The Economics Of Us Healthcare Competition Innovation Regulation And Organizations

This eBook was born out of a general diagnosis that the US healthcare sector is not only one of the most studied industries in economics but also one of the areas where the field can make the most progress. Indeed, the American healthcare industry has many features that are particularly attractive to economists. It is one of (if not the) largest sectors of the US economy, accounting for almost 20% of the national Gross Domestic Product and employing tens of millions of workers. Firms range from large conglomerates to small providers, and there is strong government-private sector interaction, with federal, state, and local governments shaping policy. The industry also has many failures, is undergoing tremendous change, and produces a wealth of data (even if not always perfectly formatted). The field, however, is far from saturated. Healthcare is such a complex and intricate sector, one where details matter so much that it is almost its own subfield of economics. These high barriers to entry prevent scholars from researching healthcare topics and weaken the cross-pollination of ideas, an increasing hallmark of many other areas. This is problematic, not the least, because any major advances in healthcare economics literally save lives (and billions of dollars). This project aimed to help lower these barriers and kick-start broader collaborations.

This is a reprint. The attributes and conduct of the physician, hospital, insurance, and long-term care industries are examined.

One of the country's leading health economists presents a provocative analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. James Robinson examines the economic and political forces that have eroded the traditional medical system of solo practice and fee-for-service insurance, hindered governmental regulation, and invited the market competition and organizational innovations that now are under way. The trend toward health care corporatization is irreversible, he says, and it parallels analogous trends toward privatization in the world economy. The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing. In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine—overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions—factors often overlooked when newer organizational models are criticized. Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful—and optimistic—view of a future health care system, one in which physician entrepreneurship is a dynamic component.

Source of the debate on how much competition and regulation are necessary in the health care industry. This is a reprint of proceedings from a 1977 conference.

The Business of Healthcare Innovation is a wide-ranging analysis of business trends in the manufacturing segment of the healthcare industry. It provides a thorough overview and introduction to the innovative sectors fueling improvements in healthcare: pharmaceuticals, biotechnology, platform technology, medical devices and information technology. For each sector, the book examines the basis and trends in scientific innovation, the business and revenue models pursued to commercialize that innovation, the regulatory constraints within which each sector must operate and the growing issues posed by more activist payers and consumers. Specific topics include market structure and competition, the economics and rationale of product development, pricing, sales and marketing, contract negotiations with buyers, alliances versus mergers, business strategies and prospects for growth. Written by professors of the Wharton School and industry executives, the book shows why healthcare sectors are such an important source of growth in any nation's economy.

This is an analysis of the transformation of American medicine from a system of professional dominance to an industry under corporate control. It examines the economic and political forces that have eroded the medical system and invited market competition and organizational innovatives.

Technological change in healthcare has led to huge improvements in health services and the health status of populations. It is also pinpointed as the main driver of healthcare expenditure. Although offering remarkable benefits, changes in technology are not free and often entail significant financial, as well as physical or social risks. These need to be balanced out in the setting of government regulations, insurance contracts, and individuals' decisions to use and consume certain technologies. With this in mind, this book addresses the following important objectives: to provide a detailed analysis of what technological change is; to identify drivers of innovation in several healthcare areas; to present existing mechanisms and processes for ensuring and valuing efficiency and development in the use of medical technologies; and to analyse the impact of advances in medical technology on health, healthcare expenditure, and health insurance. Each of the seventeen chapters summarizes an important issue concerning the innovation debate and contributes to a better understanding of the role innovation has both at the macro level and at the delivery (meso) and micro level in the healthcare sector. The effectiveness of innovation in improving people's welfare depends on its diffusion and inception by the relevant agents in the health production process, and this book recognizes the multi-faceted contribution of policy makers, regulators, managers, technicians, consumers and patients to this technology change. This book offers the first truly global economic analysis of healthcare technologies, taking the subject beyond simply economic evaluation, and exploring the behavioural aspects, organization and incentives for new technology developments, and the adoption and diffusion of these technologies.