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LECTURE WEEK 1.1 WHAT IS HEALTH (POLICY)? 3
BOOK CHAPTER 1 – WHY HEALTH ECONOMICS? 6
BOOK CHAPTER 15 – THE HEALTH POLICY CONUNDRUM 7
ARTICLE 1 – HEALTH CAPABILITY: CONCEPTUALIZATION AND OPERATIONALIZATION 12
ARTICLE 2 - INDIVIDUAL AUTONOMY AND STATE INVOLVEMENT IN HEALTH CARE 15
LECTURE WEEK 1.2 LIFECYCLE HEALTH MODELLING 17
BOOK CHAPTER 3 – THE GROSSMAN MODEL 21
ARTICLE 1 – ON THE CONCEPT OF HEALTH CAPITAL AND THE DEMAND FOR HEALTH 24
ARTICLE 2 – OPTIMAL AGING AND DEATH: UNDERSTANDING THE PRESTON CURVE 26
LECTURE WEEK 2.1 EARLY-LIFE DETERMINANTS OF HEALTH 27
ARTICLE 1 – KILLING ME SOFTLY: THE FETAL ORIGINS HYPOTHESIS 29
ARTICLE 2 – AGING: HEALTH AT ADVANCED AGES 31
ARTICLE 3 – SOCIOECONOMIC CONDITIONS IN CHILDHOOD AND MENTAL HEALTH LATER IN LIFE 34
LECTURE WEEK 2.2 HEALTHY AGING 36
BOOK CHAPTER 19 – POPULATION AGING 39
LECTURE WEEK 3 BEHAVIORAL HEALTH ECONOMICS 41
BOOK CHAPTER 23 - PROSPECT THEORY 44
BOOK CHAPTER 24 - TIME INCONSISTENCY AND HEALTH 46
ARTICLE 1 - MAPS OF BOUNDED RATIONALITY: PSYCHOLOGY FOR BEHAVIORAL ECONOMICS 47
ARTICLE 2 - A THEORY OF RATIONAL ADDICTION 50
LECTURE WEEK 4.1 SOCIAL DETERMINANTS OF HEALTH 53
ARTICLE 1 – THE DAHLGREN-WHITEHEAD MODEL OF HEALTH DETERMINANTS: 30 YEARS ON AND STILL CHASING
RAINBOWS 56
ARTICLE 2 – SOCIAL MINIMUM 57
LECTURE WEEK 4.2 HEALTH DISPARITIES I 60
BOOK CHAPTER 4 – SOCIOECONOMIC DISPARITIES IN HEALTH 61
ARTICLE 1 – EMPLOYMENT GRADE AND CORONARY HEART DISEASE IN BRITISH CIVIL SERVANTS 64
LECTURE WEEK 5.1 HEALTH DISPARITIES II 65
,ARTICLE 1 - NEIGHBORHOOD SOCIOECONOMIC STATUS AND HEALTH CARE COSTS: A POPULATION-WIDE STUDY IN
THE NETHERLANDS 68
ARTICLE 2 - SEPARATE AND COMBINED EFFECTS OF INDIVIDUAL AND NEIGHBOURHOOD SOCIO-ECONOMIC
DISADVANTAGE ON HEALTH-RELATED LIFESTYLE RISK FACTORS: A MULTILEVEL ANALYSIS 70
LECTURE WEEK 5.2 PREVENTION I 71
ARTICLE 1 – AN OUNCE OF PREVENTION 73
ARTICLE 2 – SICK INDIVIDUALS AND SICK POPULATIONS 76
LECTURE WEEK 6.1 PREVENTION II 79
BOOK CHAPTER 22 OBESITY 80
ARTICLE 1 – THE RETURNS TO PREVENTING CHRONIC DISEASE IN EUROPE AND THE UNITED STATES 82
LECTURE WEEK 6.2 PREVENTION BASED HEALTH POLICY 84
ARTICLE 1 - SMALL STEPS, BIG CHANGE. FORGING A PUBLIC-PRIVATE HEALTH INSURANCE SYSTEM IN THE
NETHERLANDS 86
ARTICLE 2 – ADVANCING THE APPLICATION OF SYSTEMS THINKING IN HEALTH: WHY CURE CROWDS OUT PREVENTION
87
ARTICLE 3 – FROM HEALTH IN ALL POLICIES TO HEALTH FOR ALL POLICIES 88
ARTICLE 4 – TOWARDS LEGALLY MANDATED PUBLIC HEALTH BENCHMARKS 89
,Lecture week 1.1 What is health (policy)?
The lecture aimed to:
• Define and critique different perspectives on health.
• Explain the role of risk aversion in health policy.
• Discuss the impact of asymmetric information on health policy.
• Evaluate arguments for and against state involvement in health.
What is health?
Health is a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity (WHO).
à Critique – this definition implies that individuals who are not “completely well” are unhealthy,
making the majority of people perpetually “sick”.
Life-expectancy gives a limited picture of disease burden:
• The current epidemiological phase is characterized by chronic diseases. They reduce quality
of life without necessarily shortening the life-span. So – reducing quality of life, not life
expectancy.
To measure burden of disease whilst living we can use healthy life-expectancy
• The number of years an individual is expected to live without a disability (in good self-
assessed health). Measuring the quality of life.
Life-Course Health – over the years, it is possible to get more diseases. And at all ages, the diseases
are different. When you are younger, other diseases/health issues are more common than when you
are older.
Health evolves over a lifetime. Few individuals are entirely free from disease at any point, but this
does not always equate to poor health.
Huber et al. – Health is the ability to adapt and self manage in the face social, physical and emotional
challenges. This approach emphasizes resilience and functional capabilities over the absence of
disease.
, Health Capabilities (Ruger) - Confidence and ability to be effective in achieving optimal health given
biologic and genetic disposition; intermediate and the broader social, political, and economic
environment; and access to the public health and health care system.
à The goal of health policy, in this framework, is to enhance individual confidence and ability to
achieve optimal health
Diminishing Marginal Utility
The law of diminishing marginal utility lies at the core of much of economics, also health economics.
As consumption increases, the additional utility derived from each additional unit decreases – a
health shock reduces resources for consumption, leading to a decrease in utility. Expected utility:
Risk-averse people prefer insurance to mitigate the uncertainty. An individual could buy a health
insurance that assures that regardless of whether a health shock occurs, an individual always
receives:
Insurance ensures consistent consumption levels, reducing the impact of health shocks. Individuals
prefer certainty (insured utility) over uncertainty (expected utility). This explains the demand for
health insurance – individuals that are risk averse, have a demand for health insurance.
= a positive demand for health insurance.
The difference between U and EU determines the amount of health insurance premium (u) that an
individual would be willing to pay to insure away the risk of the health shocks.
The actual compensation then becomes:
The formula represents the actual consumption (C¯) for an individual after accounting for the risk of
health shocks and the premium (μ) paid for insurance – it is the actual consumption level an
individual enjoys under the protection of insurance. It explains how insurance helps smooth
consumption across different states of health.
LECTURE WEEK 1.1 WHAT IS HEALTH (POLICY)? 3
BOOK CHAPTER 1 – WHY HEALTH ECONOMICS? 6
BOOK CHAPTER 15 – THE HEALTH POLICY CONUNDRUM 7
ARTICLE 1 – HEALTH CAPABILITY: CONCEPTUALIZATION AND OPERATIONALIZATION 12
ARTICLE 2 - INDIVIDUAL AUTONOMY AND STATE INVOLVEMENT IN HEALTH CARE 15
LECTURE WEEK 1.2 LIFECYCLE HEALTH MODELLING 17
BOOK CHAPTER 3 – THE GROSSMAN MODEL 21
ARTICLE 1 – ON THE CONCEPT OF HEALTH CAPITAL AND THE DEMAND FOR HEALTH 24
ARTICLE 2 – OPTIMAL AGING AND DEATH: UNDERSTANDING THE PRESTON CURVE 26
LECTURE WEEK 2.1 EARLY-LIFE DETERMINANTS OF HEALTH 27
ARTICLE 1 – KILLING ME SOFTLY: THE FETAL ORIGINS HYPOTHESIS 29
ARTICLE 2 – AGING: HEALTH AT ADVANCED AGES 31
ARTICLE 3 – SOCIOECONOMIC CONDITIONS IN CHILDHOOD AND MENTAL HEALTH LATER IN LIFE 34
LECTURE WEEK 2.2 HEALTHY AGING 36
BOOK CHAPTER 19 – POPULATION AGING 39
LECTURE WEEK 3 BEHAVIORAL HEALTH ECONOMICS 41
BOOK CHAPTER 23 - PROSPECT THEORY 44
BOOK CHAPTER 24 - TIME INCONSISTENCY AND HEALTH 46
ARTICLE 1 - MAPS OF BOUNDED RATIONALITY: PSYCHOLOGY FOR BEHAVIORAL ECONOMICS 47
ARTICLE 2 - A THEORY OF RATIONAL ADDICTION 50
LECTURE WEEK 4.1 SOCIAL DETERMINANTS OF HEALTH 53
ARTICLE 1 – THE DAHLGREN-WHITEHEAD MODEL OF HEALTH DETERMINANTS: 30 YEARS ON AND STILL CHASING
RAINBOWS 56
ARTICLE 2 – SOCIAL MINIMUM 57
LECTURE WEEK 4.2 HEALTH DISPARITIES I 60
BOOK CHAPTER 4 – SOCIOECONOMIC DISPARITIES IN HEALTH 61
ARTICLE 1 – EMPLOYMENT GRADE AND CORONARY HEART DISEASE IN BRITISH CIVIL SERVANTS 64
LECTURE WEEK 5.1 HEALTH DISPARITIES II 65
,ARTICLE 1 - NEIGHBORHOOD SOCIOECONOMIC STATUS AND HEALTH CARE COSTS: A POPULATION-WIDE STUDY IN
THE NETHERLANDS 68
ARTICLE 2 - SEPARATE AND COMBINED EFFECTS OF INDIVIDUAL AND NEIGHBOURHOOD SOCIO-ECONOMIC
DISADVANTAGE ON HEALTH-RELATED LIFESTYLE RISK FACTORS: A MULTILEVEL ANALYSIS 70
LECTURE WEEK 5.2 PREVENTION I 71
ARTICLE 1 – AN OUNCE OF PREVENTION 73
ARTICLE 2 – SICK INDIVIDUALS AND SICK POPULATIONS 76
LECTURE WEEK 6.1 PREVENTION II 79
BOOK CHAPTER 22 OBESITY 80
ARTICLE 1 – THE RETURNS TO PREVENTING CHRONIC DISEASE IN EUROPE AND THE UNITED STATES 82
LECTURE WEEK 6.2 PREVENTION BASED HEALTH POLICY 84
ARTICLE 1 - SMALL STEPS, BIG CHANGE. FORGING A PUBLIC-PRIVATE HEALTH INSURANCE SYSTEM IN THE
NETHERLANDS 86
ARTICLE 2 – ADVANCING THE APPLICATION OF SYSTEMS THINKING IN HEALTH: WHY CURE CROWDS OUT PREVENTION
87
ARTICLE 3 – FROM HEALTH IN ALL POLICIES TO HEALTH FOR ALL POLICIES 88
ARTICLE 4 – TOWARDS LEGALLY MANDATED PUBLIC HEALTH BENCHMARKS 89
,Lecture week 1.1 What is health (policy)?
The lecture aimed to:
• Define and critique different perspectives on health.
• Explain the role of risk aversion in health policy.
• Discuss the impact of asymmetric information on health policy.
• Evaluate arguments for and against state involvement in health.
What is health?
Health is a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity (WHO).
à Critique – this definition implies that individuals who are not “completely well” are unhealthy,
making the majority of people perpetually “sick”.
Life-expectancy gives a limited picture of disease burden:
• The current epidemiological phase is characterized by chronic diseases. They reduce quality
of life without necessarily shortening the life-span. So – reducing quality of life, not life
expectancy.
To measure burden of disease whilst living we can use healthy life-expectancy
• The number of years an individual is expected to live without a disability (in good self-
assessed health). Measuring the quality of life.
Life-Course Health – over the years, it is possible to get more diseases. And at all ages, the diseases
are different. When you are younger, other diseases/health issues are more common than when you
are older.
Health evolves over a lifetime. Few individuals are entirely free from disease at any point, but this
does not always equate to poor health.
Huber et al. – Health is the ability to adapt and self manage in the face social, physical and emotional
challenges. This approach emphasizes resilience and functional capabilities over the absence of
disease.
, Health Capabilities (Ruger) - Confidence and ability to be effective in achieving optimal health given
biologic and genetic disposition; intermediate and the broader social, political, and economic
environment; and access to the public health and health care system.
à The goal of health policy, in this framework, is to enhance individual confidence and ability to
achieve optimal health
Diminishing Marginal Utility
The law of diminishing marginal utility lies at the core of much of economics, also health economics.
As consumption increases, the additional utility derived from each additional unit decreases – a
health shock reduces resources for consumption, leading to a decrease in utility. Expected utility:
Risk-averse people prefer insurance to mitigate the uncertainty. An individual could buy a health
insurance that assures that regardless of whether a health shock occurs, an individual always
receives:
Insurance ensures consistent consumption levels, reducing the impact of health shocks. Individuals
prefer certainty (insured utility) over uncertainty (expected utility). This explains the demand for
health insurance – individuals that are risk averse, have a demand for health insurance.
= a positive demand for health insurance.
The difference between U and EU determines the amount of health insurance premium (u) that an
individual would be willing to pay to insure away the risk of the health shocks.
The actual compensation then becomes:
The formula represents the actual consumption (C¯) for an individual after accounting for the risk of
health shocks and the premium (μ) paid for insurance – it is the actual consumption level an
individual enjoys under the protection of insurance. It explains how insurance helps smooth
consumption across different states of health.
