European Parliament Library

Money and Medicine, The Evolution of National Health Expenditures, Thomas E. Getzen

This book frames the evolutionary path of medical spending and provides a useful forecasting model. Tracing health spending from ancient times to the present with a single ratio, health expenditures as a share of income, reveals an S-shaped growth curve, rising rapidly after science made therapies more effective and more expensive, inflecting as the rate of expansion peaked with the coalescence of national health systems in the 1960s, and decelerating after 1975. Medicine became qualitatively different as it scaled up along therapeutic, organizational, financial, and moral dimensions. The development of health insurance and changes in the flow of funds made macro effects on total spending different from micro determinants of allocation. Institutional inertia and lags require a span of observation long enough to distinguish temporary fluctuations from shifts in trend with careful attention to measurement methods and the dynamics of change over time and space. Archival data for early centuries are provided along with detailed graphical analysis of country trends since 1950 (Chapter 4). A case of the United States suggests when and how it became an outlier among OECD nations (Chapter 7). The contribution of medical expenditures to health and economic development are seen to be both obvious and difficult to measure
Table Of Contents
Contents: List of Tables and Figures - Preface - Acknowledgments - 1. Introduction: The Transformation of Medicine - 2. Hammurabi to Middlemarch, 1750 bce to 1850 ce - 3. The Rise of Modern Medicine, 1880-1975 - 4. Global and National Market Trends, 1950-2019 - 5. Scaling Up - 6. Contracts: Buying and Selling Medical Care - 7. United States: A Case Study of Leadership and Excess - 8. Aging Populations - 9. Temporary Fluctuations, Trend Shifts, Lags, and Inertia - 10. Measuring NHE: Accounting, Boundaries, and Budgets - 11. Forecasting National Health Expenditures: 2030 to 2130 - 12. Conclusion: Seeing the Growth Curve Bend - Appendices - References - Index
First Edition
Includes bibliographical references and index
Physical Description
1 online resource (361 pages)
Specific Material Designation
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