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Doctors are obviously influential in determining the costs of their services. But even more important, many believe, is the influence physicians have over the use and cost of nonphysician health-care resources and services. Doctors and Their Workshops is the first comprehensive attempt to use economic analysis to understand some of the physician effects on nonphysician aspects of health care.
"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].
A look at the American health care system through analysis of consumer and provider behavior. The health care industry in the US is peculiar. We spend close to 18% of our GDP on health care, yet other countries get better results—and we don’t know why. To date, we still lack widely accepted answers to simple questions, such as “Would requiring everyone to buy health insurance make us better off?” Drawing on behavioral economics as an alternative to the standard tools of health economics, author Douglas E. Hough seeks to diagnose the ills of health care today more clearly. A behavioral perspective makes sense of key contradictions—from the seemingly irrational choices that we sometimes make as patients, to the incongruous behavior of physicians, to the morass of the long-lived debate surrounding reform. With the new health care law in effect, it is more important than ever that consumers, health care industry leaders, and the policymakers who are governing change reckon with the power and sources of our behavior when it comes to health. Praise for Irrationality in Health Care “Hough does an extraordinary job of distilling the literature and providing key insights to help us understand how health care consumers and providers really behave, and how government can formulate better policy. A must-read for anyone interested in the burgeoning field of behavioral economics and age-old questions in health care.” —Thomas Rice, Distinguished Professor, UCLA Fielding School of Public Health “Hough explains and applies the emerging field of behavioral economics to patient and physician decision making, providing a rationale for seemingly irrational behavior, and its particular usefulness for designing health policies.” —Paul J. Feldstein, University of California, Irvine “Balancing rigor and policy relevance, Hough shows the application of behavioral economics to health policy in a most compelling way. I liked this book so much, I wish I had written it!” —Richard Scheffler, University of California, Berkeley
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Unlike earlier work in medical economics, which has focused on medical care, these ten papers stress the production and consequences of health itself. They reveal a serious concern with real-world health problems in their investigation of such subjects as infant mortality, life expectancy, morbidity, and disability. These papers are unusual, as well, in bringing to bear on these problems new and powerful theoretical and statistical tools. They draw on, and in some cases are, original sources for new bodies of data. As such, Economic Aspects of Health comprises a useful blend of relevance and rigor.
Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement of PPM is a challenge in traditional clinical, reimbursement, and regulatory landscapes because it is costly to develop and introduces a wide range of scientific, clinical, ethical, and socioeconomic issues. PPM raises a multitude of economic issues, including how information on accurate diagnosis and treatment success will be disseminated and who will bear the cost; changes to physician training to incorporate genetics, probability and statistics, and economic considerations; questions about whether the benefits of PPM will be confined to developed countries or will diffuse to emerging economies with less developed health care systems; the effects of patient heterogeneity on cost-effectiveness analysis; and opportunities for PPM’s growth beyond treatment of acute illness, such as prevention and reversal of chronic conditions. This volume explores the intersection of the scientific, clinical, and economic factors affecting the development of PPM, including its effects on the drug pipeline, on reimbursement of PPM diagnostics and treatments, and on funding of the requisite underlying research; and it examines recent empirical applications of PPM.
Record of Discussion6 Economics of Need: The Experience of the British Health Service; 7 Private Patients in N.H.S. Hospitals: Waiting Lists and Subsidies; 8 Consumer Protection, Incentives and Externalities in the Drug Market; Summary Record of Discussion; 9 Price and Income Elasticities for Medical Care Services; 10 Supplier-Induced Demand: Some Empirical Evidence and Implications; 11 Some Economic Aspects of Mortality in Developed Countries; Summary Record of Discussion; PART THREE: THE IMPACT OF DEMAND FOR HEALTH SERVICES; 12 Health, Hours and Wages
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
- Foreword - Executive summary - Introduction - The dynamics of moral decision making - Integrity in the context of social interactions - Applying behavioural insights to integrity policies - References
Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice