Health Economics Worldwide

365 Pages·1992·7.25 MB·English

by  Joseph P. Newhouse (auth.), Peter Zweifel, H. E. Frech III (eds.)

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HEALTH ECONOMICS WORLDWIDE
.
Developments in Health Economics and Public Policy
VOLUME 1
Series Editors
Peter Zweifel, University o/Zurich, Switzerland
H.E. Frech III, University 0/ California, Santa Barbara, U.S.A.
HEALTH ECONOMICS
WORLDWIDE
Edited by
Peter Zweifel
University of Zurich, Dept. of Economics, Switzerland
and
H. E. Frech III
University of California, Dept. of Economics, U.s.A.
Springer-Science+Business Media, B.V.
Library of Congress Cataloglng-In-Publlcadon Data
Health economics worldwide/edited by Peter Zweifel, H.E. Frech III.
p. cm. - (Developments in Health Economics and Public Policy; v. 1)
Papers from the Second World Congress on Health Economics, held at
the University of Zurich, Sept. 10-14, 1990.
ISBN 978-94-010-5055-5 ISBN 978-94-011-2392-1 (eBook)
DOI 10.1007/978-94-011-2392-1
1. Medical economics - Congresses. 1. Zweifel, Peter. II. Frech, H. E. III. World
Congress on Health Economics (2nd : 1990 : University of Zurich) IV. Series.
RA410.A2H46 1991
338.4'33621-dc20 91-11942
ISBN 978-94-010-5055-5
Printed Qn acid-free paper
Ali Rights Reserved
© 1992 Springer Science+Business Media Dordrecht
Originally published by Kluwer Academic Publishers in 1992
Softcover reprint ofthe hardcover 1s t edition 1992
No part of the material protected by this copyright notice may be reproduced or
utilized in any form or by any means, electronic or mechanical,
including photocopying, recording or by any information storage and
retrieval system, without written permission from the copyright owner.
.
Table of contents
Preface vii
Sponsors ix
I. Issues in health insurance
1. Newhouse, J.P.: Pricing and imperfections in the medical care
market place 3
2. Van de Ven, W.P.M.M. and van Vliet, R.C.J.A.: How can
we prevent cream skimming in a competitive health insurance
market? The great challenge for the '90s 23
3. Khandker, R.K. and Manning, W.G.: The impact of
utilization review on costs and utilization 47
4. Pauly, M.V.: The normative and positive economics of
minimum health benefits 63
II. Criteria for allocating health care resources
1. Launois, R.: Cost-effectiveness analysis of strategies for
screening prostatic cancer 81
2. Leu, R.E., Gerfin, M., Spycher, S.: The validity of the
MIMIC health index - some empirical evidence 109
3. Butler, J.R.G.: Welfare economics and cost-utility analysis 143
III. Administrative and market allocation in health care
1. Friedman, B., Ozminkowski, R.J., Taylor, Z.: Excess
demand and patient selection for heart and liver
transplantation 161
v
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VI Table of Contents
2. Milne, R.G. and Torsney, B.: Non-price allocative
procedures: Scottish solutions to a National Health Service
problem 187
3. Iversen, T. and Nord, E.: Priorities among waiting list
patients 203
4. Frech, H.E. III, Woolley, J.M.: Consumer information, price,
and nonprice competition among hospitals 217
IV. Health care in the political arena
1. Henke, K.-D.: Cost containment in health care. Justification
and consequences 245
2. Breyer, F. and Schneider, F.: Political economy of hospital
financing 267
3. Gerdtham, U.-G., S¢gaard, J., Jonsson, B., Andersson, F.: A
pooled cross-sectional analysis of the health care expenditure
of the OECD countries 287
4. Zweifel, P. and Ferrari, M.: Is there a Sisyphus syndrome in
health care? 311
5. Lopez, E., Phillips, L., Silos, M.: Deaths from gastro
intestinal cancer in Mexico: Probable cause for water
sampling 331
Index of names 349
Index of subjects 358
.
Preface
This volume reflects both the main issues confronting health economics and
the state of the art in health economics a decade before the end of the
twentieth century. It contains a selection from almost 150 papers presented
at the Second World Congress on Health Economics, held at the University
of ZUrich, Switzerland, 10-14 September 1990. This is ten years after the
last Congress (held in Leiden, The Netherlands) and more than 17 years
after the Tokyo meeting organized by the International Economic Associ
ation (which might be called the First World Congress were it not for its
small size and symposium-like character).
Out of the 16 papers appearing in this book, only four were invited, and
they were refereed like all the others. The remaining contributions are
survivors of stiff competition. However, in spite of the large sample of papers
we were able to draw from, certain gaps of coverage persist. In particular,
environmental impacts on health were designated as a field of priority interest
in the call for papers to this Congress. Yet, not even half a dozen contribu
tions were submitted, which is remarkable in view of the intense interest of
the public in the health effects of environmental degradation, ranging from
noise level to ozone concentration. Another specially designed field was the
political economy of health, dealing with the behavior of policy makers when
deciding about changes in the health care systems. It did not attract as many
contributions as we had hoped for or expected.
The papers contained in this volume can be grouped in the following
topics:
I. Issues in health insurance
II. Criteria for allocating health care resources
III. Administrative and market allocation in health care
IV. Health care in the political arena
The reader will notice a preponderance of contributions from the U.S. in
topics I and III whereas contributions from other countries (where systems
of national health insurance and of public provision of health care are more
common) tend to be found in Sections II and IV. Thus, prevailing institu-
Vll
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viii Preface
tional arrangements seem to influence research in health economics. We join
authors in the quiet hope that the converse may become true as well: that
the results of research presented in this book will contribute to the future
shaping of institutions in the health care sector.
P.Z.
H.E.F.
.
Sponsors of the second world congress on health
economICS
Interpharma (Ciba Geigy, Roche, Sandoz)
Konkordat der Schweizerischen Krankenkassen
Medizinisch Pharmazeutische Studiengesellschaft (Bayer, Boehringer
(Ingelheim), Boehringer (Mannheim), Hoechst, Knoll, Merck, Schering)
SAF (Swiss Auditing and Fiduciary Company)
Basler Insurance Company
Swiss Reinsurance Company
FMH, Federation of Swiss Medical Doctors
VESKA, Swiss Hospital Association
Upjohn (Germany)
ix
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PART ONE
Issues in health insurance