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Health Economics and Financing: Fundamentals and Flow of Funds

Author: Getzen, Thomas E.

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  • ISBN: 9780471772590
  • Author: Getzen, Thomas E.
  • Publ Date: 2007-08-31
  • Edition: 3
  • Pages: 496
  • Imprint: WILEY *#
  • Status: O/P
  • ID - 5958

Table of Contents :

Preface. Acknowledgments. About the Author. Foreword. 1 Terms of Trade: The Flow of Funds Through the Health Care System. 1.1 WHAT IS ECONOMICS? 1.2 THE FLOWOF FUNDS. 1.3 QUALITY. 1.4 PUBLIC OR PRIVATE CHOICES. 1.5 RESEARCH. 1.6 TIME. 1.7 ECONOMIC PRINCIPLES AS CONCEPTUAL TOOLS. 1.8 HEALTH PRINCIPLES. 1.9 HEALTH AND THE ECONOMY. 2 Demand and Supply. 2.1 NEED VERSUS DEMAND. 2.2 THE DEMAND CURVE. 2.3 MARGINAL REVENUE. 2.4 IS MONEY THE ONLY PRICE? 2.5 SUPPLY: INPUTS AND PRODUCTION FUNCTIONS. 2.6 MARKETS. 2.7 THE PRODUCTION OF HEALTH. 2.8 EFFICIENCY. 3 Cost-Benefit and Cost-Effectiveness Analysis. 3.1 COST-BENEFIT ANALYSIS IS ABOUT MAKING CHOICES. 3.2 MAXIMIZATION: FINDING THE OPTIMUM. 3.3 MEASURING BENEFITS. 3.4 MEASURING COSTS. 3.5 EVIDENCE-BASED MEDICINE. 3.6 THE VALUE OF LIFE. 3.7 QUALITY-ADJUSTED LIFE YEARS (QALYs). 3.8 PERSPECTIVES: PATIENT, PAYER, GOVERNMENT, PROVIDER, SOCIETY. 4 Health Insurance: Financing Medical Care. 4.1 METHODS FOR COVERING RISKS. 4.2 INSURANCE: THIRD-PARTY PAYMENT. 4.3 RISK AVERSION. 4.4 ADVERSE SELECTION. 4.5 MORAL HAZARD. 4.6 TAX BENEFITS. 4.7 EFFECTS OF HEALTH INSURANCE ON LABOR MARKETS. 4.8 HISTORY OF HEALTH INSURANCE. 4.9 FINANCING HEALTH CARE: INSURANCE AS A FUNDING MECHANISM. 5 Insurance Contracts and Managed Care. 5.1 TYPES OF INSURANCE PLANS. 5.2 HSA's, MEDICAL SAVINGS ACCOUNTS AND "CONSUMER-DRIVEN HEALTH PLANS." 5.3 A RANGE OF RISK BEARING: FIXED PREMIUMS, ADMINISTERED SERVICES ONLY, AND SELF-INSURANCE. 5.4 MANAGED CARE PLANS. 5.5 THE RANGE OF MANAGED CARE PLANS. 5.6 IS MANAGED CARE THE SOLUTION TO RISING COSTS? 5.7 MANAGED COMPETITION: THE ENTHOVEN PLAN. 5.8 INCENTIVES-TO PATIENTS, TO PAYERS, AND TO PROVIDERS. 6 Physicians. 6.1 FINANCING PHYSICIAN SERVICES: REVENUES. 6.2 PHYSICIAN INCOMES. 6.3 PHYSICIAN FINANCING: EXPENSES. 6.4 THE TRANSACTION BETWEEN DOCTOR AND PATIENT. 6.5 UNCERTAINTY. 6.6 LICENSURE: QUALITY OR PROFITS? 7 Medical Education, Organization, and Business Practices. 7.1 MEDICAL EDUCATION. 7.2 THE ORIGINS OF LICENSURE AND LINKAGE TO MEDICAL EDUCATION. 7.3 ADJUSTING PHYSICIAN SUPPLY. 7.4 GROUP PRACTICE: HOWORGANIZATION AND TECHNOLOGY AFFECT TRANSACTIONS. 7.5 KICKBACKS, SELF-DEALING, AND SIDE PAYMENTS. 7.6 PRICE DISCRIMINATION. 7.7 PRACTICE VARIATIONS. 7.8 INSURANCE, PRICE COMPETITION, AND THE STRUCTURE OF MEDICAL MARKETS. 8 Hospitals. 8.1 FROMCHARITABLE INSTITUTIONS TO CORPORATE CHAINS: DEVELOPMENT OF THE MODERN HOSPITAL. 8.2 HOSPITAL FINANCING: REVENUES. 8.3 HOSPITAL FINANCING: EXPENSES. 8.4 FINANCIAL MANAGEMENT AND COST SHIFTING. 8.5 HOWDO HOSPITALS COMPETE? 8.6 ORGANIZATION:WHOCONTROLS THE HOSPITAL AND FOR WHAT ENDS? 9 Management and Regulation of Hospital Costs. 9.1 WHY DO SOME HOSPITALS COST MORE THAN OTHERS? 9.2 HOWMANAGEMENT CONTROLS COSTS. 9.3 CONFLICT BETWEEN ECONOMIC THEORY AND ACCOUNTING MEASURES OF PER UNIT COST. 9.4 ECONOMIES OF SCALE. 9.5 QUALITY AND COST. 9.6 CONTROLLING HOSPITAL COSTS THROUGH REGULATION. 10 Long-Term Care. 10.1 DEVELOPMENT OF THE LONG-TERM CARE MARKET. 10.2 DEFINING LTC: TYPES OF CARE. 10.3 MEDICAID: NURSING HOMES AS A TWO-PART MARKET. 10.4 CERTIFICATE OF NEED: WHOSE NEEDS? 10.5 CASE-MIX REIMBURSEMENT. 10.6 SUBSTITUTION. 10.7 FINANCIAL REIMBURSEMENT CYCLES. 10.8 CONTINUING CARE RETIREMENT COMMUNITIES AND THE WEALTHY ELDERLY. 10.9 THE EFFECTS OF AGING ON COST AND UTILIZATION. 11 Pharmaceuticals. 11.1 PHARMACEUTICAL REVENUES: SOURCES OF FINANCING. 11.2 USES OF FUNDS. 11.3 HISTORY AND REGULATION OF PHARMACEUTICALS. 11.4 RESEARCH AND DEVELOPMENT. 11.5 PHARMACOECONOMICS AND OUTCOMES RESEARCH. 11.6 INDUSTRY STRUCTURE AND COMPETITION. 11.7 TRENDS: FORM FOLLOWS FUNCTION (AND MONEY). 12 Capital Financing And Ownership of Health Care Providers. 12.1 WHAT IS CAPITAL FINANCING? 12.2 VALUE AND RATE OF RETURN. 12.3 UNCORRELATED (INDEPENDENT) AND CORRELATED (SYSTEM) RISKS. 12.4 OWNERSHIP AND AGENCY. 12.5 CAPITAL FINANCING: HOSPITALS. 12.6 WORKING CAPITAL AND THE CASH FLOWCYCLE. 12.7 HMO OWNERSHIP AND CAPITAL MARKETS: SIGNS OF FAILURE. 13 Macroeconomics of Medical Care. 13.1 WHAT ISMACRO? 13.2 THE CONSUMPTION FUNCTION. 13.3 ADJUSTING TO CHANGE: DYNAMICS. 13.4 FORECASTING FUTURE HEALTH EXPENDITURES. 13.5 COST CONTROLS: SPENDING GAPS AND THE PUSH TO REGULATE. 13.6 WORKFORCE DYNAMICS: "SPENDING" IS MOSTLY LABOR. 14 The Role of Government. 14.1 GOVERNMENT HEALTH FINANCING. 14.2 THE ROLES OF GOVERNMENT. 14.3 LAWAND ORDER. 14.4 PUBLIC GOODS AND EXTERNALITIES. 14.5 MARKET FAILURE. 14.6 INCOME REDISTRIBUTION AND CARE OF THE POOR. 14.7 HOWGOVERNMENTWORKS. 14.8 PROS AND CONS OF REGULATION AND COMPETITION. 15 Public Goods and Public Health. 15.1 CHARACTERISTICS OF PUBLIC GOODS. 15.2 INFORMATION. 15.3 THE THEORY OF PURE PUBLIC GOODS. 15.4 INFECTIOUS DISEASE EXTERNALITIES. 15.5 SEX, DRUGS, ANDWAR: PUBLIC HEALTH IN ACTION. 16 History, Demography, and the Growth of Modern Medicine. 16.1 ECONOMIC GROWTH HAS DETERMINED THE SHAPE OF HEALTH CARE. 16.2 BIRTH RATES, DEATH RATES, AND POPULATION GROWTH. 16.3 THE STONE AGE. 16.4 THE AGRICULTURAL AGE. 16.5 THE INDUSTRIAL AGE. 16.6 THE INFORMATION AGE. 16.7 INCOME AND HEALTH. 16.8 REDUCING UNCERTAINTY: THE VALUE OF LIFE AND ECONOMIC SECURITY. 16.9 THE RISE OF MEDICAL TECHNOLOGY. 17 International Comparisons of Health and Health Expenditures. 17.1 WIDE DIFFERENCES AMONG NATIONS. 17.2 MICRO VERSUS MACRO ALLOCATION: HEALTH AS A NATIONAL LUXURY GOOD. 17.3 CAUSALITY: DOES MORE SPENDING IMPROVE HEALTH? 17.4 LOW-INCOME COUNTRIES. 17.5 MIDDLE-INCOME COUNTRIES. 17.6 HIGH-INCOME COUNTRIES. 17.7 INTERNATIONAL TRADE IN HEALTH CARE. 18 Value for Money in the Future of Health Care. 18.1 FORCING THE QUESTION:WHOGETS HEALTHY ANDWHO GETS PAID? 18.2 SPENDING MONEY OR PRODUCING HEALTH? 18.3 ALLOCATION, ALLOCATION, ALLOCATION. 18.4 DYNAMIC EFFICIENCY. 18.5 THE FUTURE. Glossary. Index.

Description:

A primer for the economic analysis of medical markets, this book utilizes a flow of funds approach to investigate the sources and uses of financing as well as the incentives and organizational structure of the health care system. It then takes a wider macroeconomic perspective in order to explore the dynamics of change within the health care system, and to explicitly consider determinants of national health spending and the role of governments in public and private health.

Author Biography:

Thomas E. Getzen is Professor ofRisk, Insurance andHealthManagement atTempleUniversity and the founder and Executive Director of iHEA, the International Health Economics Association. After receiving an undergraduate degree in literature from Yale University, he worked for the U.S.P.H.S. Centers for Disease Control Venereal Disease program in New York and Los Angeles, and then obtained an MHA degree in Medical Care Organization and Ph.D. in Economics from the University of Washington. Dr. Getzen's main research contributions have been in the areas of contracting, price indexes and forecasting of health care spending. His consulting work has included employee benefit negotiations, laboratory diagnostics, risk assessment, and capital financing for managed care. Dr. Getzen has been a visiting professor at the University of York (U.K.), theWharton School of the University of Pennsylvania, and the Center for Health and Wellbeing of the Woodrow Wilson School at Princeton University. He has served on the boards of Covenant House, a local community health center in Northwest Philadelphia, MSI Inc, a venture-capital financed managed behavioral health care corporation, Catholic Health East (CHE), a multi-institutional health provider system with over 60 hospitals and nursing homes. Dr. Getzen has written more than 80 papers in the field and serves on the editorial board of the journal Health Economics.


 

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