法学夏令营个人陈述
health care financing and management
syllabus, spring 2014, yan feng
health care financing and management
hsbc business school peking university instructor: feng, yan
room407, building c, hsbc business school
fengyan@phbs.pku.edu.cn
class hours: april 25th to june 24th
tuesdays and fridays
3:30pm-5:20pm
classroom: c102
office hours: wednesdays 2:00pm-4:00pm, or by appointment.
teaching assistant: tbd
1. course overview arrow highlighted the prevalence of uncertainty in health care markets: physicians are
uncertain about how to treat patients, especially when medical technology is changing so rapidly; patients are uncertain about the effectiveness of medical treatment; and consumers and health plans are uncertain about the appropriateness and quality of providers’ services.
economic models explain some but by no means all consumer and producer behaviors in the medical services sector, and as for making health care policies, the economic concept of efficiency is a helpful criterion but not the only criterion for judging the desirability of alternative arrangement (e.g., distributions and redistributions). given the uneasy balance of efficiency and equality/equity, there is by no means a best health care system suitable for every society, which is especially true for a developing economy like china. in this class we will discuss why standard economic models of behavior and efficiency sometimes work and matter and sometimes do not in this industry. we are going to discuss the available information related but not limited to the following questions: do people behave in ways that are or could be made to be efficient (and equitable)? how much inefficiency is there in this industry and what are the causes? how is health care usually financed in a society? and how might a country better manage its resources dedicated to improving the health of its population?
the main context of this course is: (1) to consider the economic analysis of the medical care sector, namely how medical care is provided and financed; (2) to explore the implication of market failures in health care market such as moral hazard, adverse selection, and externality; and (3) to help you get informed with the making of health policies and how different health system evolved and developed, and also to discuss various reform ideas.
comments and questions in class are strongly encouraged. things that seem confusing or controversial are usually that way for many students; everyone will benefit if you ask questions. and because the class will deal with policy, there is a lot of room for honest feedback and constructive disagreement. no one knows the complete answer, or even the right answer, to many of the questions that will be raised in the classes. we do not set out to find the perfect answers, in different context, a solution may have quite ambiguous delivery and effect. however, if you do not think you can tolerate the fact that most of the discussion will be from the point of view of economists and will seem to be somewhat detached (that is, not from the point of view of a beneficiary or a kind-hearted philanthropist), then you probably shouldn’t be taking this class. 2. course requirements requirements ? students are suggested and expected to read all assigned readings or notes before each class; ??any submitted work should be typed, using 12-pitch font size and times new roman or arial type (no fancy fonts, please), double-spaced, and with no more than one-inch margins; submitted work can be hard copies (dropped in my mailbox before deadlime) or electronic versions, attention to english grammar and clarity of writing
are expected;
??assignments, if any, are expected to be turned in before deadline. late submission will be graded as “0” unless permission from the professor is granted in advance
under special circumstances.
coursework
there is no regular homework for this class, but you will be requested to write a term paper on a health topic that is of interest to you, it does not have to be an academic research paper. the paper should be at least 8 pages long (single-sided), but not exceeding 12 pages. you
may use materials from the class, journal articles, magazine and newspaper articles, and the internet to support your argument in your paper, but there should be no copying and pasting from the original materials. the format should be consistent with the course requirement. the deadline for turning in the paper is june 28th, 5:30pm sharp.
grading(tentative)
class participation
term paper
midterm exam (closed book)
final exam (closed book)
3. course materials 10% 30% 30% 30%
students are not required to buy books for this class. however, i do recommend 2 books as reference. coming to the classes prepared and taking necessary notes will be the most efficient and beneficial way of acquiring a broad and systematic understanding of the topics. 2
recommended books
? charles e. phelps, health economics, addison-wesley series in economics, 4th edition, 2014
??sherman folland, allen goodman, and miron stano, the economics of health and health care, prentice hall, 6th edition, 2014
in addition, “handbook of health economics”, edited by a.j. culyer and joseph p
newhouse (volume a and b, elsevier science, 2014, will be a great reference if you are seriously interested in research in health care related issues.
additional readings
readings are listed for each topic, all of which are strongly recommended for the students to master the comprehensive original discussion.
4. class schedule
due to the scheduled amount of teaching hours, in this class, we will be covering the most basic and most important topics, which include several subtopics. there may be certain topics not covered during this time period that you are interested to know, i suggest the students to find the answers in the reading materials and the books, and to utilize other public sources for updated debates regarding health care issues.
topic 1 introduction: what’s different about medical care? overview of the
health care market
readings
arrow, kenneth, 1963, "uncertainty and the welfare economics of
medical care," the american economic review 53(5): 941-973.
the demand for medical care and health topic 2
readings
grossman, michael, 1972, "on the concept of health capital and the
demand for health," the journal of political economy 80(2): 223-255.
dardanoni, valentino and adam wagstaff, 1987, "uncertainty,
inequalities in health and the demand for health," journal of health
economics 6: 283-290. (a simpler version of the grossman model is
presented in this article. you may want to read this article first).
porter, michael e. 2014, “what is value in health care?” new england
journal of medicine 363:2477-2481.3
topic 3
topic 4 mushkin, selma, 1962, "health as an investment," the journal of political economy 70(5):129-157. ellen o'brien, 2014, "employers' benefits from workers' health insurance," the milbank quarterly 81(1):5-43.financing health care: health insurance, risk pooling and moral hazardreadings pauly, mark, 1968, "the economics of moral hazard," the american economic review 58(3): 531-537.manning, willard et a1. 1987, "health insurance and the demand for medical care," the american economic review 77(3): 251-277.zeckhauser, richard, 1970, "medical insurance: a case study of trade- off between risk spreading and appropriate incentives," journal of economic theory 2(1): 10-26.rosett, richard n. and lien-fu huang, 1973, "the effect of health insurance on the demand for medical care," the journal of political economy 81(2): 281- 305.gaynor, martin et al., 2014, "are invisible hands good hands? moral hazard, competition, and the second-best in health care markets," the journal of political economy 108(5): 992-1005.ehrlich, isaac and gary becker, 1972, "market insurance, self-insurance, and self-protection," the journal of political economy 80(4): 623-648.financing health care: individual and group health insurance,
asymmetric information and risk selection
readings
akerlof, george, 1970, "the market for lemons," the quarterly journal of economics 84(3): 488-500.
cutler, david and richard zeckhauser, 2014, "the anatomy of health
insurance," in handbook of health economics, vol. 1a, chapter 11: 606- 629 only.
rothschild, michael and joseph stiglitz, 1976, "equilibrium in
competitive insurance markets: an essay on the economics of imperfect information,"the quarterly journal of economics 90(4): 629-650.
topic 5
topic 6 frank, richard g., jacob glazer, and thomas g. mcguire, 2014, "measuring adverse selection in managed health care," journal of health economics 19:829–854.financing health care: health care and the public sectorreadings cutler, david, 2014, "health care and the public sector," in handbook of public economics, vol. 4, chapter 31(except for sections 5&8).cutler, david and jonathan gruber, 1996, "does public insurance crowd out private insurance?" the quarterly journal of economics 111(2):391- 430.pauly, mark, 1974, "overinsurance and public provision of insurance: the roles of moral hazard and adverse selection, " the quarterly journal of economics 88(1):44-62.the supply of medical care: asymmetric information and agency,
hospitals and physicians
readings
goldstein, gerald and mark pauly, 1976, "group health insurance as a
local public good," in the role of health insurance in the health
services sector, ed. rosett, nber.
pauly, mark, 1995, "paying physicians as agents: fee for service,
capitation or hybrids?" in health care policy and regulation. kluwer, ed. t. abbott, ch9: 163-174.
ellis, randall and thomas mcguire, 1990, "optimal payment systems
for health services," journal of health economics 9:375-396.
mcguire, thomas and mark pauly, 1991, "physician response to fee
changes with multiple payers," journal of health economics 10(4): 385- 410.
pauly, mark and michael redisch, 1973, "the not-for-profit hospital as a physicians' co-operative," the american economic review 63(1): 87-
100.
newhouse, joseph, 1970, "toward a theory of nonprofit institutions: an economic model of a hospital," the american economic review 60(1):
64-74.
topic 7 topic 8 dranove, david, 1988, "pricing by non-profit institutions: the case of hospital cost-shifting," journal of health economics 7(1): 47-57.the market for pharmaceuticalsreadings scherer, f. m., 2014, "the pharmaceutical industry," in handbook of health economics, vol. 1b, chapter 25.grabowski, henry and john vernon, 2014, "the determinants of pharmaceutical research and development expenditures," journal of evolutionary economics 10:201-215.kyle, margaret, 2014, "pharmaceutical price controls and entry strategies," working paper.lichtenberg, frank, 1998, "pharmaceutical innovation, mortality reduction, and economic growth," nber working paper 6569.lichtenberg, frank r. and tomas j. philipson, 2014, "the dual effects of intellectual property regulations: within- and between-patent competition in the u.s. pharmaceuticals industry, " journal of law and economics 45(2): 643-672.health system reforms readings
burton a. weisbrod, 1991, "the health care quadrilemma: an essay on technological change, insurance, quality of care, and cost
containment," journal of economic literature 29(2):523-552.
cutler, david, 2014, "equality, efficiency, and market fundamentals: the dynamics of international medical-care reform," journal of economic
literature 40(3): 881-906.
diamond, peter, 1992, "organizing the health insurance market,"
econometrica 60(6): 1233-1254.
5. important dates
term paper due: 5:30pm june 28th
midterm: may 24th
final: tbd
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