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English
Oxford University Press Inc
19 April 2023
A unique historical review that traces health spending from ancient times to the present and forecasts 21st century trends.

There are many histories of medicine, yet none that assess the dynamics of expenditures over decades and centuries. Economists have not yet addressed the magnitude of the transformation that occurred during the twentieth century as payments shifted from solo physician practices to health systems, nor the legacy effects of social practices accumulated over millennia that will shape health spending in the twenty-first. In Money and Medicine, Thomas E. Getzen provides a unified narrative of medical spending from ancient Egypt and Babylonia to the present day. Drawing on a wealth of historical reports, data, and documents, Getzen concentrates on a single ratio-the share of income devoted to medical care-to frame the evolutionary path of medicine, revealing an S-shaped growth curve that rose rapidly after 1900 as science made therapies more effective and more expensive, inflected as national health systems coalesced and rates of expansion peaked in the 1960s, then decelerated after 1975. International trends in forty-three countries are graphically illustrated with analysis supporting a parsimonious financial model. Significant lags are seen between medical innovation or macroeconomic shocks and the corresponding changes in national health expenditures. Getzen explains inertial responses to the 2008 financial crisis and Covid-19 recession, provides a method for projecting trends over the next fifty years, and suggests why spending is so much higher in the United States than other countries.

As rising costs and unequal distribution of medical care have created a sense of crisis in many countries, Money and Medicine shows that we must look beyond the last few years to craft sensible solutions.
By:  
Imprint:   Oxford University Press Inc
Country of Publication:   United States
Dimensions:   Height: 162mm,  Width: 242mm,  Spine: 29mm
Weight:   640g
ISBN:   9780197573266
ISBN 10:   0197573266
Pages:   360
Publication Date:  
Audience:   Professional and scholarly ,  Undergraduate
Format:   Hardback
Publisher's Status:   Active
Preface Acknowledgments Chapter 1: Introduction: The Transformation of Medicine Chapter 2: Hammurabi to Middlemarch, 1750 BCE to 1850 CE Chapter 3: The Rise of Modern Medicine, 1880 - 1975 Chapter 4: Global and National Market Trends 1950 - 2020 Chapter 5: Scaling Up Chapter 6: Contracts: Buying & Selling Medicine Chapter 7: USA: A Case Study of Leadership and Excess Chapter 8: Population Aging Chapter 9: Temporary Fluctuations, Trend Shifts, Lags, and Inertia Chapter 10: Measuring NHE: Accounting, Boundaries and Budgets Chapter 11: Forecasting National Health Expenditures: 2030 to 2130 Chapter 12: Conclusion: Seeing the Growth Curve Bend Appendix A: Data Sources, Documentation, and Extrapolations: International, 1850 - 2019 Appendix B: Data Sources, Documentation, and Extrapolations: United States, 1770 - 2020 Appendix C: Economic Exegesis of the Hippocratic Oath Appendix D: Is Sir William Petty 1672's Treatise on Taxes the first Health Economics paper? References Notes Index

Thomas E. Getzen is Professor Emeritus of Risk, Insurance, and Health Management at Temple University. Founder of iHEA-International Health Economics Association and its executive director for 22 years, he was instrumental in the formation of AfHEA-African Health Economics Association, ASHEcon-American Health Economics Association, and EUHEA - European Health Economics Association. His textbook Health Economics & Financing is now in its 6th edition and used at universities around the world. Formerly Editor-in-Chief for HEN-Health Economics Network at SSRN, associate editor for Health Economics, and a member of the Institute of Medicine committee for the future of public health, Professor Getzen currently produces the Model of Long Run Medical Cost Trends each year for the Society of Actuaries.

Reviews for Money and Medicine: The Evolution of National Health Expenditures

Money and Medicine weaves a clear, unified narrative about the rise of national health care systems and medical spending over time that will be of great interest to readers in health care and economics alike. * David Cutler, Otto Eckstein Professor of Applied Economics, Harvard University * Political debates about health care almost always come down to money. There is no one better than Tom Getzen to explain how nations count up what they spend on health care, to peer into the future to understand where spending is heading, and to dissect why the United States is such an outlier when it comes to health expenditures. * Larry Levitt, Executive Vice President for Health Policy, Kaiser Family Foundation * The founder of the International Health Economics Association takes a characteristically bold and ambitious view of the evolution of healthcare spending. His book reflects a lifetime of research and scholarship, having a historical and geographic sweep that brings fascinating details together with rigorous statistical evidence to highlight the macroeconomic and historical dimensions of the economics of health care. * Andrew M. Jones, Department of Economics and Related Studies, University of York * Professor Getzen offers a surprisingly personal and engaging survey of the history of health care expenditures. Taking a panoramic tour across time and space illuminates the co-transformations of the health care sector and the modern nation state. He brings to the table every relevant scrap of evidence, and then-refreshingly, with humilityDLhighlights the limits to what we can know, and we can say, about the future as it unfolds. * Chapin White, Deputy Director, Health Analysis Division, Congressional Budget Office * Global growth in health spending by people and their governments means more of our money will be headed into the world's inscrutable health systems. Getzen's mastery of the subject across time and space is a gift to everyone who wants health dollars to achieve value, fairness, and health for all. * David Bishai, MD MPH PhD, Professor, Johns Hopkins University * This book has been a major project for a number of years. I cannot think of any source documenting the key influences on health expenditure in more detail, with such a large number of citations. Much of the research for the book was conducted during the period during which Tom was establishing the International Health Economics Association (IHEA). That enduring professional society and this book will be his legacy. * Michael Drummond, Professor of Health Economics, University of York * This text intriguingly poses the enigma of why health expenditure has grown exponentially in the developed world, most acutely in the US, over the last 150 years, offering a riddle that may keep the curious reader obsessively engaged, unable to put down the book. * Choice *


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