ECONOMICS 2231: HEALTH ECONOMICS (FALL 2014)

Transcription

1 LAKEHEAD UNIVERSITY DEPARTMENT OF ECONOMICS ECONOMICS 2231: HEALTH ECONOMICS (FALL 2014) Instructor: L. Di Matteo Office: RC3016E Class: Wednesdays & Fridays, 11:30-1:00 pm. Office Phone: Fax: Office Hours: Tuesdays and Thursdays, 3:00pm-4:000pm A. INTRODUCTION The accessibility, effectiveness and sustainability of public health care is an important Canadian public policy issue. This course is an introduction to the economic and policy analysis of health care. The basic economic concepts of scarcity, opportunity cost, demand, supply and markets are introduced and applied to the provision of health care services, consumer and producer behaviour, and other assorted policy issues including health care reform. B. LEARNING OUTCOMES The outcomes of this course include: knowledge of the tools of economic analysis and policy and how they can be applied to health issues understanding how economists and policy analysts approach health care acquisition of basic tools of economic evaluation in health: cost-benefit analysis, cost analysis and cost-effectiveness analysis. knowledge of models of health capital and demand for health insurance knowledge of parameters of the health care reform debate institutional and empirical knowledge of the Canadian health care system understanding the drivers of health care spending and fiscal sustainability. 1

2 C. TEXTS AND RESOURCE MATERIALS: Text Jeremiah E. Hurley, Health Economics, 1st Edition, McGraw-Hill Ryerson, Required. Other Resources: Many of the articles and reports referred to in this course outline are available either on the web or electronically via the e-journals section of the LU library web site. As well, there are materials on this reading list available on the web at various health ministry sites. An important site is the Canadian Institute for Health Information at Students may also wish to make use of various health economics resources at York University, UK, at or at McMaster's Centre for Health Economics and Policy Analysis (CHEPA) at Other health economics and policy web sites: Canadian Association for Health Services and Policy Research: Centre for Health Services and Policy Research (CHSPR), University of British Columbia, Canada: Manitoba Centre for Health Policy: Health Canada, Canada: Ontario Ministry of Health and Long-Term Care, Canada: Ontario Ministry of Health Reports are available at: Canadian Medical Association Journal, Canadian Health Services Research Foundation, Health Evidence Network, Course Slides Available on Course Web Site on Desire To Learn: (2014F) ECON-2231-FA Health Economics D. GRADING: Two term in-class term tests: 2 X 25% One final exam: 1 X 50% 2

3 E. COURSE MODULES/TOPICS: **denotes required text reading. 1. Introduction to Health Economics and Policy What is health economics? An overview of the Canadian health expenditure system and the evolution of the Canadian health care system. Health Insurance, Hospital Insurance and Diagnostic Services Act, Medicare, Established Program Financing, Canada Health Act, Canada Health and Social Transfers. **Jeremiah Hurley (2010) Chapter 1. Health Economics, 1 st edition, Pp Canadian Institute for Health Information (2012) Health Care in Canada Canadian Institute for Health Information (2013) National Health Expenditure Trends, Fundamentals of Economic Analysis Scarcity, opportunity cost, demand, supply, market equilibrium, elasticity. The firm, production, cost, competitive markets. **Jeremiah Hurley (2010) Chapters 2,3 pp Di Matteo, L. (2014) Fundamentals of Economic Analysis for Health. 3. Public Economics, Externalities and Health Market failure, public intervention, roles of government in health, the economic case for public health programs. Di Matteo, L. (2003) Principles of Public Finance for Health Economics and Public Health. 4. Tools of Economic Evaluation Economic evaluation of health care services; cost-effectiveness analysis; quality-adjusted life-years and healthy year equivalent. **Jeremiah Hurley (2010) Chapter 4, pp The Demand for Health Capital and Health Insurance Health production, health consumption, moral hazard, asymmetric information, public versus private provision, public versus private health insurance; economic models of physician behaviour. **Jeremiah Hurley (2010), Chapters 5-9. Pp

4 6. Determinants of Health Expenditures Evidence for Canada and its provinces, international comparisons. Is health care a luxury or a necessity? Are health expenditures out of control? Controlling health care expenditures. Canadian Institute for Health Information (2011) Health Care Cost Drivers: The Facts. Di Matteo, L. and R. Di Matteo (1998) "Evidence on the determinants of Canadian provincial government health expenditures: ," Journal of Health Economics, 17, Di Matteo, L. (2005) The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time, Health Policy, 71,1, Fiscal Sustainability of Health Care Defining and measuring fiscal sustainability. Solutions to sustainability. Case Study: Public Health Care in Alberta **Jeremiah Hurley (2010), Chapter 16, Pp Livio Di Matteo (2010) The Sustainability of Public Health Expenditures: Evidence from the Canadian Federation, European Journal of Health Economics, 11,6, Livio Di Matteo and Rosanna Di Matteo (2009) The Fiscal Sustainability of Alberta s Health Care System. SPS Research Paper: The Health Series, The School of Public Policy, University of Calgary, Volume 2, Issue2, March G.P. Marchildon, T. McIntosh and P.G. Forest, eds. (2004) The Fiscal Sustainability of Health Care in Canada. Romanow Papers Volume 1. University of Toronto Press. Ruggeri, J. (2006) Health Care Spending, Fiscal Sustainability, and Public Investment Saskatchewan Institute of Public Policy, Public Policy Paper No Health Care Reform Is there a need to reform health care in Canada? Can we create a system that provides good care to all, provides care efficiently and is publicly funded? Are user fees the answer? Public vs private care. The Romanow Commission and its aftermath. Armstrong, P., H. Armstrong & C. Fuller (2000) Health Care, Limited The Privatization of Medicare. A Synthesis Report Prepared by the CCPA. Fooks, C. and S. Lewis (2002) Romanow and Beyond: A Primer on Health Reform in Canada. Canadian Policy Research Networks, Discussion Paper no

5 Di Matteo, L. (2008) Policy Choice or Economic fundamentals: What Drives the Public- Private Health Expenditure Balance in Canada, Health Economics, Policy and Law, 4,1, Getting Our Money s Worth (2008) Report of the Task Force on the Funding of the Health System. Quebec. February. Romanow, R.J. (2002) Building on Values: The Future of Health Care in Canada. Commission on the Future of Health Care in Canada. 9. Miscellaneous Additional Topics Drugs and Home Care What are the trends in drug expenditure in Canada? What are the determinants of provincial government drug expenditures? Provincial government drug plans. The determinants of home care spending. **Jeremiah Hurley (2010), Chapter 15, Pp Di Matteo, L. and P. Grootendorst (2007) The Effect of Pharmaceutical Patent Term Length on Research and Development and Drug Expenditures in Canada, Health Care Policy, 2,3 pp Di Matteo, L. and P. Grootendorst (2002) "Federal Patent Extension, Provincial Policies and Drug Expenditures: " Canadian Tax Journal. Di Matteo, L. and R. Di Matteo (2000) "Public Homecare Expenditures in Canada" Canadian Public Policy. The U.S. Health Care System & Its Reform Why does the United States spend more on health care than Canada? Is the U.S. health care system "better"? Whatever happened to the Clinton Plan? The Obama Plan? Giovannelli, J., K.W. Lucia & S. Corlette (2014) Implementing the Affordable Care Act: State Action to Reform the Individual Health Insurance Market, The commonwealth fund. National Health Expenditure Data, Centers for Medicare and Medicaid Services Reports/NationalHealthExpendData/index.html Orszag, Peter R. (2008) Growth in Health Care Costs. CBO Testimony before the Committee on the Budget, United States Senate, January