Front Matter

Front Matter

Author(s):
Peter Heller, and William Hsiao
Published Date:
April 2007
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    © 2007 International Monetary Fund

    Production: IMF Multimedia Services Division

    Cover Design: Lai Oy Louie

    Typesetting: Alicia Etchebarne-Bourdin

    Cover Photo: ©Worldwide Rights/Northfoto

    Cataloging-in-Publication Data

    Hsiao, William C.

    What macroeconomists should know about health care policy/William C. Hsiao and Peter S. Heller.—Washington, D.C. : International Monetary Fund, [2007].

    • p. cm.

    Includes bibliographical references.

    ISBN 978-1-58906-618-2

    • 1. Medical economics. 2. Medical policy—Economic aspects. 3. Medical care—Economic aspects. I. Heller, Peter S. II. International Monetary Fund.

    RA410 .H753 2007

    Disclaimer: This publication should not be reported as representing the views or policies of the International Monetary Fund. The views expressed in this work are those of the authors and do not necessarily represent those of the IMF, its Executive Board, or its management.

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    Contents

    Abbreviations

    CMH

    Commission on Macroeconomics and Health (WHO)

    DRG

    Diagnostic related group

    GDP

    Gross domestic product

    GNI

    Gross national income

    HIV/AIDS

    Human immunodeficiency virus/acquired immune deficiency syndrome

    IFI

    International financial institution

    IMF

    International Monetary Fund

    LICUS

    Low Income Countries Under Stress

    MDG

    Millennium Development Goals

    MSA

    Medical savings account

    NHA

    National Health Account

    OECD

    Organization for Economic Cooperation and Development

    PAYG

    Pay-as-you-go

    PPP

    Purchasing power parity

    SARS

    Severe acute respiratory syndrome

    SI

    Social insurance

    UN

    United Nations

    WHO

    World Health Organization

    Preface

    Economic policymakers often measure their success solely by their country’s economic growth. As a result, they devote most of their time and efforts to thinking about macroeconomic policy issues, overlooking the way in which macroeconomic policy is influenced by and influences the social sectors—education, health, and income security. Over the past decades, structural adjustment policies have had a profound impact on the social sectors and on social development in low-income countries. And in many industrial countries, policymakers are increasingly aware that developments in the health and pension areas will create fiscal pressures that have implications for the macroeconomic policy framework.

    Although incorporating health concerns into macroeconomic policy (and vice versa) requires an understanding of health economics, macroeconomics and health economics are two distinct fields. Seldom does a specialist in one field have more than a modest understanding of the other. More important, macroeconomists and economic policymakers frequently assume that social sector policies should follow the free market strategy that has worked so well in fostering economic growth. This leads them to simply apply efficient market theory in devising policies related to the social sectors, thus ignoring the ways in which various market failures make such an approach undesirable.

    This primer is a step toward bridging the divide between macroeconomic policy and health policy. It aims to acquaint macroeconomists with some fundamental facts about the economics of health care and the major health issues confronting countries. It provides a perspective for examining a country’s health care system by suggesting some broad parameters that macroeconomists can use to evaluate a country’s health policy and the performance of its health system.

    This Special Issues paper has been made possible by the generous contributions of many people. The authors benefited greatly from discussions with Sanjeev Gupta of the IMF, and in particular from his insights into macroeconomic policy and social development. Other IMF economists offered insightful comments on the earlier version of this primer, including Juan Pablo Cordoba, Luis Cubeddu, Philip Gerson, Robert Gillingham, Thomas Richardson, Markus Haacker, and George Tsibouris. Philip Musgrove also provided valuable comments. Alexander Preker, George Schieber, and Kei Kawabata of the World Bank helped the authors focus on the major issues facing low-income and middle-income countries and contributed to the paper’s substance and empirical evidence. Finally, Yessica Alvarado provided superb secretarial skills in putting this paper to bed.

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