Health Policy Commons^™

A Priceless Review, David Thomas

David Chandler Thomas, PhD

The book, Priceless, is chock full of ideas, many of which are undoubtedly useful. The style is readable, with enough anecdotes to keep the reader’s interest. Unfortunately, the book is almost as confusing as the health-care system. There are too many moving parts, too many clever ideas, and not enough high level insights into how to cut the Gordian health-care knot. As hard as it is to make changes in the U.S. health-care system, it is unlikely the author’s suggestions will find a listening ear.

Q-Ing For Health – A New Approach To Eliciting The Public’S Views On Health Care Resource Allocation, Rachel M. Baker, John Wildman, Helen Mason, Cam Donaldson

Professor Rachel Baker

The elicitation of societal views about health care priority setting is an important, contemporary research area and there are a number of studies which apply either qualitative techniques or quantitative preference elicitation methods. However there are methodological challenges in connecting qualitative information (what perspectives exist about a subject) with quantitative questions (to what extent are those perspectives ‘supported’ in a wider population). In this paper we present an integrated, mixed-methods approach to the elicitation of public perspectives in two, linked studies applying Q methodology. In the first study we identify three broad viewpoints on the subject of health priorities. In …

Medical Expenditure Measures In The Health And Retirement Study, Dana Goldman, Julie Zissimopoulos, Yang Lu

Yang Lu

This paper reviews out-of-pocket (OOP) medical expenditure measures collected in the Health and Retirement Study (HRS). Medical expenditures are an important cost of poor health. Medical expenditure measures are important for understanding retirement decisions, financial preparation for retirement, and predicting the consequences of health care reform, particularly Medicare reform. Despite the comprehensiveness of the HRS, there are always limitations to what can be learned from population interviews. To assess the quality of current HRS measures of OOP spending, we compare various measures of OOP spending across survey waves to the Medical Expenditure Panel Survey (MEPS) and Medicare Current Beneficiary Survey …

Price Elasticity Of Expenditure Across Health Care Services, Fabian Duarte

Fabian Duarte

Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. These rich data allow me to examine the heterogeneity of price elasticities across types of service and demographic groups. Using exogenous changes in price generated by changes made by the Chilean …

Economic Rationality And Health And Lifestyle Choices For People With Diabetes., Rachel M. Baker

Professor Rachel Baker

Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality (which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality) in a health context (type 2 diabetes).

Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on factor analysis of the results of a card sorting procedure undertaken by 27 respondents with type 2 diabetes. These factors …

Q Methodology In Health Economics, Rachel M. Baker, Carl Thompson, Russel Mannion

Professor Rachel Baker

The recognition that health economists need to understand the meaning of data if they are to adequately understand research findings which challenge conventional economic theory has led to the growth of qualitative modes of enquiry in health economics. The use of qualitative methods of exploration and description alongside mainstream quantitative techniques gives rise to a number of epistemological, ontological and methodological challenges: difficulties in accounting for subjectivity in choices, the need for rigour and transparency in method, and problems of disciplinary acceptability to health economists. This paper introduces Q methodology as a means of overcoming some of these challenges. The …