《健康经济学》课件Chapter1.ppt

1、Why is health economics interesting?The U.S.health care economy is massive and expensive.Health is a major source of uncertainty and risk.Governments around the world are deeply involved in financing health systems.The U.S.health care economy is massive and expensiveThe U.S.GDP in 2008 was approxima

2、tely$14 trillion.One out of every six dollars spent in the U.S.that year was spent on health care.In 1960,barely one dollar out of every twenty spent in the U.S.went toward health care.The trend has been similar in countries around the world,but no country spends quite as much on health care as the

3、U.S.What do we get for all this money?Health care expenditures in the USHealth is uncertain and contagiousThe health economy may be huge,but how is it different from other,smaller markets like the market for bananas and the market for televisions?Two interesting economic propertiesUncertainty:most p

4、eople can predict how many bananas or TVs they will buy in the next week,but not how many emergency heart surgeries they will need in the next week.Contagiousness:it doesnt matter to you if your neighbor buys a banana or a TV,but it does matter if he skips his flu shot.Uncertainty and insuranceAn un

5、foreseen broken leg or heart attack can suddenly create demand for expensive health care services.Because most people are risk averse,health-related uncertainty motivates individuals to demand health insurance.This in turn creates problems that arise in insurance markets:adverse selection and moral

6、hazard.These two phenomena are what make health policy really difficult(and really interesting).Contagiousness and externalitiesThe fact that other peoples health decisions affect you creates externalitiesExamples:Vaccinations and other preventative measures create positive externalitiesGoing out in

7、 public with Ebola virus creates negative externalitiesExternalities undermine the efficient function of markets and often require government intervention.Health economics=public financeGovernments play a huge role in health markets because of the features just discussed.In countries like the United

8、 Kingdom,Sweden,and Canada,the government is responsible for the vast majority of health care expenditures.Even in the US,with its private health care system,the government is responsible for half of all health care spending.Health care is only getting bigger and more expensive for governments and t

9、axpayersIncreasing life expectancies and graying populations throughout the developed world will place stress on public health insurance systems.Governments will have to cope with ongoing questions about whether to pay for expensive new medical technologies.Given these trends we can confidently expe

10、ct healthcare to be an ever-growing line item on governmentbalance sheets.Positive vs normative questionsNormative questionsDoes everyone deserve access to health care,even if they cannot pay?Should people be compelled to purchase insurance?When is it ethical to deny care to a dying patient?Should t

11、he government ban certain unhealthy foods?Positive questionsHow much would it cost to provide free checkups and drugs for everyone in a population?Do strict patent protections for new drugs spur innovation?How much would consumers save if doctors were not required to have medical degrees or medical

12、licenses?Would a tax on saturated fat make a nation healthier?Economic reasoning cannot answer normative questions,but it can answer positive questions,and that can help us form opinions about normative questions.The unique US health care marketIn the U.S.,patients sometimes pay out of pocket for ro

13、utine health care,like flu shots and health check ups.In many other countries,including Canada and the United Kingdom,patients almost never pay out of pocket when they receive basic health care.In the U.S.,some people are not eligible for government insurance and cannot afford(or do not want)to buy

14、private insurance.In almost all developed countries,uninsurance is extremely rare or even nonexistent.Insurance is either provided for free by the government,or provided by a mix of public and private insurers.The unique US health care marketEven though the US market is unique in this way,much of ou

15、r empirical evidence will come from the US.This allows us to understand the maladies that can occur in private markets for health care:adverse selection,moral hazard,and monopolistic firms.Understanding these problems is critical to understanding why other countries approach health policy in radically different ways.