Defining Health

Narrow Lack of disease

Broad Body, mind, spirit

Ultimate Happiness

Health Determinants

Genetic makeup Physical environment Sociocultural environment Economic environment Lifestyle/behavior Health services

U.S. Values

Individual autonomy Self-determination Personal privacy Justice for all Faith in technology Desire to prolong life

Public policies

Authorized decisions that are made in the legislative, executive or judicial branches of government that are intended to direct or influence actions, behaviours or decisions of others.

Public Health Policies

Public policies that pertain to health or influence the pursuit of health and affect groups or types of organizations. They can be in the public or private sector.

Forms of Health Policies

Laws Rules/regulations Operational decisions Judicial decisions Macro policies

Categories of Health Policies

Allocative Regulatory Redistributive

Health policies and health

Health policies

Determinants

Health

Leading causes of death…

Heart disease Cancer Stroke Accidents Pulmonary disease

Diabetes Suicide Liver disease AIDS

How do these tie to the causes of death?

Money People Technology Health Care System

Sources and uses of funds

Sources and uses of funds

Sources and uses of funds

$4,226 per person 14% + of GDP

45% Government 34% Employers 17% Self pay 4% Charity

Flow of funds

Exchange theory Two-party transaction Derived demand between firms

Freely competitive markets

Sufficient information Large numbers of buyers and sellers Sellers can enter the market Products can substitute Quantity is balanced

Circular flow

Role of Government

Sources

Growth Third-party payors

Income/Ethnicity and Mortality

Use of funds

Intensity of services Hospitals Long-term care Doctors Staff Other

Economic Evaluation

Cost Benefit Analysis (CBA) Cost Effectiveness Analysis (CEA) Opportunity Cost Marginal

Need vs. Demand

Expected value

Knee injury example (cons)

Knee injury example (pros)

Measuring benefits

Health Productivity Reductions in future medical costs

Measuring cost

Medical care and administration Follow up Time and pain Provider time

Efficiency Questions

Technical efficiency Cost efficiency Allocative efficiency Transaction cost Dynamic efficiency

Value of life

Jones-Lee Approach

Value of life

Wages vs. Risk