Distributing Health Care

This book emphasizes the economic and ethical issues in distributing health care. It provides an understanding of why health care is publicly financed in so many European (and other OECD) countries, and it provides a critique of some of the methodologies that are being used to aid priority setting in health care.

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This is a new health economics textbook with a difference. It is based firmly in the discipline of economics and, as such, it fills a gap in the health economics market. But, unlike other texts in the area, it is very explicit about the distributive implications of economic models and it provides clear rationale for public involvement in the market for health care. It separates the efficiency reasons for public involvement (based on notions of 'market failure') from the equity reasons (based on the views of society that health care should be distributed according to the notion of health needs rather than according to ability to pay).

The book illustrates the distributional aspects of money flows in the financing and provision of health care, and discusses who are the gainers and who are the losers under different financing arrangements. A central part of the book contains a discussion of those techniques that are increasingly being used to aid decisions about how to distribute health care. Beyond the parameters included in economic evaluation techniques such as cost- benefit analysis and cost-effectiveness analysis, the book discusses some key ethical issues that are relevant for decision-makers when setting health care priorities.