The economics of health and health care:
Gespeichert in:
| Hauptverfasser: | , , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Upper Saddle River, NJ
Pearson Prentice Hall
2007
|
| Ausgabe: | 5. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis Inhaltsverzeichnis |
| Beschreibung: | Includes bibliographical references (p. 566-593) and index |
| Beschreibung: | XXVII, 607 S. Ill. |
| ISBN: | 0132279428 0132342529 |
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| 245 | 1 | 0 | |a The economics of health and health care |c Sherman Folland ; Allen C. Goodman ; Miron Stano |
| 250 | |a 5. ed. | ||
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| 300 | |a XXVII, 607 S. |b Ill. | ||
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Datensatz im Suchindex
| _version_ | 1804137191437238272 |
|---|---|
| adam_text | Brief Contents
PART I: BASIC ECONOMICS TOOLS 1
Chapter 1 Introduction 1
Chapter 2 Microeconomic Tools for Health Economics 20
Chapter 3 Statistical Tools for Health Economics 51
Chapter 4 Economic Efficiency and Cost Benefit Analysis 68
PART II: SUPPLY AND DEMAND 89
Chapter 5 The Production of Health 89
Chapter 6 The Production, Cost, and Technology of Health Care 111
Chapter 7 Demand for Health Capital 137
Chapter 8 Demand and Supply of Health Insurance 153
Chapter 9 Consumer Choice and Demand 176
PART III: INFORMATION AND INSURANCE MARKETS 199
Chapter 10 Asymmetric Information and Agency 199
Chapter 11 The Organization of Health Insurance Markets 215
Chapter 12 Managed Care 241
Chapter 13 Nonprofit Firms 270
PART IV: KEY PLAYERS IN THE HEALTH CARE SECTOR 294
Chapter 14 Hospitals and Long Term Care 294
Chapter 15 The Physician s Practice 313
Chapter 16 Health Care Labor Markets and Professional Training 331
Chapter 17 The Pharmaceutical Industry 358
PARTV: SOCIAL INSURANCE 383
Chapter 18 Equity, Efficiency, and Need 383
Chapter 19 Government Intervention in Health Care Markets 407
Chapter 20 Government Regulation: Principal Regulatory Mechanisms 430
vi Brief Contents
Chapter 21 Social Insurance 461
Chapter 22 Comparative Health Care Systems and Health System Reform 491
PART VI: SPECIAL TOPICS 525
Chapter 23 The Health Economics of Bads 525
Chapter 24 Epidemiology and Economics: HIV/AIDS in Africa 541
Contents
Preface xxiii
PARTI: BASIC ECONOMICS TOOLS 1
CHAPTER 1 Introduction 1
The Relevance of Health Economics 1
The Size and Scope of the Health Economy 2
Health Care s Share of GDP in the United States 2
Health Care Spending in Other Countries 3
Importance of the Health Economy in Personal Spending 4
Importance of the Health Economy to the Labor Force 4
Capital Investment in the Health Economy 5
Time— The Ultimate Resource 6
The Importance Attached to Economic Problems of Health Care Delivery 6
Inflation 7
Access 7
Quality 7
The Economic Side to Other Health Issues 7
Economic Methods and Examples of Analysis 8
Features of Economic Analysis 8
Examples of Health Economics Analysis 9
Does Economics Apply to Health and Health Care? 10
An Example: Does Price Matter? 11
Is Health Care Different? 11
Presence and Extent of Uncertainty 12
Prominence of Insurance 12
Problems of Information 13
Large Role of Nonprofit Firms 13
Restrictions on Competition 14
Role of Equity and Need 14
Government Subsidies and Public Provision 14
New Challenges to Health Economists —Managed Care, Health Care Costs, and Health
Insurance 14
Conclusions 17
Summary 17
Discussion Questions 18
Exercises 18
viii Contents
CHAPTER 2 Microeconomic Tools for Health Economics 20
Scarcity and the Production Possibilities Frontier 21
Practice with Supply and Demand 24
The Demand Curve and Demand Shifters 24
The Supply Curve and Supply Shifters 25
Equilibrium 26
Comparative Statics 26
Functions and Curves 27
Linear Functions 27
Demand Functions 28
Derived Demand 29
Consumer Theory: Ideas Behind the Demand Curve 29
Utility 29
Indifference Curves 31
Budget Constraints 32
Consumer Equilibrium 33
Individual and Market Demands 34
Elasticities 35
Production and Market Supply 36
The Production Function 37
Production Functions 38
Isocost Curves 40
Cost Minimization or Output Maximization 41
Marginal and Average Cost Curves 42
The Firm Supply Curve Under Perfect Competition 43
Monopoly and Other Market Structures 45
Welfare Losses 46
Conclusions 48
Summary 49
Discussion Questions 49
Exercises 50
CHAPTER 3 Statistical Tools for Health Economics 51
Hypothesis Testing 52
Difference of Means 53
The Variance of a Distribution 53
Standard Error of the Mean 54
Hypotheses and Inferences 56
Regression Analysis 57
Ordinary Least Squares (OLS) Regressions 58
A Demand Regression 59
Estimating Elasticities 60
Multiple Regression Analysis 61
Interpreting Regression Coefficients 61
Dummy Variables 62
Statistical Inference in the Sciences and Social Sciences 64
Conclusions 65
Summary 65
Contents IX
Discussion Questions 66
Exercises 66
CHAPTER 4 Economic Efficiency and Cost Benefit Analysis 68
Economic Efficiency 68
Cost Benefit Analysis: Background 71
Cost Benefit Analysis: Basic Principles 72
Measuring Costs 72
Risk Equity Versus Equality of Marginal Costs per Life Saved 73
Marginal Analysis in CBA 73
Discounting 74
Risk Adjustment and CBA 76
Distributional A djustments 77
Inflation 77
Valuing Human Life 77
Cost Benefit Analyses of Disease Screening Programs 79
Cost Effectiveness Analysis 80
Advantages of CEA 81
Cost Utility Analysis, QALYs, and DALYs 81
An Ace Inhibitor Application of Cost Effectiveness Analysis 82
Is CUA Consistent with CBA? 83
Extra Welfarism 83
The Ageism Critique of QALYs 84
Conclusions 84
Summary 85
Discussion Questions 86
Exercises 86
Appendix—Discounting 88
PART II: SUPPLY AND DEMAND 89
CHAPTER 5 The Production of Health 89
The Production Function of Health 89
The Historical Role of Medicine and Health Care 92
The Rising Population and the Role of Medicine 92
What Caused the Mortality Rate Declines? 94
On the Role of Public Health and Nutrition 95
What Lessons Are Learned from the Medical Historian? 97
What Does Health Care Contribute? 98
The Production Function of Health in the Modern Day 99
Preliminary Issues 99
The Contribution of Health Care to Population Health: The Modern Era 99
Is Health Care Worth It? 100
Issues of Race and Gender 101
Prenatal Care Works 101
The World s Pharmacies 102
Morbidity Studies 102
X Contents
How Does Health Care Affect Other Measures of Health? 103
On the Importance of Lifestyle and Environment 104
Cigarettes and Health 105
The Family as Producer of Health 105
Environmental Pollution 106
Income and Health 106
The Role of Schooling 106
Two Different Theories About the Role of Schooling 107
Empirical Studies on the Role of Schooling in Health 107
Conclusions 108
Summary 109
Discussion Questions 109
Exercises 110
CHAPTER 6 The Production, Cost, and Technology of Health Care 111
Production and the Possibilities for Substitution 112
Substitution 112
What Degree of Substitution Is Possible? 113
Elasticity of Substitution 114
Estimates for Hospital Care 115
Costs in Theory and Practice 116
Deriving the Cost Function 116
Cost Minimization 116
Economies of Scale and Scope 118
Why Would Economies of Scale and Scope Be Important? 119
Empirical Cost Function Studies 121
Differences Among Hospital Cost Studies 121
Difficulties Faced by All Hospital Cost Studies 122
Summarizing Cost Studies 124
Technical and Allocative Inefficiency 124
Technical Inefficiency 124
Allocative Inefficiency 125
Frontier Analysis 126
Technological Changes and Costs 128
Technological Change: Cost Increasing or Decreasing? 129
Health Care Price Increases When Technological Change Occurs 129
Diffusion of New Health Care Technologies 132
Who Adopts and Why? 132
Other Factors That May Affect Adoption Rates 133
Diffusion of Technology and Managed Care 133
Conclusions 134
Summary 134
Discussion Questions 135
Exercises 135
CHAPTER 7 Demand for Health Capital 137
The Demand for Health 137
The Consumer as Health Producer 137
Time Spent Producing Health 139
Contents xi
Labor Leisure Trade Offs 139
Trading Leisure for Wages 139
Preferences Between Leisure and Income 140
The Investment/Consumption Aspects of Health 141
Production of Healthy Days 141
Production of Health and Home Goods 142
Investment over Time 143
The Cost of Capital 143
The Demand for Health Capital 144
Marginal Efficiency of Investment (MET) and Rate of Return 144
The Decreasing MEI 144
Changes in Equilibrium: Age, Wage, Education, and Uncertainty 145
Age 145
Wage Rate 146
Education 147
Uncertainty 148
Empirical Analyses Using Grossman s Model 148
Conclusions 151
Summary 151
Discussion Questions 151
Exercises 152
CHAPTER 8 Demand and Supply of Health Insurance 153
What Is Insurance? 153
Insurance Versus Social Insurance 154
Insurance Terminology 154
Risk and Insurance 155
Expected Value 156
Marginal Utility of Wealth and Risk Aversion 156
Purchasing Insurance 158
The Demand for Insurance 158
How Much Insurance? 158
Changes in Premiums 159
Changes in Expected Loss 161
Changes in Wealth 161
The Supply of Insurance 162
Competition and Normal Profits 162
The Case of Moral Hazard 164
Demand for Care and Moral Hazard 165
Effects of Coinsurance and Deductibles 166
Health Insurance and the Efficient Allocation of Resources 168
The Impact of Coinsurance 168
The Demand for Insurance and the Price of Care 171
The Welfare Loss of Excess Health Insurance 172
Conclusions 173
Summary 173
Discussion Questions 174
Exercises 174
xii Contents
CHAPTER 9 Consumer Choice and Demand 176
Applying the Standard Budget Constraint Model 176
The Consumer s Equilibrium 178
Demand Shifters 179
Health Status and Demand 181
Two Additional Demand Shifters—Time and Coinsurance 181
The Role of Time 181
The Role of Coinsurance 183
Issues in Measuring Health Care Demand 185
Individual and Market Demand Functions 186
Measurement and Definitions 186
Differences in the Study Populations 186
Data Sources 187
Experimental and Nonexperimental Data 187
Empirical Measurements of Demand Elasticities 188
Price Elasticities 188
Individual Income Elasticities 189
Income Elasticities Across Countries 190
Insurance Elasticities 191
Impacts of Insurance on Aggregate Expenditures 193
Other Variables Affecting Demand 193
Ethnicity and Gender 193
Urban Versus Rural 194
Education 194
Age, Health Status, and Uncertainty 195
Conclusions 195
Summary 196
Discussion Questions 197
Exercises 197
PART III: INFORMATION AND INSURANCE MARKETS 199
CHAPTER 10 Asymmetric Information and Agency 199
Overview of Information Issues 200
Asymmetric Information 200
On the Extent of Information Problems in the Health Sector 201
Asymmetric Information in the Used Car Market: The Lemons Principle 202
Application of the Lemons Principle: Health Insurance 204
Inefficiencies of Adverse Selection 205
Experience Rating and Adverse Selection 206
The Agency Relationship 206
Agency and Health Care 207
Consumer Information, Prices, and Quality 208
Consumer Information and Prices 208
Consumer Information and Quality 209
Other Quality Indicators 210
Conclusions 211
Contents Xlii
Summary 212
Discussion Questions 213
Exercises 213
CHAPTER 11 The Organization of Health Insurance Markets 215
Loading Costs and the Behavior of Insurance Firms 215
Impacts of Loading Costs 216
Insurance for Heart Attacks and Hangnails 217
Loading Costs and the Uninsured 217
Employer Provision of Health Insurance: Who Pays? 218
Spousal Coverage: Who Pays? 220
How the Tax System Influences Health Insurance Demand 221
Who Pays—Empirical Tests 222
Other Impacts of Employer Provision of Health Insurance 223
Employer Based Health Insurance and Labor Supply 224
Health Insurance and Retirement 224
Health Insurance and Mobility 224
The Market for Insurance 226
The Market for Private Insurance 226
Insurance Practices 226
The Past 20 Years 228
The Uninsured: An Analytical Framework 229
The Working Uninsured 230
The Impacts of Mandated Coverage 233
Insurance, Technological Change, and Higher Costs 234
The Cost Increasing Bias Hypothesis 234
The Goddeeris Model 235
Evidence on Insurance, Technological Change, and Inflation 236
Does Induced Technological Change Make the Patient Better Off? 237
Conclusions 237
Summary 238
Discussion Questions 238
Exercises 239
CHAPTER 12 Managed Care 241
What Is the Organizational Structure? 243
What Are the Economic Characteristics? 243
The Emergence of Managed Care Plans 245
Employer Sponsored Managed Care 245
Medicaid Managed Care Plans 246
Managed Care Contracts with Physicians 247
Managed Care Contracts with Hospitals 248
Development and Growth of Managed Care: Why Did It Take
So Long? 249
Federal Policy and the Growth of Managed Care 249
The Economics of Managed Care 250
Modeling Managed Care 251
Modeling Individual HMOs 251
xiv Contents
How Much Care? 252
What Types of Care? 253
Framework for Prediction 253
Where Managed Care Differs from FFS—Dumping, Creaming,
and Skimping 254
Equilibrium and Adverse Selection in a Market with HMOs 254
How Does Managed Care Differ? —Empirical Results 256
Methodological Issues—Selection Bias and Quality of Care 257
Comparative Utilization and Costs 257
The Rand Study: A Randomized Experiment 258
The Most Recent Evidence 259
Growth in Spending 259
Competitive Effects 262
Theoretical Issues 262
Managed Care Competition in Hospital Markets 263
Managed Care Competition in Insurance Markets 264
Managed Care and Technological Change 265
Conclusions 266
Summary 267
Discussion Questions 268
Exercises 268
CHAPTER 13 Nonprofit Firms 270
An Introduction to Nonprofits 270
Why Nonprofits Exist and Why They Are Prevalent in Health Care 271
Nonprofits as Providers of Unmet Demands for Public Goods 271
The Public Good Private Good Aspect of Donations 272
Relevance to Health Care Markets 274
Nonprofits as a Response to Contract Failure 275
Applications of Contract Failure to Nursing Home Care 275
Relevance of Contract Failure to Hospitals and Other Firms 276
The Role of Physicians in the Hospital Industry 276
Financial Matters and the Nonprofit 277
Summary of the Reasons for the Prevalence of Nonprofits 277
Models of Nonprofit Hospital Behavior 278
The Quality Quantity Nonprofit Theory 278
The Hospital as a Physicians Cooperative 280
Maximizing Net Revenue per Physician 281
A Comparison of the Quantity Quality and the Physicians Cooperative Theories 282
The Evidence: Do Nonprofit Hospitals Differ from For Profit Hospitals? 284
The Harris Model 285
Summary of Models of Hospital Behavior 286
What Causes Conversion of Nonprofits into For Profits? 287
The Relative Efficiency of Nonprofits Versus For Profits 288
Property Rights Theory and Its Application to Nonprofits 288
Are Nonprofit Health Care Firms Less Efficient? — Hospital and Nursing
Home Studies 290
Conclusions 291
Summary 292
Contents XV
Discussion Questions 293
Exercises 293
PART IV: KEY PLAYERS IN THE HEALTH CARE SECTOR 294
CHAPTER 14 Hospitals and Long Term Care 294
Background and Overview of Hospitals 294
History 295
Organization 296
Regulation and Accreditation 297
Hospital Utilization and Costs 298
Competition and Costs 299
Closures, Mergers, and Restructuring in the Hospital Industry 302
Nursing Homes 303
Background and Costs 303
Quality of Care 305
Excess Demand 306
Financing Long Term Care 307
Hospice, Home Health, and Informal Care 309
Conclusions 310
Summary 310
Discussion Questions 311
Exercises 311
CHAPTER 15 The Physician s Practice 313
A Benchmark Model of the Physician s Practice 313
Supplier Induced Demand (SID) 316
The Supply and Demand Model 316
The Target Income Hypothesis 317
The Benchmark Model as a Synthesis 318
The Parallel Between Inducement and Advertising 319
What Do the Data Say About Supplier Induced Demand? 320
Physician Fees, Fee Tests, and Fee Controls 320
Small Area Variations (S AV) 321
Contributions to These Variations 322
The Physician Practice Style Hypothesis 323
Checking the Practice Style Hypothesis Against the Data 323
SAV and the Social Cost of Inappropriate Utilization 324
SAV Analysis in Other Applications 325
Other Physician Issues and Policy Puzzles 326
Physician Pricing and Price Discrimination 326
Paying for Outcomes 327
Conclusions 328
Summary 328
Discussion Questions 329
Exercises 330
XVI Contents
CHAPTER 16 Health Care Labor Markets and Professional Training 331
The Demand for and Supply of Health Care Labor 331
Production Functions and Isoquants 332
Marginal Productivity of Labor 333
Factor Substitution and Labor Demand 334
The Supply of Labor 334
Factor Productivity and Substitution Among Factors 336
Measurement of Physician Productivity 336
The Efficient Utilization of Physician Assistants: Substitution Among Inputs 337
Health Manpower Availability and the Meaning of Shortages 338
Availability of Physicians 338
Economic Definitions of Shortages of Health Professionals 340
The Role of Monopsony Power: Shortages of Registered Nurses 342
Medical Education Issues and the Question of Control 344
Sources of Medical School Revenues 345
Capital Market Imperfections Justify Subsidies 345
Teaching Hospitals, Medical Schools, and Joint Production 345
Foreign Medical School Graduates (FMGs) 346
The Control of Medical Education 347
Control over Entry 348
Another View: The Donor Preference Hypothesis 348
Licensure and Monopoly Rents 349
Public Interest or Self interest 350
Licensure and Quality 351
Other Physician Labor Issues 353
Specialization 353
Physician Income by Gender 353
Conclusions 354
Summary 355
Discussion Questions 355
Exercises 356
CHAPTER 17 The Pharmaceutical Industry 358
Structure and Regulation 360
Competition 360
Barriers to Entry 361
Regulation 362
The Production of Health and Substitutability 363
Least Cost Production 365
Insurance and Substitutability 366
Technological Change 366
Drug Pricing and Profits 368
Monopoly Pricing 369
Price Discrimination 370
Behavior Other Than Profit Maximizing Behavior 371
Monopsony Pricing and Price Controls 371
Competition and Generic Entry 372
R D and Innovation 372
Investment Decisions 373
Contents xvii
R D Spending 374
Firm Size and Innovation 375
Cost Containment 375
Copayments 377
Generic Substitutes 378
Drug Formularies 378
Conclusions 379
Summary 380
Discussion Questions 380
Exercises 381
PARTV: SOCIAL INSURANCE 383
CHAPTER 18 Equity, Efficiency, and Need 383
Efficiency and Competitive Markets 384
The Concept of Pareto Efficiency (Optimality) 384
Trading Along the Budget Line 386
The Competitive Equilibrium 386
The First Fundamental Theorem of Welfare Economics 387
Redistribution of the Endowment 387
Price Discrimination 388
Trade offs Between Equity and Efficiency 389
Deviations from the Competitive Model in the Health Care Sector 389
The Assumptions Under Perfect Competition 389
Promoting Competition in the Health Care Sector 391
The Theorem of the Second Best 391
An Economic Efficiency Rationale for Health Care Programs Based on Externalities 392
Need and Need Based Distributions 394
Health Care Needs and the Social Welfare Function 395
Norman Daniels s Concept of Health Care Need 397
Economic Criticisms of Need Based Distributions 399
Horizontal Equity and Need 399
Comparing Horizontal Equity Among Countries 400
The Results 400
Theories of Social Justice 401
Utilitarianism 401
Rawls and Justice as Fairness 402
Liberalism, Classical and Modern 403
Conclusions 404
Summary 405
Discussion Questions 405
Exercises 406
CHAPTER 19 Government Intervention in Health Care Markets 407
Economic Rationale for Government Intervention 407
Monopoly Power 408
Public Goods 409
Xviii Contents
Externalities 411
Other Rationales for Government Intervention 412
Forms of Government Intervention 412
Commodity Taxes and Subsidies 412
Public Provision 414
Transfer Programs 414
Regulation 415
Government Involvement in Health Care Markets 415
Support of Hospitals 416
The Hill Burton Act 416
The Veterans Administration and CHAMPUS 416
Food and Drug Administration 417
Mandated Health Insurance Benefits 417
Tax Policy 417
Public Health 418
Other Government Programs 418
Government Failure 420
Who Does the Regulator Represent? 420
Bureaucracy and Efficiency 422
Competitive Strategies 423
Increased Cost Sharing 424
Development of Alternative Delivery Systems 424
Consumer Driven Health Plans and Health Savings Accounts 425
Representation of the Competitive Approach 427
Conclusions 428
Summary 428
Discussion Questions 429
Exercises 429
CHAPTER 20 Government Regulation: Principal Regulatory Mechanisms 430
Do the Laws of Supply and Demand Apply? 430
Objectives of Regulation 431
Regulatory Policy 432
Regulatory Instruments in Health Care 432
Regulation of the Hospital Sector 433
Rate Regulation, Utilization Review, and Certificate of Need 433
Empirical Findings on Regulation 434
Prospective Payment 438
Description of PPS 438
The Theory of Yardstick Competition and DRGs 440
On the Effects of Medicare s Prospective Payment System 444
Prospective Payment: Recent Evidence 448
Regulation of Physician Payment 449
UCR Reimbursement, Assignment, and Alternative Payment Mechanisms 449
Relative Value Scales 449
Antitrust 451
Enforcement 451
Exemptions 451
Contents xix
Measuring Monopoly Power 453
Antitrust Procedures 454
The Elzinga Hogarty (EH) Criterion 456
Conclusions 457
Summary 458
Discussion Questions 458
Exercises 459
CHAPTER 21 Social Insurance 461
Social Insurance Policies and Social Programs 461
Program Features 462
Historical Roots of Social Insurance 463
European Beginnings 463
Early Experience in the United States 464
The Establishment of Medicare and Medicaid 465
Medicare and Medicaid in the United States 465
Medicare 466
Medicaid Overview 471
Medicaid Eligibility 471
The Medicaid Medicare Relationship 474
State Children s Health Insurance Program 474
Public Insurance and Health 474
The Effects of Medicare and Medicaid 477
Costs and Inflation 477
Health Status 482
Medicare: Recent Changes and Future Prospects 483
Criticisms of the U.S. Health Care System 486
Conclusions 487
Summary 488
Discussion Questions 488
Exercises 489
CHAPTER 22 Comparative Health Care Systems and Health System Reform 491
Contemporary Health Care Systems 491
A Typology of Contemporary Health Care Systems 491
National Health Programs: United Kingdom and Germany 492
The United Kingdom: The National Health Service 494
Germany 498
The Canadian Health Care System 502
Background 503
Physician Fees and Quantity 505
Why Are Fees and Hospital Costs Lower in Canada? 505
Administrative Costs 506
A Comparison 506
Different Systems: The Public s Evaluation 508
Differences in Health Care Spending Across Countries 510
A Simple Model of Health Expenditures Shares 511
XX Contents
National Health Insurance 514
Different Kinds of National Health Insurance (NHI) Plans 514
The Costs of NHI 515
Ensuring Access to Care 516
Employer Versus Individual Mandates 516
Separation of Health Insurance from Employment 518
Single Payer Versus Multiple Insurers 518
Health Care Reform and International Competitiveness 520
Conclusions 521
Summary 521
Discussion Questions 522
Exercises 523
PART VI: SPECIAL TOPICS 525
CHAPTER 23 The Health Economics of Bads 525
An Introduction to Bads 526
Models of Addiction 527
Imperfectly Rational Addiction Models 527
Myopic Addiction Models 527
Rational Addiction 528
Rationales for Public Intervention 530
Other Interventions 531
Advertising Restrictions on Cigarettes and Alcohol 531
Theories of Advertising 532
The Possible Effects of Brand Switching 533
Increased Demand or Brand Switching? 534
Advertising and Alcohol Consumption 535
Excise Taxes and Consumption of Cigarettes and Alcohol 535
The Consumption Reducing Effects of Excise Taxes in Theory 535
Excise Taxes and Cigarette Consumption in Practice 536
Excise Taxes and Alcohol Consumption 538
Conclusions 539
Summary 539
Discussion Questions 539
Exercises 540
CHAPTER 24 Epidemiology and Economics: HIV/AIDS in Africa 541
Concepts from Epidemiology 541
Economic Epidemiology 543
Rational Epidemics 543
The Prevalence Elasticity of Demand for Prevention 544
The Economic Consequences of Epidemics 545
The Difficulty of Eradicating Diseases 546
Information 547
The Role of Government in Battling Epidemics 547
Contents XXI
Case Study: HIV/AIDS in Africa 548
HIV/AIDS 548
Costs of AIDS 550
Fighting AIDS 551
Economic Theory and African Reality 555
Conclusions 555
Summary 556
Discussion Questions 556
Exercises 556
Glossary 559
References 566
Name Index 594
Subject Index 598
|
| adam_txt |
Brief Contents
PART I: BASIC ECONOMICS TOOLS 1
Chapter 1 Introduction 1
Chapter 2 Microeconomic Tools for Health Economics 20
Chapter 3 Statistical Tools for Health Economics 51
Chapter 4 Economic Efficiency and Cost Benefit Analysis 68
PART II: SUPPLY AND DEMAND 89
Chapter 5 The Production of Health 89
Chapter 6 The Production, Cost, and Technology of Health Care 111
Chapter 7 Demand for Health Capital 137
Chapter 8 Demand and Supply of Health Insurance 153
Chapter 9 Consumer Choice and Demand 176
PART III: INFORMATION AND INSURANCE MARKETS 199
Chapter 10 Asymmetric Information and Agency 199
Chapter 11 The Organization of Health Insurance Markets 215
Chapter 12 Managed Care 241
Chapter 13 Nonprofit Firms 270
PART IV: KEY PLAYERS IN THE HEALTH CARE SECTOR 294
Chapter 14 Hospitals and Long Term Care 294
Chapter 15 The Physician's Practice 313
Chapter 16 Health Care Labor Markets and Professional Training 331
Chapter 17 The Pharmaceutical Industry 358
PARTV: SOCIAL INSURANCE 383
Chapter 18 Equity, Efficiency, and Need 383
Chapter 19 Government Intervention in Health Care Markets 407
Chapter 20 Government Regulation: Principal Regulatory Mechanisms 430
vi Brief Contents
Chapter 21 Social Insurance 461
Chapter 22 Comparative Health Care Systems and Health System Reform 491
PART VI: SPECIAL TOPICS 525
Chapter 23 The Health Economics of Bads 525
Chapter 24 Epidemiology and Economics: HIV/AIDS in Africa 541
Contents
Preface xxiii
PARTI: BASIC ECONOMICS TOOLS 1
CHAPTER 1 Introduction 1
The Relevance of Health Economics 1
The Size and Scope of the Health Economy 2
Health Care's Share of GDP in the United States 2
Health Care Spending in Other Countries 3
Importance of the Health Economy in Personal Spending 4
Importance of the Health Economy to the Labor Force 4
Capital Investment in the Health Economy 5
Time— The Ultimate Resource 6
The Importance Attached to Economic Problems of Health Care Delivery 6
Inflation 7
Access 7
Quality 7
The Economic Side to Other Health Issues 7
Economic Methods and Examples of Analysis 8
Features of Economic Analysis 8
Examples of Health Economics Analysis 9
Does Economics Apply to Health and Health Care? 10
An Example: Does Price Matter? 11
Is Health Care Different? 11
Presence and Extent of Uncertainty 12
Prominence of Insurance 12
Problems of Information 13
Large Role of Nonprofit Firms 13
Restrictions on Competition 14
Role of Equity and Need 14
Government Subsidies and Public Provision 14
New Challenges to Health Economists —Managed Care, Health Care Costs, and Health
Insurance 14
Conclusions 17
Summary 17
Discussion Questions 18
Exercises 18
viii Contents
CHAPTER 2 Microeconomic Tools for Health Economics 20
Scarcity and the Production Possibilities Frontier 21
Practice with Supply and Demand 24
The Demand Curve and Demand Shifters 24
The Supply Curve and Supply Shifters 25
Equilibrium 26
Comparative Statics 26
Functions and Curves 27
Linear Functions 27
Demand Functions 28
Derived Demand 29
Consumer Theory: Ideas Behind the Demand Curve 29
Utility 29
Indifference Curves 31
Budget Constraints 32
Consumer Equilibrium 33
Individual and Market Demands 34
Elasticities 35
Production and Market Supply 36
The Production Function 37
Production Functions 38
Isocost Curves 40
Cost Minimization or Output Maximization 41
Marginal and Average Cost Curves 42
The Firm Supply Curve Under Perfect Competition 43
Monopoly and Other Market Structures 45
Welfare Losses 46
Conclusions 48
Summary 49
Discussion Questions 49
Exercises 50
CHAPTER 3 Statistical Tools for Health Economics 51
Hypothesis Testing 52
Difference of Means 53
The Variance of a Distribution 53
Standard Error of the Mean 54
Hypotheses and Inferences 56
Regression Analysis 57
Ordinary Least Squares (OLS) Regressions 58
A Demand Regression 59
Estimating Elasticities 60
Multiple Regression Analysis 61
Interpreting Regression Coefficients 61
Dummy Variables 62
Statistical Inference in the Sciences and Social Sciences 64
Conclusions 65
Summary 65
Contents IX
Discussion Questions 66
Exercises 66
CHAPTER 4 Economic Efficiency and Cost Benefit Analysis 68
Economic Efficiency 68
Cost Benefit Analysis: Background 71
Cost Benefit Analysis: Basic Principles 72
Measuring Costs 72
Risk Equity Versus Equality of Marginal Costs per Life Saved 73
Marginal Analysis in CBA 73
Discounting 74
Risk Adjustment and CBA 76
Distributional A djustments 77
Inflation 77
Valuing Human Life 77
Cost Benefit Analyses of Disease Screening Programs 79
Cost Effectiveness Analysis 80
Advantages of CEA 81
Cost Utility Analysis, QALYs, and DALYs 81
An Ace Inhibitor Application of Cost Effectiveness Analysis 82
Is CUA Consistent with CBA? 83
Extra Welfarism 83
The Ageism Critique of QALYs 84
Conclusions 84
Summary 85
Discussion Questions 86
Exercises 86
Appendix—Discounting 88
PART II: SUPPLY AND DEMAND 89
CHAPTER 5 The Production of Health 89
The Production Function of Health 89
The Historical Role of Medicine and Health Care 92
The Rising Population and the Role of Medicine 92
What Caused the Mortality Rate Declines? 94
On the Role of Public Health and Nutrition 95
What Lessons Are Learned from the Medical Historian? 97
What Does Health Care Contribute? 98
The Production Function of Health in the Modern Day 99
Preliminary Issues 99
The Contribution of Health Care to Population Health: The Modern Era 99
Is Health Care Worth It? 100
Issues of Race and Gender 101
Prenatal Care Works 101
The World's Pharmacies 102
Morbidity Studies 102
X Contents
How Does Health Care Affect Other Measures of Health? 103
On the Importance of Lifestyle and Environment 104
Cigarettes and Health 105
The Family as Producer of Health 105
Environmental Pollution 106
Income and Health 106
The Role of Schooling 106
Two Different Theories About the Role of Schooling 107
Empirical Studies on the Role of Schooling in Health 107
Conclusions 108
Summary 109
Discussion Questions 109
Exercises 110
CHAPTER 6 The Production, Cost, and Technology of Health Care 111
Production and the Possibilities for Substitution 112
Substitution 112
What Degree of Substitution Is Possible? 113
Elasticity of Substitution 114
Estimates for Hospital Care 115
Costs in Theory and Practice 116
Deriving the Cost Function 116
Cost Minimization 116
Economies of Scale and Scope 118
Why Would Economies of Scale and Scope Be Important? 119
Empirical Cost Function Studies 121
Differences Among Hospital Cost Studies 121
Difficulties Faced by All Hospital Cost Studies 122
Summarizing Cost Studies 124
Technical and Allocative Inefficiency 124
Technical Inefficiency 124
Allocative Inefficiency 125
Frontier Analysis 126
Technological Changes and Costs 128
Technological Change: Cost Increasing or Decreasing? 129
Health Care Price Increases When Technological Change Occurs 129
Diffusion of New Health Care Technologies 132
Who Adopts and Why? 132
Other Factors That May Affect Adoption Rates 133
Diffusion of Technology and Managed Care 133
Conclusions 134
Summary 134
Discussion Questions 135
Exercises 135
CHAPTER 7 Demand for Health Capital 137
The Demand for Health 137
The Consumer as Health Producer 137
Time Spent Producing Health 139
Contents xi
Labor Leisure Trade Offs 139
Trading Leisure for Wages 139
Preferences Between Leisure and Income 140
The Investment/Consumption Aspects of Health 141
Production of Healthy Days 141
Production of Health and Home Goods 142
Investment over Time 143
The Cost of Capital 143
The Demand for Health Capital 144
Marginal Efficiency of Investment (MET) and Rate of Return 144
The Decreasing MEI 144
Changes in Equilibrium: Age, Wage, Education, and Uncertainty 145
Age 145
Wage Rate 146
Education 147
Uncertainty 148
Empirical Analyses Using Grossman's Model 148
Conclusions 151
Summary 151
Discussion Questions 151
Exercises 152
CHAPTER 8 Demand and Supply of Health Insurance 153
What Is Insurance? 153
Insurance Versus Social Insurance 154
Insurance Terminology 154
Risk and Insurance 155
Expected Value 156
Marginal Utility of Wealth and Risk Aversion 156
Purchasing Insurance 158
The Demand for Insurance 158
How Much Insurance? 158
Changes in Premiums 159
Changes in Expected Loss 161
Changes in Wealth 161
The Supply of Insurance 162
Competition and Normal Profits 162
The Case of Moral Hazard 164
Demand for Care and Moral Hazard 165
Effects of Coinsurance and Deductibles 166
Health Insurance and the Efficient Allocation of Resources 168
The Impact of Coinsurance 168
The Demand for Insurance and the Price of Care 171
The Welfare Loss of Excess Health Insurance 172
Conclusions 173
Summary 173
Discussion Questions 174
Exercises 174
xii Contents
CHAPTER 9 Consumer Choice and Demand 176
Applying the Standard Budget Constraint Model 176
The Consumer's Equilibrium 178
Demand Shifters 179
Health Status and Demand 181
Two Additional Demand Shifters—Time and Coinsurance 181
The Role of Time 181
The Role of Coinsurance 183
Issues in Measuring Health Care Demand 185
Individual and Market Demand Functions 186
Measurement and Definitions 186
Differences in the Study Populations 186
Data Sources 187
Experimental and Nonexperimental Data 187
Empirical Measurements of Demand Elasticities 188
Price Elasticities 188
Individual Income Elasticities 189
Income Elasticities Across Countries 190
Insurance Elasticities 191
Impacts of Insurance on Aggregate Expenditures 193
Other Variables Affecting Demand 193
Ethnicity and Gender 193
Urban Versus Rural 194
Education 194
Age, Health Status, and Uncertainty 195
Conclusions 195
Summary 196
Discussion Questions 197
Exercises 197
PART III: INFORMATION AND INSURANCE MARKETS 199
CHAPTER 10 Asymmetric Information and Agency 199
Overview of Information Issues 200
Asymmetric Information 200
On the Extent of Information Problems in the Health Sector 201
Asymmetric Information in the Used Car Market: The Lemons Principle 202
Application of the Lemons Principle: Health Insurance 204
Inefficiencies of Adverse Selection 205
Experience Rating and Adverse Selection 206
The Agency Relationship 206
Agency and Health Care 207
Consumer Information, Prices, and Quality 208
Consumer Information and Prices 208
Consumer Information and Quality 209
Other Quality Indicators 210
Conclusions 211
Contents Xlii
Summary 212
Discussion Questions 213
Exercises 213
CHAPTER 11 The Organization of Health Insurance Markets 215
Loading Costs and the Behavior of Insurance Firms 215
Impacts of Loading Costs 216
Insurance for Heart Attacks and Hangnails 217
Loading Costs and the Uninsured 217
Employer Provision of Health Insurance: Who Pays? 218
Spousal Coverage: Who Pays? 220
How the Tax System Influences Health Insurance Demand 221
Who Pays—Empirical Tests 222
Other Impacts of Employer Provision of Health Insurance 223
Employer Based Health Insurance and Labor Supply 224
Health Insurance and Retirement 224
Health Insurance and Mobility 224
The Market for Insurance 226
The Market for Private Insurance 226
Insurance Practices 226
The Past 20 Years 228
The Uninsured: An Analytical Framework 229
The Working Uninsured 230
The Impacts of Mandated Coverage 233
Insurance, Technological Change, and Higher Costs 234
The Cost Increasing Bias Hypothesis 234
The Goddeeris Model 235
Evidence on Insurance, Technological Change, and Inflation 236
Does Induced Technological Change Make the Patient Better Off? 237
Conclusions 237
Summary 238
Discussion Questions 238
Exercises 239
CHAPTER 12 Managed Care 241
What Is the Organizational Structure? 243
What Are the Economic Characteristics? 243
The Emergence of Managed Care Plans 245
Employer Sponsored Managed Care 245
Medicaid Managed Care Plans 246
Managed Care Contracts with Physicians 247
Managed Care Contracts with Hospitals 248
Development and Growth of Managed Care: Why Did It Take
So Long? 249
Federal Policy and the Growth of Managed Care 249
The Economics of Managed Care 250
Modeling Managed Care 251
Modeling Individual HMOs 251
xiv Contents
How Much Care? 252
What Types of Care? 253
Framework for Prediction 253
Where Managed Care Differs from FFS—Dumping, Creaming,
and Skimping 254
Equilibrium and Adverse Selection in a Market with HMOs 254
How Does Managed Care Differ? —Empirical Results 256
Methodological Issues—Selection Bias and Quality of Care 257
Comparative Utilization and Costs 257
The Rand Study: A Randomized Experiment 258
The Most Recent Evidence 259
Growth in Spending 259
Competitive Effects 262
Theoretical Issues 262
Managed Care Competition in Hospital Markets 263
Managed Care Competition in Insurance Markets 264
Managed Care and Technological Change 265
Conclusions 266
Summary 267
Discussion Questions 268
Exercises 268
CHAPTER 13 Nonprofit Firms 270
An Introduction to Nonprofits 270
Why Nonprofits Exist and Why They Are Prevalent in Health Care 271
Nonprofits as Providers of Unmet Demands for Public Goods 271
The Public Good Private Good Aspect of Donations 272
Relevance to Health Care Markets 274
Nonprofits as a Response to Contract Failure 275
Applications of Contract Failure to Nursing Home Care 275
Relevance of Contract Failure to Hospitals and Other Firms 276
The Role of Physicians in the Hospital Industry 276
Financial Matters and the Nonprofit 277
Summary of the Reasons for the Prevalence of Nonprofits 277
Models of Nonprofit Hospital Behavior 278
The Quality Quantity Nonprofit Theory 278
The Hospital as a Physicians' Cooperative 280
Maximizing Net Revenue per Physician 281
A Comparison of the Quantity Quality and the Physicians' Cooperative Theories 282
The Evidence: Do Nonprofit Hospitals Differ from For Profit Hospitals? 284
The Harris Model 285
Summary of Models of Hospital Behavior 286
What Causes Conversion of Nonprofits into For Profits? 287
The Relative Efficiency of Nonprofits Versus For Profits 288
Property Rights Theory and Its Application to Nonprofits 288
Are Nonprofit Health Care Firms Less Efficient? — Hospital and Nursing
Home Studies 290
Conclusions 291
Summary 292
Contents XV
Discussion Questions 293
Exercises 293
PART IV: KEY PLAYERS IN THE HEALTH CARE SECTOR 294
CHAPTER 14 Hospitals and Long Term Care 294
Background and Overview of Hospitals 294
History 295
Organization 296
Regulation and Accreditation 297
Hospital Utilization and Costs 298
Competition and Costs 299
Closures, Mergers, and Restructuring in the Hospital Industry 302
Nursing Homes 303
Background and Costs 303
Quality of Care 305
Excess Demand 306
Financing Long Term Care 307
Hospice, Home Health, and Informal Care 309
Conclusions 310
Summary 310
Discussion Questions 311
Exercises 311
CHAPTER 15 The Physician's Practice 313
A Benchmark Model of the Physician's Practice 313
Supplier Induced Demand (SID) 316
The Supply and Demand Model 316
The Target Income Hypothesis 317
The Benchmark Model as a Synthesis 318
The Parallel Between Inducement and Advertising 319
What Do the Data Say About Supplier Induced Demand? 320
Physician Fees, Fee Tests, and Fee Controls 320
Small Area Variations (S AV) 321
Contributions to These Variations 322
The Physician Practice Style Hypothesis 323
Checking the Practice Style Hypothesis Against the Data 323
SAV and the Social Cost of Inappropriate Utilization 324
SAV Analysis in Other Applications 325
Other Physician Issues and Policy Puzzles 326
Physician Pricing and Price Discrimination 326
Paying for Outcomes 327
Conclusions 328
Summary 328
Discussion Questions 329
Exercises 330
XVI Contents
CHAPTER 16 Health Care Labor Markets and Professional Training 331
The Demand for and Supply of Health Care Labor 331
Production Functions and Isoquants 332
Marginal Productivity of Labor 333
Factor Substitution and Labor Demand 334
The Supply of Labor 334
Factor Productivity and Substitution Among Factors 336
Measurement of Physician Productivity 336
The Efficient Utilization of Physician Assistants: Substitution Among Inputs 337
Health Manpower Availability and the Meaning of Shortages 338
Availability of Physicians 338
Economic Definitions of Shortages of Health Professionals 340
The Role of Monopsony Power: Shortages of Registered Nurses 342
Medical Education Issues and the Question of Control 344
Sources of Medical School Revenues 345
Capital Market Imperfections Justify Subsidies 345
Teaching Hospitals, Medical Schools, and Joint Production 345
Foreign Medical School Graduates (FMGs) 346
The Control of Medical Education 347
Control over Entry 348
Another View: The Donor Preference Hypothesis 348
Licensure and Monopoly Rents 349
Public Interest or Self interest 350
Licensure and Quality 351
Other Physician Labor Issues 353
Specialization 353
Physician Income by Gender 353
Conclusions 354
Summary 355
Discussion Questions 355
Exercises 356
CHAPTER 17 The Pharmaceutical Industry 358
Structure and Regulation 360
Competition 360
Barriers to Entry 361
Regulation 362
The Production of Health and Substitutability 363
Least Cost Production 365
Insurance and Substitutability 366
Technological Change 366
Drug Pricing and Profits 368
Monopoly Pricing 369
Price Discrimination 370
Behavior Other Than Profit Maximizing Behavior 371
Monopsony Pricing and Price Controls 371
Competition and Generic Entry 372
R D and Innovation 372
Investment Decisions 373
Contents xvii
R D Spending 374
Firm Size and Innovation 375
Cost Containment 375
Copayments 377
Generic Substitutes 378
Drug Formularies 378
Conclusions 379
Summary 380
Discussion Questions 380
Exercises 381
PARTV: SOCIAL INSURANCE 383
CHAPTER 18 Equity, Efficiency, and Need 383
Efficiency and Competitive Markets 384
The Concept of Pareto Efficiency (Optimality) 384
Trading Along the Budget Line 386
The Competitive Equilibrium 386
The First Fundamental Theorem of Welfare Economics 387
Redistribution of the Endowment 387
Price Discrimination 388
Trade offs Between Equity and Efficiency 389
Deviations from the Competitive Model in the Health Care Sector 389
The Assumptions Under Perfect Competition 389
Promoting Competition in the Health Care Sector 391
The Theorem of the Second Best 391
An Economic Efficiency Rationale for Health Care Programs Based on Externalities 392
Need and Need Based Distributions 394
Health Care Needs and the Social Welfare Function 395
Norman Daniels's Concept of Health Care Need 397
Economic Criticisms of Need Based Distributions 399
Horizontal Equity and Need 399
Comparing Horizontal Equity Among Countries 400
The Results 400
Theories of Social Justice 401
Utilitarianism 401
Rawls and Justice as Fairness 402
Liberalism, Classical and Modern 403
Conclusions 404
Summary 405
Discussion Questions 405
Exercises 406
CHAPTER 19 Government Intervention in Health Care Markets 407
Economic Rationale for Government Intervention 407
Monopoly Power 408
Public Goods 409
Xviii Contents
Externalities 411
Other Rationales for Government Intervention 412
Forms of Government Intervention 412
Commodity Taxes and Subsidies 412
Public Provision 414
Transfer Programs 414
Regulation 415
Government Involvement in Health Care Markets 415
Support of Hospitals 416
The Hill Burton Act 416
The Veterans Administration and CHAMPUS 416
Food and Drug Administration 417
Mandated Health Insurance Benefits 417
Tax Policy 417
Public Health 418
Other Government Programs 418
Government Failure 420
Who Does the Regulator Represent? 420
Bureaucracy and Efficiency 422
Competitive Strategies 423
Increased Cost Sharing 424
Development of Alternative Delivery Systems 424
Consumer Driven Health Plans and Health Savings Accounts 425
Representation of the Competitive Approach 427
Conclusions 428
Summary 428
Discussion Questions 429
Exercises 429
CHAPTER 20 Government Regulation: Principal Regulatory Mechanisms 430
Do the Laws of Supply and Demand Apply? 430
Objectives of Regulation 431
Regulatory Policy 432
Regulatory Instruments in Health Care 432
Regulation of the Hospital Sector 433
Rate Regulation, Utilization Review, and Certificate of Need 433
Empirical Findings on Regulation 434
Prospective Payment 438
Description of PPS 438
The Theory of Yardstick Competition and DRGs 440
On the Effects of Medicare's Prospective Payment System 444
Prospective Payment: Recent Evidence 448
Regulation of Physician Payment 449
UCR Reimbursement, Assignment, and Alternative Payment Mechanisms 449
Relative Value Scales 449
Antitrust 451
Enforcement 451
Exemptions 451
Contents xix
Measuring Monopoly Power 453
Antitrust Procedures 454
The Elzinga Hogarty (EH) Criterion 456
Conclusions 457
Summary 458
Discussion Questions 458
Exercises 459
CHAPTER 21 Social Insurance 461
Social Insurance Policies and Social Programs 461
Program Features 462
Historical Roots of Social Insurance 463
European Beginnings 463
Early Experience in the United States 464
The Establishment of Medicare and Medicaid 465
Medicare and Medicaid in the United States 465
Medicare 466
Medicaid Overview 471
Medicaid Eligibility 471
The Medicaid Medicare Relationship 474
State Children's Health Insurance Program 474
Public Insurance and Health 474
The Effects of Medicare and Medicaid 477
Costs and Inflation 477
Health Status 482
Medicare: Recent Changes and Future Prospects 483
Criticisms of the U.S. Health Care System 486
Conclusions 487
Summary 488
Discussion Questions 488
Exercises 489
CHAPTER 22 Comparative Health Care Systems and Health System Reform 491
Contemporary Health Care Systems 491
A Typology of Contemporary Health Care Systems 491
National Health Programs: United Kingdom and Germany 492
The United Kingdom: The National Health Service 494
Germany 498
The Canadian Health Care System 502
Background 503
Physician Fees and Quantity 505
Why Are Fees and Hospital Costs Lower in Canada? 505
Administrative Costs 506
A Comparison 506
Different Systems: The Public's Evaluation 508
Differences in Health Care Spending Across Countries 510
A Simple Model of Health Expenditures Shares 511
XX Contents
National Health Insurance 514
Different Kinds of National Health Insurance (NHI) Plans 514
The Costs of NHI 515
Ensuring Access to Care 516
Employer Versus Individual Mandates 516
Separation of Health Insurance from Employment 518
Single Payer Versus Multiple Insurers 518
Health Care Reform and International Competitiveness 520
Conclusions 521
Summary 521
Discussion Questions 522
Exercises 523
PART VI: SPECIAL TOPICS 525
CHAPTER 23 The Health Economics of Bads 525
An Introduction to Bads 526
Models of Addiction 527
Imperfectly Rational Addiction Models 527
Myopic Addiction Models 527
Rational Addiction 528
Rationales for Public Intervention 530
Other Interventions 531
Advertising Restrictions on Cigarettes and Alcohol 531
Theories of Advertising 532
The Possible Effects of Brand Switching 533
Increased Demand or Brand Switching? 534
Advertising and Alcohol Consumption 535
Excise Taxes and Consumption of Cigarettes and Alcohol 535
The Consumption Reducing Effects of Excise Taxes in Theory 535
Excise Taxes and Cigarette Consumption in Practice 536
Excise Taxes and Alcohol Consumption 538
Conclusions 539
Summary 539
Discussion Questions 539
Exercises 540
CHAPTER 24 Epidemiology and Economics: HIV/AIDS in Africa 541
Concepts from Epidemiology 541
Economic Epidemiology 543
Rational Epidemics 543
The Prevalence Elasticity of Demand for Prevention 544
The Economic Consequences of Epidemics 545
The Difficulty of Eradicating Diseases 546
Information 547
The Role of Government in Battling Epidemics 547
Contents XXI
Case Study: HIV/AIDS in Africa 548
HIV/AIDS 548
Costs of AIDS 550
Fighting AIDS 551
Economic Theory and African Reality 555
Conclusions 555
Summary 556
Discussion Questions 556
Exercises 556
Glossary 559
References 566
Name Index 594
Subject Index 598 |
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| author | Folland, Sherman Goodman, Allen C. 1947- Stano, Miron |
| author_GND | (DE-588)111468906 |
| author_facet | Folland, Sherman Goodman, Allen C. 1947- Stano, Miron |
| author_role | aut aut aut |
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| callnumber-first | R - Medicine |
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| callnumber-raw | RA410 |
| callnumber-search | RA410 |
| callnumber-sort | RA 3410 |
| callnumber-subject | RA - Public Medicine |
| classification_rvk | QX 700 |
| ctrlnum | (OCoLC)68800440 (DE-599)DNB 2006044808 |
| dewey-full | 338.4/33621 |
| dewey-hundreds | 300 - Social sciences |
| dewey-ones | 338 - Production |
| dewey-raw | 338.4/33621 |
| dewey-search | 338.4/33621 |
| dewey-sort | 3338.4 533621 |
| dewey-tens | 330 - Economics |
| discipline | Wirtschaftswissenschaften |
| discipline_str_mv | Wirtschaftswissenschaften |
| edition | 5. ed. |
| format | Book |
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| genre | (DE-588)4123623-3 Lehrbuch gnd-content |
| genre_facet | Lehrbuch |
| id | DE-604.BV022949081 |
| illustrated | Illustrated |
| index_date | 2024-07-02T19:01:21Z |
| indexdate | 2024-07-09T21:08:22Z |
| institution | BVB |
| isbn | 0132279428 0132342529 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016153580 |
| oclc_num | 68800440 |
| open_access_boolean | |
| owner | DE-703 DE-945 DE-1049 DE-83 DE-11 DE-2070s |
| owner_facet | DE-703 DE-945 DE-1049 DE-83 DE-11 DE-2070s |
| physical | XXVII, 607 S. Ill. |
| publishDate | 2007 |
| publishDateSearch | 2007 |
| publishDateSort | 2007 |
| publisher | Pearson Prentice Hall |
| record_format | marc |
| spelling | Folland, Sherman Verfasser aut The economics of health and health care Sherman Folland ; Allen C. Goodman ; Miron Stano 5. ed. Upper Saddle River, NJ Pearson Prentice Hall 2007 XXVII, 607 S. Ill. txt rdacontent n rdamedia nc rdacarrier Includes bibliographical references (p. 566-593) and index Gesundheitsökonomie Medical economics Gesundheitswesen (DE-588)4020775-4 gnd rswk-swf Gesundheit (DE-588)4020754-7 gnd rswk-swf Gesundheitsökonomie (DE-588)4130935-2 gnd rswk-swf Gesundheitspolitik (DE-588)4113743-7 gnd rswk-swf (DE-588)4123623-3 Lehrbuch gnd-content Gesundheitsökonomie (DE-588)4130935-2 s Gesundheitspolitik (DE-588)4113743-7 s 1\p DE-604 Gesundheit (DE-588)4020754-7 s 2\p DE-604 Gesundheitswesen (DE-588)4020775-4 s 3\p DE-604 Goodman, Allen C. 1947- Verfasser (DE-588)111468906 aut Stano, Miron Verfasser aut http://www3.ub.tu-berlin.de/ihv/001703614.pdf Inhaltsverzeichnis HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016153580&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis 1\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk 2\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk 3\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk |
| spellingShingle | Folland, Sherman Goodman, Allen C. 1947- Stano, Miron The economics of health and health care Gesundheitsökonomie Medical economics Gesundheitswesen (DE-588)4020775-4 gnd Gesundheit (DE-588)4020754-7 gnd Gesundheitsökonomie (DE-588)4130935-2 gnd Gesundheitspolitik (DE-588)4113743-7 gnd |
| subject_GND | (DE-588)4020775-4 (DE-588)4020754-7 (DE-588)4130935-2 (DE-588)4113743-7 (DE-588)4123623-3 |
| title | The economics of health and health care |
| title_auth | The economics of health and health care |
| title_exact_search | The economics of health and health care |
| title_exact_search_txtP | The economics of health and health care |
| title_full | The economics of health and health care Sherman Folland ; Allen C. Goodman ; Miron Stano |
| title_fullStr | The economics of health and health care Sherman Folland ; Allen C. Goodman ; Miron Stano |
| title_full_unstemmed | The economics of health and health care Sherman Folland ; Allen C. Goodman ; Miron Stano |
| title_short | The economics of health and health care |
| title_sort | the economics of health and health care |
| topic | Gesundheitsökonomie Medical economics Gesundheitswesen (DE-588)4020775-4 gnd Gesundheit (DE-588)4020754-7 gnd Gesundheitsökonomie (DE-588)4130935-2 gnd Gesundheitspolitik (DE-588)4113743-7 gnd |
| topic_facet | Gesundheitsökonomie Medical economics Gesundheitswesen Gesundheit Gesundheitspolitik Lehrbuch |
| url | http://www3.ub.tu-berlin.de/ihv/001703614.pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016153580&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT follandsherman theeconomicsofhealthandhealthcare AT goodmanallenc theeconomicsofhealthandhealthcare AT stanomiron theeconomicsofhealthandhealthcare |
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