transformation of medicine
Further reading
16 Global health and social health protection
16.1 Global health
The economics of global public health: polio eradication
The perverse logic of welfare economics: a memorandum from the World Bank
16.2 Global intervention and collaboration
The influence of donors
Governance
16.3 Social protection in a changing demography
16.4 Measuring social protection
16.5 Translating behavioural economics into practice: nudging and conditionality
Further reading
17 Toward rational financing of healthcare
17.1 Principles of financing.
Four criteria of a healthcare financing arrangement
Three core functions of healthcare financing
17.2 Goals of government-run financing schemes
Goals
17.3 Implementing a financing scheme at the national level
Decision I: set-up and governance
Decision II: enrolment, benefit package and entitlement to services
Decision III: sourcing and pooling of funds
Decision IV: ownership of providers
Decision V: flow of funds and deposit of financial reserves
17.4 Technical aspects
17.5 Actuarial calculations and monitoring
Further reading
18 Priority-setting and essential health service packages
18.1 Scarcity of resources and the need for rationing
18.2 The cost per QALY approach as a prioritization tool
The balance between efficiency and distributive justice
"Individual" versus "statistical" life
A concept of distributive justice
18.3 Essential healthcare services (or benefits) packages
Examples from Mexico and Chile
18.4 Defining a benefit package
Further reading
Epilogue: Moving beyond the commoditization of health and making better use of the "dismal science"
References
Index.
Half Title
Title Page
Dedication
Copyright Page
Contents
Preface and acknowledgements
Introduction: approaching health economics
Our approach and structure of the book
Part I Health, healthcare and healthcare systems
1 Understanding "health" in health economics
1.1 Definitions and models of "health" and "disease"
1.2 Pathology and the definition of specific diseases
1.3 Factors influencing health and disease
1.4 Data, data sources and data analysis
1.5 Health and human rights
Further reading
2 From disease to care
2.1 Need and demand for healthcare
2.2 Healthcare systems
2.3 Providing care
2.4 Quality of care
Further reading
3 Ethics, values and the idea of a good life
3.1 Theories of justice
3.2 Governance and the role of social institutions
3.3 Positive and normative health economics
3.4 Disease, incentives and moral convictions: towards a dictatorship of health?
Further reading
4 Healthcare management
4.1 Management: history and terminology
4.2 Management and organizations
4.3 Management activities
Further reading
5 Financing healthcare
5.1 Spending on healthcare
5.2 Describing financial flows: national health accounts
5.3 Who pays for whom? Equity in financing
5.4 Effects of healthcare spending on the household
Further reading
6 The relationship between macroeconomics and health
6.1 The economic consequences of disease
6.2 Investing in health
6.3 The basis for government spending: fiscal space
6.4 Social security, automatic stabilizers and projecting future costs
Further reading
7 Comparing healthcare systems
7.1 Comparative healthcare system analysis: economics, data, history and attitudes
7.2 Social health insurance in Germany
7.3 The Beveridge Report and the UK welfare state.
7.4 Sin taxes to finance national health insurance: the Philippines
7.5 World war and vested interests prevented the creation of a national health insurance: the United States
Further reading
Part II Health economic theory
8 Approaching healthcare from an economic perspective
8.1 Economic thinking in healthcare and the role of health economics
The role of public goods
The role of health economics: providing data and reflecting on goals
8.2 Economics as a field of study and economics as a method
8.3 A very short history of health economics
8.4 The political economy of healthcare systems
8.5 Mathematics, models and causality in health economics
Independent and dependent variables, models, econometrics and mixed methods
Further reading
9 Neoclassical economics: The prevailing approach
9.1 Homo economicus
Utility
Marginal analysis
Efficiency
Rationality
Human capital and investing in people
9.2 Welfare economics
9.3 Two key works: Kenneth Arrow and Michael Grossman
9.4 Game theory
Vaccination
9.5 Criticisms of neoclassical theory
Unrealistic modelling of human behaviour
Neglect of transaction costs
Neglect of institutions
Ignoring alternative modes of distribution
9.6 Responses: historical school, behavioural economics and new institutional economics
Historical school: putting economics in context
Behavioural economics: how do people make decisions?
New institutional economics: understanding markets and institutions
Further reading
Appendix
An example of neoclassical reasoning in health economics: Arrow's calculation of loss of utility
10 Markets, market failure, state intervention and state failure
10.1 Markets
Pareto efficiency and Pareto optimum
10.2 Market failure
10.3 Government intervention and government failure.
10.4 Where markets and governments fail: common goods for health
Further reading
11 Options for financing medical care
11.1 Uncertainty in health and healthcare
11.2 Non-insurance forms of health financing
Out-of-pocket payments
Direct subsidies
Consumer-directed healthcare plans
Health savings accounts
Micro-credit, micro-savings and micro-insurance
Taxation-based funding
11.3 Health insurance
11.4 Overview of insurance types
Social health insurance
Community-based health insurance
Private/employer-based health insurance
Further reading
12 Evaluation methods in health economics
12.1 Why economic evaluation?
12.2 Welfarism, extra-welfarism and different forms of economic evaluation
Cost-benefit analysis
Cost-effectiveness analysis
Cost-utility analysis
Incremental cost-effectiveness ratio (ICER)
Multi-criteria decision-making
12.3 Measuring health and disease
The quality-adjusted life year (QALY)
Disability-adjusted life year (DALY)
12.4 Problems with QALYs
12.5 Comparing neoclassical, QALY-based and medical thinking
12.6 Distributional equity impacts and trade-offs
12.7 Cost measurement and analysis
12.8 Important modelling techniques
Further reading
13 Health technology and health technology assessment
13.1 What is health technology assessment and where can it be applied?
13.2 HTA as a political and technical endeavour
Indonesia: linking HTA to the national health insurance programme
Thailand: a success story based on a private initiative
Malaysia: gradual evolution of comprehensive HTA
13.3 Key elements of an HTA system
13.4 HTA and reimbursement in a changing healthcare system
The UK: using the cost per QALY
Germany: the efficiency frontier
New Zealand: programme budgeting and marginal analysis
Further reading.
14 Paying for medical care: Balancing appropriateness, quality and cost
14.1 Strategic purchasing of healthcare
14.2 Paying for curative care, public healthcare and preventative services
Fee-for-service and per diems
Capitation
Pathology-based systems
Mixed systems
Payment methods for public health and preventative services
Social-impact bonds
14.3 Pay-for-performance
14.4 Co-payments and user fees
14.5 Value-based healthcare
14.6 Context matters
Further reading
Part III From theory to practice: Using medical economics to improve global health
15 Medical economics: An applied interdisciplinary science that looks at evidence, considers complexity and implements what works
15.1 Applying the logic of medicine in medical economics
15.2 The interdisciplinary nature of medical economics and the uses of economic thinking
Transforming concepts into policy
The advantages of rigorous analysis: the health economics of old age
The useful challenges of economic thinking
A word of caution
15.3 Health policy, data and health reform
Health reform
15.4 Managing complexity
The digitalization of medicine
A "theory of everything"?
The (second) transformation of medicine
Further reading
16 Global health and social health protection
16.1 Global health
The economics of global public health: polio eradication
The perverse logic of welfare economics: a memorandum from the World Bank
16.2 Global intervention and collaboration
The influence of donors
Governance
16.3 Social protection in a changing demography
16.4 Measuring social protection
16.5 Translating behavioural economics into practice: nudging and conditionality
Further reading
17 Toward rational financing of healthcare
17.1 Principles of financing.
Four criteria of a healthcare financing arrangement
Three core functions of healthcare financing
17.2 Goals of government-run financing schemes
Goals
17.3 Implementing a financing scheme at the national level
Decision I: set-up and governance
Decision II: enrolment, benefit package and entitlement to services
Decision III: sourcing and pooling of funds
Decision IV: ownership of providers
Decision V: flow of funds and deposit of financial reserves
17.4 Technical aspects
17.5 Actuarial calculations and monitoring
Further reading
18 Priority-setting and essential health service packages
18.1 Scarcity of resources and the need for rationing
18.2 The cost per QALY approach as a prioritization tool
The balance between efficiency and distributive justice
"Individual" versus "statistical" life
A concept of distributive justice
18.3 Essential healthcare services (or benefits) packages
Examples from Mexico and Chile
18.4 Defining a benefit package
Further reading
Epilogue: Moving beyond the commoditization of health and making better use of the "dismal science"
References
Index.