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Doody's Review ServiceReviewer: Richard L. O'Brien, MD (Creighton University)
Description: The authors explore the uses of economics models and methods in making policy for the distribution of healthcare. They provide basic accounts of economic theory applied to healthcare distribution and include analyses of the ethics of distribution based on economics. They conclude that economists frequently make normative assumptions that do not take into account the values underlying healthcare systems.
Purpose: This is intended to provide basic instruction in the ethics and economics of healthcare distribution policy. The authors state their intention to determine how healthcare "should" be distributed in publicly funded health systems. They intend to examine how economists reason from normative assumptions and to compare those assumptions to the values upon which health systems may be based.
Audience: The audience includes economists and noneconomists. This is a good economics primer for noneconomists who are interested in health policy. I'm not sure how much impact it will have on economists, since it is much more economics than healthcare, although there is a chapter exploring principles of justice and fairness and their application to healthcare.
Features: The treatment is heavily weighted toward economics, introducing basic concepts of markets, how they succeed and fail, and different responses to market failure. Useful diagrams and formulae are employed when necessary to make or clarify important concepts. The authors explore the financing of health systems and how economists might analyze health systems and the values underlying them.
Assessment: This reviewer finds the book interesting, easy to read, and enlightening about economic theory and its application to healthcare. The authors acknowledge that the focus on publicly funded systems narrows its scope but point out that most developed nations have such systems. The subjects are presented in a logical, easy to follow sequence, each chapter building appropriately on those that precede it. Will it affect the behavior and attitudes of economists and policy makers? I wish I could be optimistic about that.