This course explores the role of economics in global health. It reviews health and economic metrics (such as population disease burden); health economics methods (such as costing and cost-effectiveness analysis); the interaction of health and wealth; health systems organization, financing, and reform (abroad and in the US); behavioral economics; and related ethical issues. The course incorporates hands-on exercises and several student debates on controversial topics in global health economics.
At the end of the course students will be able to:
- Learn the metrics used by economists to assess burden of disease, cost, cost-effectiveness, and cost-benefit of health programs
- Understand various measures of population economic and social well-being and the advantages and disadvantages of each
- Debate the impact of economic status on health, and of health on economic status
- Describe the concept of health systems and describe major variation by global region
- Demonstrate an understanding of how to use economics to assess health programs and issues
- Describe major theories regarding causes of poverty
- Understand the principles and potential applications of behavioral economics
- Understand ethical issues in the application of economics principles
- Introduction to health economics in the context of global health growth (terms, types of economic analysis, how economics informs health policy)
- Health metrics (DALYs, QALYs, U5M, mortality, etc.). How health outcomes are measured. GDP and GINI as measures of well-being: problems and alternative indices. Purchasing power parity. Valuation of health and health services (cost, productivity, willingness to pay, discounting). Debate.
- Health and wealth. Relationship of wealth and health (e.g., Preston curve). Bidirectional causality: making people healthier improves economic development; economic development makes people healthier. Debate.
- Health systems around the world. Organization, financing. Role of the public and private sector. Definition and measurement of health care utilization and expenditures.
- Health care reform in the US. History of health financing; Affordable Care Act; administrative costs. Debate on reform strategies.
- Poverty causes and reduction strategies and interaction with health, e.g., microfinance, aid, social marketing).
- Behavioral economics. Prospect theory and decision heuristics. Examples from health. Influences on behavior, potential for intervention strategies.
- Cost-effectiveness analysis. Brief introduction and exercise (reverse classroom approach).
- Resource allocation and ethics. How do economic issues play out in reality? What ethical issues are raised, and how are they resolved?
James G. Kahn, MD, MPH
Lectures, participatory seminar exercises, quizzes, term paper (in two rounds), and final exam. One session "reverse classroom" (lecture online before class).