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lecture9_2_07_11_large - LECTURE 9: Health Care Systems and...

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Unformatted text preview: LECTURE 9: Health Care Systems and Health Insurance Were now beginning a series of lectures on the supply of health An important focus of these lectures and readings will be on how supply-side incentives are (or are not) aligned with good population health We will examine these incentives at the macro-level (what incentives do politicians face to improve population health) and at the micro-level (what incentives do organizations and individuals working within health care systems face). Additionally, we will spend a lecture not on incentives to provide existing health technologies or services, but incentives for the development of new technologies as well. Today we will briefly consider the logic (and some logical problems) of a major WHO effort to evaluate health care systems and then turn to conceptual and empirical issues in developing country health insurance Around 2000, the World Health Organization undertook an ambitious project to assess the performance of health systems around the world The work was poorly received for a number of legitimate reasons (but it may nevertheless have been productive in generating healthy debate and more serious analytic study) Spotty (at best) underlying data for analysis, lots of unrepresentativeness and imputation Controversial technical approach Judgment required in defining health systems and specifying criteria for evaluation I dont care about you knowing the specifics of the World Health Report 2000, but it raises some important background issues: What are the objectives of a health care system? What are the objectives of health systems? The WHR 2000 says: (1) Improve health (2) Respond to peoples expectations (non-health aspects of medical care) (3) Provide financial protection against the costs of ill-health We will consider this (via health insurance) in greater detail today Emphasis on both level and distribution Can these objectives be used to evaluate health care systems? Consider the first objective: Assume two countries with two identical populations, each with heterogeneous preferences for trading-off health with other things and hence heterogeneous preferences for health spending Country 1 allows choice of health spending, Country 2 doesnt Same health spending in both, higher welfare in Country 1, but better health in Country 2: H 1 <H 2 (courtesy of Alan Garber) Health Spending, Country 1 Health Health is Low Spending Group is High Spending Group Average Health H 1 Average Health H 2 Same average health spending as in Country 1 Health Spending, Country 2 Can these objectives be used to evaluate health care systems? Consider part of the third objective: Fair financing the risks that each household faces due to the costs of the health system are distributed according to ability to pay rather than to the risk of illness For a given amount of desired redistribution from the wealthy to the poor, it is...
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This note was uploaded on 03/19/2011 for the course ECON 127 taught by Professor Staff during the Winter '11 term at Stanford.

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lecture9_2_07_11_large - LECTURE 9: Health Care Systems and...

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