Health and healthcare -
historical, market
Health
What is health?
Health is a multifaceted concept and not easily measurable.
WHO definition:
Health is a state of complete physical and mental well-being and not merely
the absence of disease or infirmity
Refer to peoples’ health status (how healthy they are)
Important part of human capital
Human capital: value of learning, experience and ability embodied in workers
which increases productivity and income
A healthy population will generate more wealth and have fewer expenses and is
therefore more economically sustainable
Asset: accumulates and depreciates
Individual or households can improve their health through use of health care
Health Production Functions
Determinants of health
Health or wellbeing?
Different instruments and the way to measure them as also implications
Health and healthcare - historical, market 1
, Ex. People from India or Bangladesh have higher scores of happiness, this because
happiness is a subjective concept and, very often, we have cultural factors (religion,
expectations of life) that have implications in the way we see and measure
happiness
80% of improving health is outside the health care sector (education, house
conditions, employee)
to produce health we need to look to individual health styles factors, improve
social and community networks, invest in agriculture and education, improve
water and sanitation
Changing health or health determinants
Individual lifestyles factors - age, sex, constitutional factors
Social and community networks
General socioeconomic, cultural and environmental conditions
Agriculture and food production
Education
Work environment
Living and working conditions
Unemployment
Water and Sanitation
Health care services
Housing
Health care
What is health care?
The prevention, treatment, and management of illness and the preservation of
mental and physical well-being through the services offered by the medical and
Health and healthcare - historical, market 2
, allied health professions.
Health care can be traded on the market but health cannot
Demand health care to improve our health
Health care markets differ from markets for other commodities
Role for government
Chain for universal health coverage
1. Inputs and processes
a. Health financing and workforce
b. Medicines, health products and infrastructure
c. Information
d. Governance and legislation
2. Outputs
a. Service access and readiness, including medicines
b. Service quality and safety
c. Service utilization
d. Financial resources pooled
3. Outcomes
a. Coverage of interventions
b. Financial risk protection
c. Risk factor mitigation
4. Impact
a. Improved health status and financial well-being
b. Increased responsiveness
c. Increased health security
Health and healthcare - historical, market 3
, Bismarck vs. Beveridge
Bismarck
GermanSocial health insurance
Compulsory for workers earning up to a defined income ceiling
Shared between employee and employer
Elected boards are equally represented by employers and employees
Non-profit funds
Access to sick-pay, maternity pay and death benefits
Primary care and drugs
Hospital care (discretionary)
Difficulty of controlling costs since there is a lack of a central power
Beveridge
UKNational Health Service
Central government control
Nationalization of hospitals
Creation of health centres
Professional autonomy
Tax financed - only one payer
Free at the point of use
Separation of hospital and community services
Health and healthcare - historical, market 4
historical, market
Health
What is health?
Health is a multifaceted concept and not easily measurable.
WHO definition:
Health is a state of complete physical and mental well-being and not merely
the absence of disease or infirmity
Refer to peoples’ health status (how healthy they are)
Important part of human capital
Human capital: value of learning, experience and ability embodied in workers
which increases productivity and income
A healthy population will generate more wealth and have fewer expenses and is
therefore more economically sustainable
Asset: accumulates and depreciates
Individual or households can improve their health through use of health care
Health Production Functions
Determinants of health
Health or wellbeing?
Different instruments and the way to measure them as also implications
Health and healthcare - historical, market 1
, Ex. People from India or Bangladesh have higher scores of happiness, this because
happiness is a subjective concept and, very often, we have cultural factors (religion,
expectations of life) that have implications in the way we see and measure
happiness
80% of improving health is outside the health care sector (education, house
conditions, employee)
to produce health we need to look to individual health styles factors, improve
social and community networks, invest in agriculture and education, improve
water and sanitation
Changing health or health determinants
Individual lifestyles factors - age, sex, constitutional factors
Social and community networks
General socioeconomic, cultural and environmental conditions
Agriculture and food production
Education
Work environment
Living and working conditions
Unemployment
Water and Sanitation
Health care services
Housing
Health care
What is health care?
The prevention, treatment, and management of illness and the preservation of
mental and physical well-being through the services offered by the medical and
Health and healthcare - historical, market 2
, allied health professions.
Health care can be traded on the market but health cannot
Demand health care to improve our health
Health care markets differ from markets for other commodities
Role for government
Chain for universal health coverage
1. Inputs and processes
a. Health financing and workforce
b. Medicines, health products and infrastructure
c. Information
d. Governance and legislation
2. Outputs
a. Service access and readiness, including medicines
b. Service quality and safety
c. Service utilization
d. Financial resources pooled
3. Outcomes
a. Coverage of interventions
b. Financial risk protection
c. Risk factor mitigation
4. Impact
a. Improved health status and financial well-being
b. Increased responsiveness
c. Increased health security
Health and healthcare - historical, market 3
, Bismarck vs. Beveridge
Bismarck
GermanSocial health insurance
Compulsory for workers earning up to a defined income ceiling
Shared between employee and employer
Elected boards are equally represented by employers and employees
Non-profit funds
Access to sick-pay, maternity pay and death benefits
Primary care and drugs
Hospital care (discretionary)
Difficulty of controlling costs since there is a lack of a central power
Beveridge
UKNational Health Service
Central government control
Nationalization of hospitals
Creation of health centres
Professional autonomy
Tax financed - only one payer
Free at the point of use
Separation of hospital and community services
Health and healthcare - historical, market 4
