Health Economics and Financing

ISBN-10: 1118184904
ISBN-13: 9781118184905
Edition: 5th 2013
Authors: Thomas E. Getzen
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Description: Getzen’s 5th edition of Health Economics and Financing is a primer for the economic analysis of medical markets that engages the central economic issues of the health economics and financing field. It provides principles and concepts of health  More...

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Book details

List price: $202.99
Edition: 5th
Copyright year: 2013
Publisher: John Wiley & Sons, Limited
Publication date: 8/9/2013
Binding: Hardcover
Pages: 496
Size: 7.25" wide x 10.00" long x 0.75" tall
Weight: 2.244
Language: English

Getzen’s 5th edition of Health Economics and Financing is a primer for the economic analysis of medical markets that engages the central economic issues of the health economics and financing field. It provides principles and concepts of health economics rather and limited research methods, use of attribution, footnotes and references. Furthermore, this edition offers a strengthened macro section along with additional material on the ACA (Health Reform) as it is such a relevant topic today.

Preface
Acknowledgments
About the Author
Foreword
Choices: Money, Medicine and Health
Questions
What Is Economics?
Terms of Trade
Value
Can We Pay Somebody to Care?
Financing Health Care
Full Cost: Paying For Medical Care
The Flow of Funds
Health Care Spending in the United States
Sources of Financing
Health Care Providers: The Uses of Funds
Economic Principles As Conceptual Tools
Scarcity (Budget Constraints)
Opportunity Cost
Willingness to Pay
Trade
Money Flows in a Circle
The Margin: What Matters?
Maximization: Marginal Costs and Marginal Benefits
Choice: Are Benefits Greater Than Costs?
Investment
Contracts: Complex Exchanges to Deal with Timing and Risk
Organizations Adapt and Evolve
Distribution: Who Gets What
Health Disparities
Whose Choices:� Personal, Group or Public?
Social Science and Rational Choice Theory
Suggestions for Further Reading
Summary
Problems
Endnotes
Demand and Supply
Questions
The Demand Curve
The Diamonds?Water Paradox: An Example of Marginal Analysis
Consumer Surplus: Marginal versus Average Value of Medicine
Ceteris Paribus
Individual, Firm, and Market Demand Curves
The Supply Curve
Marginal Revenue
Price Sensitivity
Price Elasticity and Marginal Revenue
Price Discrimination
Is Money the Only Price?
Inputs and Production Functions
Production Functions
Marginal Productivity
Markets: The Intersection of Demand and Supply
Need versus Demand
How Much is a Doctor Visit Worth?
The Demand for Medical Care is Derived Demand
The Demand for Health: What Makes Medical Care Different
The Determinants of Health
Efficiency
Suggestions for Further Reading
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Problems���
Endnotes
Cost?benefit And Cost-Effectiveness Analysis
Questions
Cost?Benefit Analysis is About Making Choices
An Everyday Example: Knee Injury
Stepwise Choices:� Yes or No? How Much?
Calculating Marginal and Average Costs
Defining Marginal: What is the Decision?
Maximization: Finding the Optimum
Declining Marginal Benefits
Optimization: Maximum Net Benefits Expected Value
The Value of Life
Quality-Adjusted Life Years
Discounting Over Time
QALY League Tables
Perspectives: Patient, Payer, Government, Provider, Society
Distribution: Whose Costs and Whose Benefits?
CBA Is a Limited Perspective
CBA and Public Policy Decision Making
CBA Is a Limited Perspective/
Suggestions for Further Reading
Summary
Problems
Endnotes
Health Insurance: Financing Medical Care
Questions
Methods for Covering Risks
Savings
Family and Friends
Charity
Private Market Insurance Contracts
Social Insurance
Strengths and Weaknesses of Different Forms of Risk Spreading
Insurance: Third-Party Payment
Why Third-Party Payment?
Variability
Third-Party Transactions
Who Pays? How Much?
How Are Benefits Determined?
Risk Aversion
Adverse Selection
Moral Hazard
Welfare Losses Due to Moral Hazard
Ex Ante Moral Hazard
Tax Benefits
Effects of Health Insurance on Labor Markets
History of Health Insurance
Suggestions for Further Reading
Summary
Problems
Endnotes
Insurance Contracts And Managed Care
Questions
Sources of Insurance
Employer-Based Group Health Insurance
Medicare
Medicaid
State Children?s Health Insurance Program
Other Government Programs and Charity
The Uninsured
Contracting and Payments
Risk Bearing: From Fixed Premiums to Self-Insurance
Purchasing Medical Care for Groups
Medical Loss Ratios
Claim Processing
The Underwriting Cycle
ERISA, Taxes, and Mandated Benefits
Other People?s Money: Rising Costs and Mediocre Benefits
Consumer-Driven Health Plans: High Deductibles and Health Savings Accounts
Defined Contribution Health Plans
Managed Care
Closed-Panel Group Practice HMOs
IPA-HMOs and Open Contracts
Managed Care Contract Provisions
The Range of Managed Care Contracts: POS, PPO, HMO
Provider Networks and Legal Structure
Management: The Distinctive Feature of Managed Care
Contractual Reforms to Control Costs
Unresolved Issues: Split Incentives, Divided Loyalties
Suggestions for Further Reading
Summary
Problems
Endnotes
Physicians
Questions
Financing Physician Services: Revenues
Copayments, Assignment, and Balance Billing
Physician Payment in Managed Care Plans
Incentives: Why Differences in the Type of Payment Matter
A Progression: From Prices to Reimbursement Mechanisms
Physician Incomes
Physician Financing: Expenses
Physician Practice Expenses
The Labor versus Leisure Choice
The Doctor's Workshop and Unpaid Hospital Inputs
Malpractice
The Medical Transaction
Asymmetric Information
Agency: Whose Choices?
Uncertainty
Licensure: Quality or Profits?
How Does Licensure Increase Physician Profits?
Supply and Demand Response in Licensed versus Unlicensed Professions
How Does Licensure Improve Quality?
A Test of the Quality Hypothesis: Strong Versus Weak Licensure
Suggestions for Further Reading
Summary
Problems
Endnotes
Medical Education, Organization, and Business Practices
Questions
Medical Education
The Origins of Licensure and Linkage to Medical Education
AMA Controls Over Physician Supply, 1930?1965
Breaking the Contract: The Great Medical Student Expansion of 1970 to
Building Pressure: Fixed Domestic Graduation Rates 1980 to
Adjusting Physician Supply
The Flow of New Entrants and the Stock of Physicians
Immigration of International Medical Graduates
Growth in Non-MD Physicians
Balancing Supply and Incomes: Tracing the Past and Projecting the Future
Group Practice: How Organization and Technology Affect Transactions
Kickbacks, Self-Dealing, and Side Payments
Price Discrimination
Practice Variations
Insurance, Price Competition, and the Structure of Medical Markets
Choices by and for Physicians
Suggestions for Further Reading
Summary
Problems
Endnotes
Hospitals
Questions
From Charitable Institutions to Corporate Chains: Development of the Modern Hospital
Hospital Financing: Revenues
Sources of Revenues
Hospital Financing: Expenses
Financial Management and Cost Shifting
How Do Hospitals Compete?
Competing for Patients
Competing for Physicians
Competing for Contracts
Measuring Competitive Success
Measuring the Competitiveness of Markets
Organization: Who Controls the Hospital and for What Ends?
Suggestions for Further Reading
Summary
Problems
Endnotes
Management And Regulation Of Hospital Costs
Questions
Why Do Some Hospitals Cost More than Others?
How Management Controls Costs
Short-Run versus Long-Run Cost Functions
Uncertainty and Budgeting
Conflict Between Economic Theory and Accounting Measures of Per Unit Cost
Timing
Whose Costs?
Economies of Scale
The Hospital is a Multiproduct Firm
Contracting Out
Quality and Cost
Technology: Cutting Costs or Enhancing Quality?
Improved Efficiency Can Raise Total Spending
Hospital Charges, Costs, and Prices: Confusion and Chaos
Chargemaster and Negotiated Fees
Cost Finding: Gross Revenues and the RCCAC
Medicare as a Standard for Pricing
Controlling Hospital Costs through Regulation
Suggestions for Further Reading
Summary
Problems
Endnotes
Long-Term Care
Questions
Development of the Long-Term Care Market
Age and Health Care Spending
Defining LTC: Types of Care
Medicaid: Nursing Homes as a Two-Part Market
Certificate of Need: Whose Needs?
Money and Quality
Competing for Certificates of Need, Not for Patients
Evidence on the Effects of Certificates of Need
Cost Control by Substitution
Case-Mix Reimbursement
Long-term Care Insurance
Is Long-Term Care ?Medical??
Retirement, Assisted Living, and the Wealthy Elderly
Financial Reimbursement Cycles
Suggestions for Further Reading

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