Talk:Health economics

Overall effort

This is a pretty weak article. Past disagreements, I guess, makes people unwilling to make a serious effort. Health economics may be a low-profile academic discipline, but nevertheless concerns a huge part of the economy and deserves better than this. 82.183.209.109 02:52, 2 March 2007 (UTC)

I agree - this page is a bit weak! I've added in a reference to the Williams plumbing diagram as an introduction to the article. Would be good to have a copy of the diagram itself here, but not sure about copyright - I'll ask Macmillan if I can put a copy on here when I get around to it.

I also moved the bullets listing market types to the markets section - it seems more appropriate there, but please correct me if I'm wrong.

It'd be good to structure the whole page around the eight areas in the plumbing diagram?

Would be good to see some discussion on here. If there are no objections, I'll make more changes / additions as and when I get the time.

NB: this is my first edit to a page so please go easy on me :)

--EdW UK 14:27, 12 April 2007 (UTC)

yree

Next chance I get, I will start working on this page. I think the start is the differences between Health Economics and Economics. I think Phelps and I will have fun. Nmourfield 15:30, 31 October 2007 (UTC)

I don't think that the idealogical bias is appropriate to health care economics in general. I think a discussion into the specifics of government intervention within health care is more appropriate. Nmourfield (talk) 14:06, 15 April 2008 (UTC)

Macro analysis

Thanks for Gregalton's welcome to wikipedia. This continues to edit my first Wiki post. I've taken his advice and incorporated the phrase "population externalities" as well as two sources. This also resulted in my correcting the reference to one of the sources--thanks for that too!

The article positions health economics as fully focused on microeconomic analysis. There is a case to be made that multi-regional macroeconomic analysis can contribute significantly to assessing population externalities in healthcare impacts by including systemic interactions across regions and time, especially if conducted using high-end multi-regional equilibrium forecasting models such as REMI or REDYN.

As an example, consider analysing protocol training and tracking for chronic-persistent conditions affecting over half of all US health system costs. Large-scale results from Asheville, NC for diabetes remained robust over a five-year period as reported in the Journal of the American Pharmaceutical Association (http://japha.metapress.com/link.asp?id=m5nm6h0758753345) and as replicated in a number of cities. New York State and elsewhere corroborated these results for mental health (see New York's five year results at http://www.treatmentadvocacycenter.org/BriefingPapers/BP18.htm). If protocol training and tracking were implemented in context with single-payor resources (i.e., Medicaid, Medicare, S-CHIP, and the Veterans Administration), then it can be posited that...

[a] Demand can be reduced for general hospital services (ERs and hospital stays) and for offices of physicians, only partly offset by less expensive increased demand for clinic and pharmacy services (integrate demand changes in [a] with changes in [b.1] spending on consumer commodities to avoid double counting),

[b] Cost can be reduced [b.1] for individuals (due to reduced co-pays and insurance coverage cost due to reduced ER and physician visits, offset by increases in less expensive pharmacy and clinic visits, resulting in a net increase in disposable income available for non-health purposes), [b.2] for firms (due to reduced health benefit costs, resulting in increased opportunities for capital investment at higher or stable capital/output ratios or for job growth at stable or lower capital/output ratios), and [b.3] for government (due to reduced health benefit costs and health system financing),

[c] Productivity can be increased for the general workforce due to improved protocol outcomes driven by protocol training and tracking under single-payor financing, resulting in [c.1] reduced time lost by workers directly and by workplace team distraction and need-to-cover, and by family workforce time given to caretaking, [c.2] better skills-occupations-requirements alignment due to expanded health portability enabling an increased ability to switch and optimize jobs, [c.3] new capital investment, and [c.4] higher training ROI due to reduced worry and diversion, i.e., a Hawthorne effect, especially as boosted by a reduced benefit burden that lets employers hire proportionately more workers with more education and more vocational or workforce training.

The productivity modeling needs to account for (a) capital and labor factor substitution due to the reduced benefit cost of labor, and (b) effects from improved capital stock, increased skills alignment and training ROI, and reduced direct and secondary sick leave usage. The use of multi-regional sub-national analysis ensures domestic trade flow and commuter shed effects are captured together with regional differences in starting conditions and infrastructure. The point in citing this detail is to demonstrate that healthcare economics includes a basis for macroeconomic multi-regional systemic analysis, not only or primarily microeconomic decision analysis. (71.192.212.228 (talk) 03:37, 3 September 2008 (UTC))(71.192.212.228 (talk) 03:33, 3 September 2008 (UTC))(71.192.212.228 (talk) 00:07, 26 July 2008 (UTC))(71.192.212.228 (talk) 23:34, 25 July 2008 (UTC))(71.192.212.228 (talk) 23:26, 25 July 2008 (UTC))(71.192.212.228 (talk) 16:18, 2 May 2008 (UTC))(71.192.212.228 (talk) 16:05, 2 May 2008 (UTC))(71.192.212.228 (talk) 13:42, 30 April 2008 (UTC))(71.192.212.228 (talk) 19:11, 26 April 2008 (UTC))(71.192.212.228 (talk) 12:54, 24 April 2008 (UTC))(71.192.212.228 (talk) 21:30, 23 April 2008 (UTC)) (71.192.212.228 (talk) 20:34, 23 April 2008 (UTC))(71.192.212.228 (talk) 19:04, 23 April 2008 (UTC)) (71.192.212.228 (talk) 18:49, 23 April 2008 (UTC)) (71.192.212.228 (talk))(71.192.212.228 (talk) 13:38, 23 April 2008 (UTC))(71.192.212.228 (talk) 22:06, 22 April 2008 (UTC))

Welcome to wikipedia. The ideas above (if I understand correctly) are fine, although you need above all a source. As an alternative, I'd paraphrase and simplify to something like "Externalities in health care, such as the benefit received by the population when others are vaccinated, can have effects of a macro scale on the economy. For example, there is evidence that better health care results in the workforce receiving more education overall, which increases skills and boosts overall productivity." Just a suggestion.--Gregalton (talk) 13:23, 24 April 2008 (UTC)

Original research.

This article is full of original research. Could you please update unsourced claims accordingly of which there are many. Supposed (talk) 10:09, 12 November 2008 (UTC)

Moral hazard used contrary to meaning

In the text "Insured patients are naturally less concerned about health care costs than they would if they paid the full price of care. The resulting moral hazard drives up costs, as shown by the famous RAND Health Insurance Experiment. Insurers use several techniques to limit the costs of moral hazard, including imposing co-payments on patients and limiting physician incentives to provide costly care. Insurers often compete by their choice of service offerings, cost sharing requirements, and limitations on physicians." moral hazard is used when I can see no evidence of moral hazard. A moral hazard is when I conceal information from you in order to strike a bargain that you would refuse if you knew the information. The cited RAND article does not discuss or mention moral hazard.

Moral hazard is endemic in the US health care system. For example, you can work as a contract worker while young and single without buying expensive individual insurance, expecting to be hired by a big employer with great health care if you get sick knowing that your pre-existing conditions will be covered at the low group rate.

But if you are told you should spend $1000 out of pocket for a colonoscopy because you have a 2% chance of requiring $100,000 in cancer treatment for which $95,000 will be paid by your catastrophic coverage, refusing the treatment is not a moral hazard. Both the insurer who doesn't set the price low enough for the colonoscopy under its rate schedule, and the patient, roll the dice hoping for the 98% chance it isn't needed.

Now I know that conservatives in particular have latched onto the term moral hazard as a vague allegation that any government involvement in health care is immoral like thou shalt not steal or commit adultery, but that is political rhetoric, not objective description of a term which has a fairly precise meaning in the insurance and securities underwriting field. Mulp (talk) 20:41, 8 May 2009 (UTC)

It occurs to me that Moral Hazard applies in two directions. Under those few countries that apply the "science" of health economics - that is the UK only - a decision has been made to put a price against the continuing life of a human being. This allows institutions such as Nice to prevent the prescription of treatments that are known to be more effective if the marginal cost of the drug is higher than the defined price. This therefore removes from the NHS the Moral Hazard of restricting treatments to patients in the sure knowledge that this will cause a reduced standard of life and a shortened life span.

Could I suggest that the complexity of the formulae used in calculating the acceptability hides the fact that a moral judgement has been made on the value of a human life and that as the calculation of a value of a life is no way a scientific one then Health Economics is itself in no way a science. Clientscope (talk) 11:07, 20 December 2011 (UTC)

human capital versus health capital

How are human and health capital related to each other? how do they differ from each other? —Preceding unsigned comment added by Kapset 69 (talk • contribs) 17:02, 31 October 2009 (UTC)