American Healthcare

Selected by the Association of University Programs in Health Administration for the Bugbee-Falk Book Award
Is the health sector a curse or a blessing? The American health sector now accounts for a fifth of the economy. American healthcare spending per capita far exceeds that of other developed countries. Yet our health, as measured by life expectancy and infant mortality, is poor by comparison with the developed world. Other measures of quality including hospital-acquired infection are too common. Healthcare costs financially cripple households despite advances associated with the Affordable Care Act. There is widespread dissatisfaction with the American healthcare system and support for more change.
It is also the case that the health sector has been a leader in the evolution of the American economy. Economic development is driven by innovative technology. We tend to applaud new technology and the improvement it brings to our lives. Important recent technologies often grow rapidly and faster than the wider economy. This leads to larger shares of the economy. Yet there is considerable apprehension about costs and economic impact of health spending. This book details important health sector institutions and uniquely, explores linkages between healthcare and broader economic growth. The book addresses asymmetric information between providers and consumers as well as between insurers and beneficiaries. There is a focus on monopoly power in labor markets which contributes to inefficiencies in the system. The author also discusses cost-effectiveness and allocative efficiency as well as emphasizing productivity and its relationship to the wider economy.

Peter Hilsenrath received his BA in economics and environmental studies from the University of California at Santa Cruz and PhD in economics from the University of Texas at Austin. He held the Joseph M. Long Chair in Healthcare Management and Economics at the University of the Pacific. Previously, he was Professor and founding Department Chair of Health Management and Policy at the University of North Texas Health Science Center in Fort Worth. And before that, Dr. Hilsenrath was an Assistant and then Associate Professor at the University of Iowa, first in the College of Medicine and later in the College of Public Health. He also held faculty appointments in the Economics Department at the University of the Witwatersrand in Johannesburg, South Africa. Additionally, Dr. Hilsenrath has held non-academic positions. He served as Chief Economist for Syfrets Managed Assets in Cape Town and was on the Research Staff at the Center for Naval Analyses in Alexandria, Virginia. Peter has taught courses about finance, management, and economics in the health sector. He has also taught courses in ethics and corporate social responsibility. Peter's research is wide-ranging. He has published over seventy-five peer-reviewed articles and reports. They include publications in medical, management and economics journals such as the American Journal of Public Health, American Journal of Roentgenology, Annals of Epidemiology, Archives of Pediatrics & Adolescent Medicine, Health Care Management Review, Journal of Management History, and the Journal of Rural Health. He has also published in the news media including Business Day (South Africa) China Daily, Fortune, Huffington Post, Jerusalem Post and The Wall Street Journal. He has served on Editorial Boards for Hospital Topics, The Journal of Health Administration Education, Journal of Health Care Finance, Inquiry: The Journal of Medical Care Organization, Provision and Financing and The Journal of Rural Health. Dr. Hilsenrath has presented his work at national and international conferences as well as in important institutions such as the Pentagon and South Africa's Parliament. He has participated on funded projects from organizations that include the Centers for Disease Control, the U.S. Agency for Health Care Policy and Research, and the U.S. Department of Education.

Foreword Prelude Part 1: History and Evolution Chapter 1: Origins and Evolution of Healthcare Chapter 2: Early Evolution of American Healthcare Chapter 3: 20th and 21st Century Evolution of American Healthcare Part II: Topics in Health Economics Chapter 4: Market Failure: Asymmetric Information and Monopoly Power Chapter 5: Occupational Licensure and Control Chapter 6: Health Insurance Chapter 7: Allocative Efficiency and Cost-Effectiveness Analysis Part III: The Health Sector, Macroeconomics and Economic Development Chapter 8: Production and Productivity in the Health Sector Chapter 9: Healthcare and Macroeconomics: Productivity, the Economy & Monetary Policy Chapter 10: Healthcare Institutions, Technology, Ethics and the Path Forward