WHAT SHOULD PHYSICIANS KNOW ABOUT HEALTH 医生应该知道什么健康.pptVIP

“WHAT SHOULD PHYSICIANS KNOW ABOUT HEALTH ECONOMICS?” Victor R. Fuchs Henry J. Kaiser Jr. Professor Emeritus Stanford University Universita Cattolica del Sacro Cuore Rome, Italy 8 October 2002 “…the age of chivalry is gone. That of sophisters, economists, and calculators has succeeded; and the glory of Europe is extinguished forever” Edmund Burke 18th century British statesman A very romantic and aristocratic view For most Europeans, life was “nasty, brutish, and short” Life expectancy at birth was about 35 years Poverty, violence, and disease were widespread “ When the sentimentalist and the moralist fails, he will have as a last resource to call in the aid of the economist.” Edwin Chadwick 19th century leader of public health reform in Britain Important Similarities Between Physicians and Economists Realistic approach to life’s problems Reliance on quantitative information Often must make difficult choices in the face of uncertainty Good decisions require comparing benefits and risks (costs) Big Difference Between Physicians and Economists Physicians are usually concerned with an individual patient Economists are usually concerned with large aggregations: organizations, industries, governments, society as a whole Economics is not primarily about saving money It is about using scarce resources as efficiently as possible Useful concepts: A production function The margin (i.e. incremental change) A Production Function The slope of the curve at any point is the marginal product of health with respect to medical care Effect on Women-Years of Life Extended As Frequency of Pap Smear Varies A Basic Problem of Health Economics Q1 is the socially optimal amount of care Q2 is the technologic (medical) optimal amount of care Advances in Knowledge shift the production function upwards over time Advances in Knowledge come in many forms from different kinds of research: New diagnostic procedures e.g. MRI and CT sc