Προσθήκη στα αγαπημένα
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.
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
Περιγραφή
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.
