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Questions and Answers

Which of the following is not a commonly recognized means of economic evaluation in the case of health care?

  • Cost-Equity Analysis (correct)
  • Cost-Utility Analysis
  • Cost-Effectiveness Analysis
  • All of the above are commonly practiced

QALYs are a means of quantifying the benefits of a medical intervention that takes both the quantity and quality of life lived into account. QALYs are used in which type of economic evaluation?

  • Cost-Benefit Analysis
  • Cost-Effectiveness Analysis
  • Cost-Minimization Analysis
  • None of the above (correct)

If an evaluator wanted to place a heavy weight on the considerations of future generations, they would?

  • Use a high discount rate
  • Use a moderate discount rate
  • Use a low discount rate (correct)
  • Use a discount rate equal to the inflation rate

Cost-effectiveness analysis is poorly suited for programs with multiple types of health outcomes.

<p>True (A)</p> Signup and view all the answers

A recent study by Health Canada, the federal Department of Health, that calculated the economic burden imposed by leading diseases in Canada (e.g., health care costs, lost work productivity, etc.) constitutes an economic evaluation.

<p>False (B)</p> Signup and view all the answers

Economists generally recommend that economic evaluations be conducted from the viewpoint of all members of society.

<p>True (A)</p> Signup and view all the answers

Because it incorporates a subjective utility weight into the calculation of quality-adjusted life-years, cost-utility analysis can address questions of allocative efficiency.

<p>False (B)</p> Signup and view all the answers

Other things equal, the higher is the rate of time preference, the more attractive will investments in prevention programs be from an economic point of view.

<p>False (B)</p> Signup and view all the answers

The use of the net-benefit measure to summarize the results of a cost-benefit study follows directly from the Pareto efficiency principle.

<p>False (B)</p> Signup and view all the answers

Health economists believe that the relevant aspect of health is

<p>All of the above are important and relevant (D)</p> Signup and view all the answers

Focusing on your total product of health due to health care, moving to a new area with less industrial pollution will likely

<p>Shift your total product of health curve upward (B)</p> Signup and view all the answers

McKeown showed that majority of historically rapidly falling rates of mortality for common diseases occurred

<p>Before the invention of modern medicine became available (D)</p> Signup and view all the answers

More education is correlated with better health because people with “long time horizons” with preferences for the future tend to invest in both. Therefore we should increase subsidies to education in order to increase health.

<p>False (B)</p> Signup and view all the answers

The concept of the social gradient in health means that there exists a social cost curve which lies above the private marginal cost curve (commonly known as the supply curve) which shows the full true cost of supply.

<p>False (B)</p> Signup and view all the answers

Give an example of how health might be produced from a market good. Give an example of how health might be produced from a non-market good.

<p>Examples of market goods that produce health are apples (high in vitamin C), cranberry juice (known to fight urinary infections) and toothbrushes (for good dental health). Examples of non-market goods that produce health are jogging (for exercise) and sleep (sleep deprivation can negatively affect health).</p> Signup and view all the answers

Uncertainty regarding the effectiveness of a specific health service for a particular individual:

<p>is an important reason why patients have difficulty assessing quality of care (D)</p> Signup and view all the answers

Informational asymmetry in the market for health care services refers to:

<p>the fact that a health care provider has more knowledge than does the patient regarding what care will be effective in correcting the patient’s health problem (A)</p> Signup and view all the answers

Which of the following characteristics of health care plays an important role in defining need:

<p>Derived demand – because this leads to the importance of the underlying production relationship between health care and health, and the necessary condition for a need to exist being a positive marginal product of health care. (A)</p> Signup and view all the answers

Because health care consumers often do not know what would have happened to their condition even if they had not consumed a particular health care service:

<p>there are limited opportunities to learn from past experience when making decisions about health care consumption. (A)</p> Signup and view all the answers

The increasing number of antibiotic resistant bacteria caused by over-consumption of antibiotics is an example of:

<p>a negative externality from health care consumption. (B)</p> Signup and view all the answers

Which of the following is a reason why some health economists argue that we should not interpret the area under the demand curve for health care as representing the value of health care to an individual?

<p>Informational asymmetry between the patient and the physician (D)</p> Signup and view all the answers

The demand for hospital care is generally:

<p>Less elastic than demand for primary care (B)</p> Signup and view all the answers

The Rand Health Insurance Experiment found that the consumption of physician visits did respond negatively to cost-sharing while the expected total cost of visits did not. This would be consistent with the phenomenon of:

<p>Supplier-induced demand (D)</p> Signup and view all the answers

The problem of informational asymmetry in health care markets can undermine the normative interpretation of the demand curve as representing marginal benefit.

<p>True (A)</p> Signup and view all the answers

If a doctor is a perfect agent for her patients, she will always provide care that is expected to improve a patient's health.

<p>False (B)</p> Signup and view all the answers

The physician's ability to influence a person's consumption of health care services arises from externalities.

<p>False (B)</p> Signup and view all the answers

The concept of need in health care derives from the presence of externalities in health care markets.

<p>False (B)</p> Signup and view all the answers

If we define a health care service as needed if the expected health effect for a person is positive, then society should ensure that all health care needs are met.

<p>False (B)</p> Signup and view all the answers

The demand curve for health care provides a good measure of the benefits of health care to a consumer.

<p>False (B)</p> Signup and view all the answers

There is a large health care literature that examines variation across regions in the per-capita utilization of health care services. Such studies consistently find that rates of variation of many procedures can vary 2-5 fold even after adjusting for differences in the age-sex distributions of the population. Many studies also find that utilization per capita is positively correlated with physician supply. The most logical explanation of these findings is self-interested supplier-induced demand.

<p>False (B)</p> Signup and view all the answers

Even when care is free at the point of service, we would expect low and high-income individuals with the same level of need to demand different quantities of health care.

<p>True (A)</p> Signup and view all the answers

For two individuals who have identical probabilities of being ill and identical monetary losses associated with being ill, but who have differing risk preferences:

<p>The actuarially fair premiums for both are the same (A)</p> Signup and view all the answers

A new drug has been developed that is effective in preventing heart attacks. Before the new drug was developed, an average 55-year-old man had a 20% chance of a heart attack and the loss associated with the attack was $4000. Taking the drug reduces the chance of a heart attack to 10%, but the loss associated with the attack increases to $8000. All else equal, if a 55-year-old man begins taking the new drug, the maximum premium he would be willing to pay for health insurance to cover the loss associated with a heart attack:

<p>Increases (A)</p> Signup and view all the answers

The effectiveness of pooling financial risk through insurance:

<p>a. increases as the number of individuals in the risk pool grows (A)</p> Signup and view all the answers

A risk-averse individual prefers all situations with certainty compared to a risky prospect.

<p>False (B)</p> Signup and view all the answers

If an insurance company charges more than the actuarially fair premium, people will not buy insurance.

<p>False (B)</p> Signup and view all the answers

Risk aversion is a necessary condition for insurance to be welfare improving to an individual.

<p>True (A)</p> Signup and view all the answers

Flashcards

Cost-Equity Analysis

Not a commonly recognized means of economic evaluation in healthcare.

QALYs

QALYs quantify medical intervention benefits considering both the length and quality of life.

Emphasis on future generations

Use a low discount rate. This gives future benefits a higher present value.

Cost-effectiveness analysis

False. CEA can handle multiple outcomes, but each must be measured in its natural units.

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Economic evaluation

False. Economic evaluations compare costs and benefits of two or more programs.

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Societal viewpoint in economics

True. Includes all individuals and organizations in society.

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Cost-utility analysis

False. It only answers the least expensive way to produce a QALY.

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Time preference rate

False. Prevention programs have high upfront costs, so they are less attractive.

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Net-benefit measure

False. Potential Pareto criterion.

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Study Notes

  • The topic is economic evaluation in healthcare.

Economic Evaluation Methods

  • Cost-Equity Analysis is not a commonly recognized means of economic evaluation in healthcare.
  • Cost-Utility Analysis and Cost-Effectiveness Analysis are commonly practiced methods.

QALYs in Economic Evaluation

  • QALYs quantify the benefits of medical interventions by considering both the quantity and quality of life.
  • QALYs are used in Cost-Benefit Analysis.

Discount Rate Considerations

  • Evaluators placing heavy weight on future generations should use a low discount rate.
  • High discount rates would de-emphasize future costs and benefits.

Cost-Effectiveness Analysis

  • Cost-effectiveness analysis measures outcomes in natural units.
  • It is poorly suited for programs with multiple types of health outcomes as each outcome is measured in a different unit and cannot be combined into a single indicator.
  • Cost-effectiveness analysis is better suited to situations with a single, primary outcome of a treatment that is of interest.

Economic Evaluation Requirements

  • An economic evaluation must compare two or more programs in terms of their costs and benefits.
  • A study that calculates the economic costs to society without comparing programs or interventions doesn't qualify as an economic evaluation.
  • Furthermore, the study considers only one aspect (the costs of disease) rather than the costs and consequences of a course of action.

Societal Perspective in Economic Evaluations

  • Economists recommend conducting economic evaluations from the viewpoint of all members of society to maximize social welfare.
  • Failing to do so gives zero weight to the costs borne or benefits obtained by some members of society.
  • Viewpoint refers to the set of people and organizations whose costs and benefits are included in the evaluation.

Cost-Utility Analysis and Allocative Efficiency

  • Cost-utility analysis incorporates subjective values into the calculation of quality-adjusted life-years (QALY).
  • Cost-utility analysis only answers the question of the least expensive way to produce a QALY.
  • It cannot, through the analysis itself, reveal whether a program would generate positive net benefit to society and address questions of allocative efficiency.
  • Policy makers must judge whether producing QALYs at the indicated cost is a good investment.
  • In contrast, cost-benefit analysis produces a measure of the net benefit to society under all the assumptions associated with CBA.

Time Preference and Prevention Programs

  • A higher rate of time preference means that a person weights costs and benefits that occur now or in the near future much more heavily than costs and benefits that arise far in the future.
  • Prevention programs are generally characterized by high up-front costs followed by benefits in the future.
  • Preventive programs are less attractive to those with high rates of time preference than for those with low rates of time preference.

Net-Benefit Measure and Pareto Efficiency

  • The use of the net-benefit measure to summarize the results of a cost-benefit study does not follow directly from the Pareto efficiency principle.
  • The net-benefit principle deems an allocation efficient if it increases net benefit.
  • Note that many individuals may be harmed by the action, but if the gains by those are sufficiently large, the action is deemed efficient.
  • The net-benefit measure corresponds more closely with the potential Pareto criterion.
  • In contrast, the Pareto efficiency principle deems an allocation efficient if it is impossible to reallocate resources so as to make at least one person better off while not making anyone else worse off.

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