Module: Health systems, economics and policy

Topic 8


Topic 8: Health System Reform and the Demand for Health Care

Objectives/learning outcomes

 

Students will be able to:

Recognise and understand concepts of market reform.

Critically examine health system expenditure and cost inflation data.

 


Seminar: Demand-side health system reforms: what are they and how would you critically assess them?

 

Seminar: Demand-side health system reforms: what are they and how would you critically assess them?

Class discussion. Select a health system from the health systems in transition database (http://www.euro.who.int/en/who-we-are/partners/observatory/health-systems-in-transition-hit-series) and using the summaries identify mechanisms that have been introduced to combat demand-side cost inflation.

Describe the objectives and mechanism. How would you critically examine the public health effects of the policy? 

 

Set Reading

Figueras J, Health Systems and Health Wealth, 2008 (Read it here) CHAPTER 4 ONLY.

Cutler D (2002) Equality, Efficency and Market Fundamnentals, Journal of Economic Literature. Vol XL 881-906 (Read it here)

Lecture: Cost containment and demand side reform

 

Despite enormous variation in per capita spending, health systems world-wide have undergone a series reforms in the last thirty years in response to claims about the rising costs of health care and the need to contain them. Market reforms have been widely advocated as the preferred method of cost containment on the ground that competitive markets improve cost efficiency. Reforms that target the ‘demand’ for health are known as ‘demand-side’ reforms. These reforms and the cost containment thesis are examined in this lecture.

 

The reform agenda is intensely political because it involves reductions in state intervention and challenges redistributive policy. For example, Roberts et al (2004, pp.16-17) assert: ‘The global turn to the market has brought a trend toward diminished social solidarity and a parallel turn against government action in many countries.’ Though contestable, the statement underlines the reform movement’s major implications for redistribution. The conflict between market and planned redistribution is a recurring theme in the literature

Lecture Notes and Powerpoints