Health Care Expenditure and Income: A Global Perspective by Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti :: SSRN

December 6, 2016

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and crosssection dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, health care is a necessity rather than a luxury. However, results vary greatly depending on the sub-sample analysed. Our findings seem to suggest that size of income elasticity depends on the position of different countries in the global income distribution, with poorer countries showing higher elasticity.

Source: Health Care Expenditure and Income: A Global Perspective by Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti :: SSRN


American Economic Association

December 2, 2016

Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the choice constraints imposed on patients. We find that, post-removal, patients became more responsive to clinical quality. This led to a modest reduction in mortality and a substantial increase in patient welfare. The elasticity of demand faced by hospitals increased substantially post-reform and we find evidence that hospitals responded to the enhanced incentives by improving quality. This suggests greater choice can raise quality.

Source: American Economic Association


The Measurement of Health Inequalities: Does Status Matter? by Joan Costa-Font, Frank Cowell :: SSRN

December 1, 2016

The measurement of health inequalities usually involves either estimating the concentration of health outcomes using an income-based measure of status or applying conventional inequality-measurement tools to a health variable that is non-continuous or, in many cases, categorical. However, these approaches are problematic as they ignore less restrictive approaches to status. The approach in this paper is based on measuring inequality conditional on an individual’s position in the distribution of health outcomes: this enables us to deal consistently with categorical data. We examine several status concepts to examine self-assessed health inequality using the sample of world countries contained in the World Health Survey. We also perform correlation and regression analysis on the determinants of inequality estimates assuming an arbitrary cardinalisation. Our findings indicate major heterogeneity in health inequality estimates depending on the status approach, distributional-sensitivity parameter and measure adopted. We find evidence that pure health inequalities vary with median health status alongside measures of government quality.

Source: The Measurement of Health Inequalities: Does Status Matter? by Joan Costa-Font, Frank Cowell :: SSRN


Hours Worked in Europe and the US: New Data, New Answers by Alexander Bick, Bettina Brüggemann, Nicola Fuchs-Schundeln :: SSRN

November 10, 2016

We use national labor force surveys from 1983 through 2011 to construct hours worked per person on the aggregate level and for different demographic groups for 18 European countries and the US. We find that Europeans work 19% fewer hours than US citizens. Differences in weeks worked and in the educational composition each account for one third to one half of this gap. Lower hours per person than in the US are in addition driven by lower weekly hours worked in Scandinavia and Western Europe, but by lower employment rates in Eastern and Southern Europe.

Source: Hours Worked in Europe and the US: New Data, New Answers by Alexander Bick, Bettina Brüggemann, Nicola Fuchs-Schundeln :: SSRN


Competition in the Healthcare Sector in Singapore – An Explorative Case Study by Andrea K. Gideon :: SSRN

October 29, 2016

Market mechanisms have increasingly been introduced into the public service regimes of many countries over recent decades. This was meant to foster competition and choice which in turn was thought to increase quality while decreasing prices. Such progressive liberalisation led to public services increasingly falling within the ambit of competition laws which in turn partly required further liberalisation in some competition law regimes. However, there are certain tensions between providing such services in a competitive market and, at the same time, allowing them to retain their public interest character including such elements as universal provision, trust based relationships or equality of access. The ASEAN countries, in which competition law is still a relatively new area of law, might face such tensions with increasing application of competition law to these areas. Yet, the application of competition law to public services in ASEAN countries has thus far received virtually no attention.

The explorative case study ‘Competition in the healthcare sector in Singapore’ aims to make a first step in filling this gap in the research by exploring the healthcare sector in Singapore from a competition law perspective. It will leave to one side questions on medical research, pharma firms’ interaction with the market and primary care. Instead it focuses its analysis on hospital care; more specifically on in-patient care (i.e. mainly secondary care). The research will explore in how far the notion of undertaking is applicable to hospital in-patient services in Singapore. Since the notion of undertaking in Singaporean competition law has received hardly any attention so far this is of relevance beyond the case study. It will then proceed to analyse in how far there might be potential issues with competition law application (s 34, 47 and 54 of the Competition Act) and if there would be recommendations beyond the legal analysis.

Source: Competition in the Healthcare Sector in Singapore – An Explorative Case Study by Andrea K. Gideon :: SSRN


Primary Health Care and Universal Health Coverage in Certain International Instruments and the Implementation — The Case of Japan by Yasushi Takahashi :: SSRN

October 29, 2016

This article discusses two healthcare policies or systems “Primary Health Care (PHC)” and “Universal Health Coverage (UHC),” and also the issues surrounding the policy/system implementation. PHC is a term adopted in the Declaration of Alma Ata (1978), and UHC in the 2030 Agenda for Sustainable Development (2015). The objective of the two international instruments is to make health care available to everyone without financial concern. Partly due to the idealistic nature of PHC and UHC, implementation of each of the two has been and would be difficult for certain countries. Today, the 2030 Agenda for Sustainable Development demands that countries and organizations cooperate in UHC implementation. Some countries have expressed their willingness to cooperate in the implementation abroad, and Japan is one of them. This article examines the case of Japan as a UHC implementation cooperator. The problem is Japan’s competency. The country may not be competent enough to contribute as much as it hopes to, because it has yet to discover the resolution to its own domestic health-related issues such as population ageing and non-communicable disease prevalence that are related to UHC. Japan’s possible incompetency arises from the problems in its healthcare insurance and delivery systems.

Source: Primary Health Care and Universal Health Coverage in Certain International Instruments and the Implementation — The Case of Japan by Yasushi Takahashi :: SSRN


Let’s be honest: the NHS is costing thousands of lives

October 25, 2016

If you add up all the cases where more people die prematurely in Britain compared with these average countries, it comes to 17,000 deaths. This is appalling. It is certainly nothing for us to be proud of. When people in Britain say they admire the NHS, I have to stop myself from gasping and saying: “Aren’t you unaware of how the NHS saves fewer lives than other systems?”

Source: Let’s be honest: the NHS is costing thousands of lives