Why It Costs So Much Yet Remains a Beacon of Growth and Development
American Healthcare: Why It Costs So Much Yet Remains a Beacon of Development explores economic growth and the health sector. Is the health sector a curse or a blessing? The American health sector now accounts for at least 18 percent of the economy and will likely increase in coming years. American healthcare spending per capita far exceeds that of other developed countries. Yet our health, as measured by life expectancy and infant mortality, is relatively poor by comparison with the developed world. Other measures of quality including hospital acquired infection are too common. Healthcare costs financially cripple households despite advances associated with the Affordable Care Act. There is widespread dissatisfaction with the American healthcare system and support for more change.
It is also the case that the health sector has been a leader in the evolution of the American economy. The history of economic development is largely attributable to integration of new technology. We tend to applaud new technology and the improvement it brings to our lives. Important new technologies often grow rapidly and faster than the economy as a whole. This leads to larger shares of the economy. There have clearly been enormous advances in pharmaceuticals, medical devices, genomics and molecular biology as well as other subsectors. Yet there is considerable apprehension about costs and economic impact. This book details important health sector institutions and perhaps uniquely, explores linkages between healthcare and broader economic growth. The book addresses asymmetric information between providers and consumers as well as between insurers and beneficiaries. There is a focus on monopoly power in labor markets which contributes to inefficiencies in the system. The author also discusses cost-effectiveness and allocative efficiency as well as emphasizing productivity and its relationship to the wider economy. Policy directions for improved long run efficiency are provided.
Table of Contents
Part 1: History and Evolution
Chapter 1: Origins and Evolution of Healthcare
Chapter 2: Early Evolution of American Healthcare
Chapter 3: 20th and 21st Century Evolution of American Healthcare
Part II: Topics in Health Economics
Chapter 4: Market Failure: Asymmetric Information and Monopoly Power
Chapter 5: Occupational Licensure and Control
Chapter 6: Health Insurance
Chapter 7: Allocative Efficiency and Cost-Effectiveness Analysis
Part III: The Health Sector, Macroeconomics and Economic Development
Chapter 8: Production and Productivity in the Health Sector
Chapter 9: Healthcare and Macroeconomics: Productivity, the Economy & Monetary Policy
Chapter 10: Healthcare Institutions, Technology, Ethics and the Path Forward
Peter Hilsenrath received his BA in economics and environmental studies from the University of California at Santa Cruz and PhD in economics from the University of Texas at Austin. He held the Joseph M. Long Chair in Healthcare Management and Economics at the University of the Pacific. He was Professor and founding Department Chair of Health Management and Policy at the University of North Texas Health Science Center in Fort Worth. Earlier, Dr. Hilsenrath was an Assistant and then Associate Professor at the University of Iowa, first in the College of Medicine and later in the College of Public Health. He also held faculty appointments in the Economics Department at the University of the Witwatersrand in Johannesburg, South Africa.
Additionally, Dr. Hilsenrath has held non-academic positions. He served as Chief Economist for Syfrets Managed Assets in Cape Town and was on the Research Staff at the Center for Naval Analyses in Alexandria, Virginia.
Peter has taught courses about finance, management and economics in the health sector. He has also taught courses in ethics and corporate social responsibility as well as natural resource economics. Peter's research is wide-ranging. He has published over 75 peer-reviewed articles and reports. They include publications in medical, management and economics journals such as the American Journal of Clinical Pathology, American Journal of Public Health, American Journal of Roentgenology, Annals of Epidemiology, Archives of Pediatrics & Adolescent Medicine, Defence & Peace Economics, Health Care Management Review, Inquiry: The Journal of Medical Care Organization, Provision and Financing, Journal of Management History, Journal of Rural Health, PLOS One, South African Journal of Economics, and Technology in Society. Many of his papers address issues of efficiency in the health sector. He has also published in the news media including Business Day (South Africa) China Daily, Fortune, Huffington Post, Jerusalem Post and The Wall Street Journal. He has served on Editorial Boards for Hospital Topics, International Journal of Pharmaceutical and Healthcare Marketing, The Journal of Health Administration Education, Journal of Health Care Finance, Inquiry: The Journal of Medical Care Organization, Provision and Financing, Journal of Primary Care & Community Health and The Journal of Rural Health.
Dr. Hilsenrath has presented his work at many national and international conferences as well as in important institutions such as the Pentagon and South Africa's Parliament. He has participated on funded projects from organizations that include the Centers for Disease Control, the U.S. Agency for Health Care Policy and Research, and the U.S. Department of Education.