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This is a pretty weak article. Past disagreements, I guess, makes people unwilling to make a serious effort. Health economics may be a low-profile academic discipline, but nevertheless concerns a huge part of the economy and deserves better than this. 82.183.209.109 02:52, 2 March 2007 (UTC)
yree
Thanks for Gregalton's welcome to wikipedia. This continues to edit my first Wiki post. I've taken his advice and incorporated the phrase "population externalities" as well as two sources. This also resulted in my correcting the reference to one of the sources--thanks for that too!
The article positions health economics as fully focused on microeconomic analysis. There is a case to be made that multi-regional macroeconomic analysis can contribute significantly to assessing population externalities in healthcare impacts by including systemic interactions across regions and time, especially if conducted using high-end multi-regional equilibrium forecasting models such as REMI or REDYN.
As an example, consider analysing protocol training and tracking for chronic-persistent conditions affecting over half of all US health system costs. Large-scale results from Asheville, NC for diabetes remained robust over a five-year period as reported in the Journal of the American Pharmaceutical Association (http://japha.metapress.com/link.asp?id=m5nm6h0758753345) and as replicated in a number of cities. New York State and elsewhere corroborated these results for mental health (see New York's five year results at http://www.treatmentadvocacycenter.org/BriefingPapers/BP18.htm). If protocol training and tracking were implemented in context with single-payor resources (i.e., Medicaid, Medicare, S-CHIP, and the Veterans Administration), then it can be posited that...
[a] Demand can be reduced for general hospital services (ERs and hospital stays) and for offices of physicians, only partly offset by less expensive increased demand for clinic and pharmacy services (integrate demand changes in [a] with changes in [b.1] spending on consumer commodities to avoid double counting),
[b] Cost can be reduced [b.1] for individuals (due to reduced co-pays and insurance coverage cost due to reduced ER and physician visits, offset by increases in less expensive pharmacy and clinic visits, resulting in a net increase in disposable income available for non-health purposes), [b.2] for firms (due to reduced health benefit costs, resulting in increased opportunities for capital investment at higher or stable capital/output ratios or for job growth at stable or lower capital/output ratios), and [b.3] for government (due to reduced health benefit costs and health system financing),
[c] Productivity can be increased for the general workforce due to improved protocol outcomes driven by protocol training and tracking under single-payor financing, resulting in [c.1] reduced time lost by workers directly and by workplace team distraction and need-to-cover, and by family workforce time given to caretaking, [c.2] better skills-occupations-requirements alignment due to expanded health portability enabling an increased ability to switch and optimize jobs, [c.3] new capital investment, and [c.4] higher training ROI due to reduced worry and diversion, i.e., a Hawthorne effect, especially as boosted by a reduced benefit burden that lets employers hire proportionately more workers with more education and more vocational or workforce training.
The productivity modeling needs to account for (a) capital and labor factor substitution due to the reduced benefit cost of labor, and (b) effects from improved capital stock, increased skills alignment and training ROI, and reduced direct and secondary sick leave usage. The use of multi-regional sub-national analysis ensures domestic trade flow and commuter shed effects are captured together with regional differences in starting conditions and infrastructure. The point in citing this detail is to demonstrate that healthcare economics includes a basis for macroeconomic multi-regional systemic analysis, not only or primarily microeconomic decision analysis. (71.192.212.228 (talk) 03:37, 3 September 2008 (UTC))(71.192.212.228 (talk) 03:33, 3 September 2008 (UTC))(71.192.212.228 (talk) 00:07, 26 July 2008 (UTC))(71.192.212.228 (talk) 23:34, 25 July 2008 (UTC))(71.192.212.228 (talk) 23:26, 25 July 2008 (UTC))(71.192.212.228 (talk) 16:18, 2 May 2008 (UTC))(71.192.212.228 (talk) 16:05, 2 May 2008 (UTC))(71.192.212.228 (talk) 13:42, 30 April 2008 (UTC))(71.192.212.228 (talk) 19:11, 26 April 2008 (UTC))(71.192.212.228 (talk) 12:54, 24 April 2008 (UTC))(71.192.212.228 (talk) 21:30, 23 April 2008 (UTC)) (71.192.212.228 (talk) 20:34, 23 April 2008 (UTC))(71.192.212.228 (talk) 19:04, 23 April 2008 (UTC)) (71.192.212.228 (talk) 18:49, 23 April 2008 (UTC)) (71.192.212.228 (talk))(71.192.212.228 (talk) 13:38, 23 April 2008 (UTC))(71.192.212.228 (talk) 22:06, 22 April 2008 (UTC))
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