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About Health Economics An International Perspective, 3rd Edition

Barbara McPake

As a part of The Economics of Healthcare, Barbara McPake takes us for a closer look at her textbook Health Economics: An International Perspective, 3rd Edition.

What can we see updated in this new edition?

We’ve benefited from reader’s feedback to the last two editions, leading us to simplify the introductory material and add to the material on economic evaluation. In particular, we’ve added a new section on decision analysis there, and generally updated other material so it reflects how thinking on economic evaluation has evolved since the last edition. The final section is always the one where the literature moves fastest and we have substantially reorganised it and ensured that more recent health systems developments and current health systems policy initiatives are well reflected. There have been major changes for example to the health systems policies in China and the US, and although it is still too early to evaluate the success of these, we’ve made sure these changes are reflected and discussed from first economic principles.

Are there specific countries focused on in your book?

No – the essence of the thinking behind this book is that economic principles are universal, even if the most popular ways of applying them vary as you travel around the world. However, some approaches to teaching health economics embed themselves so deeply in a particular country’s health system that it can be difficult for students from outside that system to see that. The authors of this book have worked in all corners of the globe and have found the ideas in the book useful everywhere. Examples are drawn from a very wide range of countries spanning geographical regions and levels of economic development.

What is the importance of studying health economics internationally?

Health sectors in all parts of the world are growing faster than the economies of which they are part. In the US, around one in every 5 dollars spent is for health and other countries are headed in that direction. This is underpinned by a number of different phenomena: populations are ageing and non-communicable diseases, which are expensive to manage, are becoming ever more important. The price of health care seems also to increase faster than prices of other goods. This means that all countries are facing challenges related to the sustainability of their health systems. ‘Business as usual’ just isn’t an option. Solutions are needed at every level: the selection of cost-effective interventions, the management of incentives, the control of costs and prices across the sector, and these will need people with a good understanding of economic principles to help identify. What’s more, understanding how other countries are tackling similar issues and why their approaches are working or not will add important understanding to the crafting of strategies.

How has international healthcare changed over recent history?

The major trends relate to ageing, growth of non-communicable diseases, and developing technology. These have different characteristics in different contexts but the trend is the same almost everywhere. Health care has also become a much more international business. Trade in health care is increasing, with medical tourism and multinational corporate activity increasing, posing new questions for those trying to manage health care systems. Countries are learning from each other to an increasing extent with some convergence of policies. Both the US and China are moving towards more inclusive health systems: both are trying to catch up with other health systems in their regions and with comparable economies in this respect.

What do you believe the future of health care will hold?

There is a good case to be made that health systems just about everywhere have been allowed to be pretty inefficient. For example, there are many interventions for which the evidence that they are even effective seems to be lacking, far less that they are cost-effective. A number of health input markets are characterised by monopolistic structures so are probably charging higher prices that might apply if those buying the inputs were better organized. As it becomes more and more difficult for countries of all economic levels to be able to afford the health systems their populations demand, the pressure to find more efficient solutions may produce much more efficient health systems delivering cost-effective interventions to those that need them most. A more pessimistic scenario, and one that will obtain if those responsible fail to grasp the principles in the book, is one of ever more expensive technologies which may not be very cost-effective increasingly available only outside universal systems to members of economic elites.


Related Products

  1. Health Economics

    An International Perspective, 3rd Edition

    By Barbara McPake, Charles Normand, Samantha Smith

    This third edition of Barbara McPake and Charles Normand’s textbook confirms it as providing the only properly international treatment of health economics on the market. A key tenet of the book is its analysis of comparative health systems across borders, and the text has been updated and revised...

    Published May 24th 2013 by Routledge