HCMI 5243: Health Care Economics
Spring 2022 6:00 PM – 9:00 PM Online
Instructor: Shane Murphy; Email: shane@uconn.edu; Website: https://shane-murphy.uconn.edu/teaching/spring-2022-hcmi-5243/; Office: BUSN 460
Office Hours: TBD and by appointment

This is the website for HCMI 5243: Health Care Economics. The syllabus can be found here.

On this page you can find a calendar which includes links to materials from each week and lists the weeks readings. Homework assignments are to do a reading response for one of the readings and are listed on HuskyCT.

Information about the final exam is here.

Information about the final paper is here.

Playlist of Lecture videos is here.

Course Schedule:

(for off campus access, you may need to use the UConn VPN)
January 19: Landscape of health in the US (slides)
• Fuchs, Victor R. “Major trends in the US health economy since 1950.” New England Journal of Medicine 366, no. 11 (2012): 973-977.
• (optional) Grossman, Michael. “The demand for health, 30 years later: a very personal retrospective and prospective reflection.” Journal of health economics 23, no. 4 (2004): 629-636.
• (optional) Dieleman, Joseph L., et al. “US spending on personal health care and public health, 1996-2013.” Jama 316.24 (2016): 2627-2646.
• (optional) Mokdad, Ali H., Katherine Ballestros, Michelle Echko, Scott Glenn, Helen E. Olsen, Erin Mullany, Alex Lee et al. “The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states.” Jama 319, no. 14 (2018): 1444-1472.
• (optional) Alan Krueger | Keynote 3 | Subjective Well Being Over The Life Course

January 22: History of health economics and health economics in history (slides)
• (recommended) Fuchs, Victor R. “Economics, values, and health care reform.” American Economic Review 86, no. 1 (1996): 1-24.
• (optional) Deaton, Angus. “The great escape: A review of robert fogel’s the escape from hunger and premature death, 1700-2100.” Journal of Economic Literature 44, no. 1 (2006): 106-114.
• (recommended) Cutler, David, and Grant Miller. “The role of public health improvements in health advances: the twentieth-century United States.” Demography 42, no. 1 (2005): 1-22.
• Angus Deaton – “The Great Escape: Health, Wealth, and the Origins of Inequality” at the Woodrow Wilson School of Public Affairs

February 2: Insurance, Moral Hazard, and Adverse Selection (slides)
• Nyman, John A. “Is ‘moral hazard’ inefficient? The policy implications of a new theory.” Health Affairs 23, no. 5 (2004): 194-199.
• (optional) Reinhardt, Uwe. “Where does the health insurance premium dollar go?.” Jama 317, no. 22 (2017): 2269-2270.
• (optional) America’s Health Insurance Plans (AHIP), Where does the health insurance premium dollar go? May 22, 2018
• (optional) Arrow, Kenneth J. “Uncertainty and the Welfare Economics of Medical Care.” The American Economic Review 53, no. 5 (1963): 941-973.

February 9: Rand and Oregon health experiments (slides)
• Gruber, Jonathan. The role of consumer copayments for health care: lessons from the RAND health insurance experiment and beyond. Menlo Park, CA: Henry J. Kaiser Family Foundation, 2006.
• James, Julia. “The Oregon Health Insurance Experiment, ” Health Affairs Health Policy Brief, July 16, 2015.
• Youtube video: The RAND Health Insurance Experiment: A Retrospective at 40 Years
• Podcast: Frakt on Medicaid and the Oregon Medicaid Study

February 16: Cost-effectiveness analysis/Cost-benefit analysis, Experiments in health economics (slides)
• Viscusi, W. Kip. “The value of risks to life and health.” Journal of economic literature 31, no. 4 (1993): 1912-1946.
• Sue Horton, Investing in Nutrition part 1, part 2, and part 3.
• Tengs, Tammy O., Miriam E. Adams, Joseph S. Pliskin, Dana Gelb Safran, Joanna E. Siegel, Milton C. Weinstein, and John D. Graham. “Five‐hundred life‐saving interventions and their cost‐effectiveness.” Risk analysis 15, no. 3 (1995): 369-390.

February 23: Health industrial organization (slides)
• Berndt, Ernst R. “Pharmaceuticals in US health care: determinants of quantity and price.” Journal of Economic perspectives 16, no. 4 (2002): 45-66.
Also watch the following videos:
Medicare, Pharmaceutical Industry Lobbying, and Drug Development – Marcia Angell, MD
Or listen to the following podcast:
Marcia Angell on Big Pharma
The following two papers are optional:
• (optional) Thomasson, Melissa A. “The importance of group coverage: How tax policy shaped US health insurance.” American Economic Review 93, no. 4 (2003): 1373-1384. (optional)
• (optional) Gaynor, Martin. “Issues in the industrial organization of the market for physician services.” Journal of Economics & Management Strategy 3, no. 1 (1994): 211-255. (optional)

March 2: Ethics and Health Coverage – Discussion sign up (slides)
• Gawande, Atul. “Is health care a right?” New Yorker, October 2, 2017
• Section I (pages 5-10) of Ruger, Jennifer Prah. “Toward a theory of a right to health: capability and incompletely theorized agreements.” Yale Journal of Law & the Humanities 18, no. 2 (2006): 3.
• (optional) Hamel, Mary Beth, Jennifer Prah Ruger, Theodore W. Ruger, and George J. Annas. “The elusive right to health care under US Law.” N Engl J Med 372, no. 26 (2015): 2558-63.
March 9: Determinants of health (slides)
Listen to the podcast:
Russ Roberts and Darius Lakdawalla, The Economics of Obesity, Econ Talk, Sep 25 2006
Read:
• Cutler, David, Angus Deaton, and Adriana Lleras-Muney. “The determinants of mortality.” Journal of economic perspectives 20, no. 3 (2006): 97-120.
• Cutler, David M., Edward L. Glaeser, and Jesse M. Shapiro. “Why have Americans become more obese?.” Journal of Economic perspectives 17, no. 3 (2003): 93-118.
• Almond, Douglas, and Janet Currie. “Killing me softly: The fetal origins hypothesis.” Journal of economic perspectives 25, no. 3 (2011): 153-72.

March 23: Global health (slides)
Listen to the podcast:
• Rationally Speaking, David Roodman on Worm Wars, New York City Skeptics, March 19, 2017
Read:
• Ahuja, Amrita, Sarah Baird, Joan Hamory Hicks, Michael Kremer, and Edward Miguel. “Economics of Mass Deworming Programs.” DCP-3 Education (2018): 201.
• (optional) Mills, Anne. “Reflections on the development of health economics in low-and middle-income countries.” Proceedings of the Royal Society B: Biological Sciences 281, no. 1789 (2014): 20140451.
• (optional) Pritchett, Lant, and Lawrence H. Summers. Wealthier is healthier. Vol. 1150. World Bank Publications, 1993.

March 29: Cost (slides)
• Newhouse, Joseph P. “Medical care costs: how much welfare loss?.” Journal of Economic perspectives 6, no. 3 (1992): 3-21.
Also do additional reading from this reading list as described in the homework link.

April 6: Medicare/Medicaid (slides)
• Sommers, Benjamin D., Katherine Baicker, and Arnold M. Epstein. “Mortality and access to care among adults after state Medicaid expansions.” New England Journal of Medicine 367, no. 11 (2012): 1025-1034.
• Card, David, Carlos Dobkin, and Nicole Maestas. “Does Medicare save lives?.” The quarterly journal of economics 124, no. 2 (2009): 597-636.

April 13: Provision quality and pay-for-performance (slides
• Rosenthal, Meredith B., and R. Adams Dudley. “Pay-for-performance: will the latest payment trend improve care?.” Jama 297, no. 7 (2007): 740-744.
• Jha, Ashish K., Karen E. Joynt, E. John Orav, and Arnold M. Epstein. “The long-term effect of premier pay for performance on patient outcomes.” New England Journal of Medicine 366, no. 17 (2012): 1606-1615.
• Mendelson, Aaron, Karli Kondo, Cheryl Damberg, Allison Low, Makalapua Motúapuaka, Michele Freeman, Maya O’neil, Rose Relevo, and Devan Kansagara. “The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review.” Annals of internal medicine 166, no. 5 (2017): 341-353. (optional)

April 20: Health insurance reform (slides)
• (optional) Quadagno, Jill. “Why the United States has no national health insurance: Stakeholder mobilization against the welfare state, 1945-1996.” Journal of Health and Social Behavior (2004): 25-44.
• (optional) Obama, Barack. “United States health care reform: progress to date and next steps.” Jama 316, no. 5 (2016): 525-532.
• (optional) Courtemanche, Charles, James Marton, Benjamin Ukert, Aaron Yelowitz, and Daniela Zapata. “Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health.” Southern Economic Journal 84, no. 3 (2018): 660-691.
• (optional) Antonisse, Larisa, Rachel Garfield, Robin Rudowitz, and Samantha Artiga. “The effects of Medicaid expansion under the ACA: Updated findings from a literature review.” (2017). KFF

April 27: Pandemics and their response (slides)
• Thurnstrom et al. The Benefits and Costs of Flattening the Curve for COVID-19, SSRN, 2022
• (optional) Almond, Douglas. “Is the 1918 influenza pandemic over? Long-term effects of in utero influenza exposure in the post-1940 US population.” Journal of political Economy 114, no. 4 (2006): 672-712.

Tentative future schedule