Accounting and Pharmacy Business Administration
Health Economics (Pharmacy Business Administration Series)
This book presents an introduction for students to the issues of economics in healthcare. This text is part of the "RPS Pharmacy Business Administration Series"; a group of introductory textbooks covering all business aspects relating to pharmacy practice. Part one of this book introduces health economics with a history a overview. Part two examines health economics in relation to specific areas such as technology, prescription drugs etc. It concludes with general observations of today and the future. The purpose of this book is to acquaint students with the economic issues within healthcare today in the USA in terms of costs, affordability, the historical development, the magnitude of the economic crisis and contributing factors such as technology, drugs, and hospital care. The book also looks at the mechanisms available today to help consumers combat, afford and pay for the high costs of health; and discusses the successes and failures and reasoning behind these.
Table of contents :
Cover
......Page 1
Title Page......Page 4
Copyright......Page 5
Dedication......Page 6
Contents......Page 8
Preface......Page 14
Acknowledgments......Page 16
About the author......Page 18
Introduction......Page 20
Introduction......Page 22
The 19th century......Page 23
The Progressive Era......Page 24
The 1920s......Page 25
The 1930s......Page 26
The 1940s......Page 29
The 1950s......Page 30
The 1960s......Page 32
The 1970s......Page 33
The 1980s......Page 38
The 1990s......Page 40
The 21st century......Page 42
The year 2012......Page 44
References......Page 46
Introduction......Page 48
History of medical technology assessment......Page 49
What US health care spending has not solved......Page 51
Background of rising costs......Page 59
Societal impact of health care costs......Page 61
Why health care costs outpace general economy......Page 66
Addressing rising costs......Page 67
References......Page 68
3 - The high costs of health care: the reasons why......Page 70
Introduction......Page 120
What is managed care?......Page 71
Origins and elements in health care crisis......Page 73
Health care costs......Page 74
Practice patterns......Page 75
Hospital costs......Page 76
Physician services......Page 78
Operation Restore Trust......Page 79
Health insurance......Page 81
Medicaid and Medicare......Page 84
Manpower......Page 87
Resolving the health care crisis......Page 91
The future......Page 94
References......Page 95
Introduction......Page 98
Character of hospitals......Page 99
Physician reimbursement......Page 104
Financial impact of new medical technology......Page 110
Socialized medicine......Page 115
The British view......Page 174
Basic services......Page 122
Brand name versus generic drugs: differences and costs......Page 124
FDA's assurance of quality drugs......Page 126
Pharmacists......Page 127
Civil Monetary Penalties Law......Page 326
Conclusion......Page 137
References......Page 139
Introduction......Page 140
Hospital costs......Page 142
Hospital utilization: a brief profile......Page 148
Diagnosis-related groups......Page 149
Hospital medications......Page 154
Report cards......Page 158
Conclusion......Page 159
Prescription drug coverage......Page 285
Introduction......Page 164
Medicare......Page 297
Factors influencing growth of new technology......Page 172
Medical technology expenditures......Page 173
References......Page 175
References......Page 177
Introduction......Page 180
Health Maintenance Organization Act of 1973......Page 183
Definition of a skilled nursing home......Page 185
Components of nursing home care......Page 189
Medicare's Nursing Home Compare......Page 194
Financing nursing home care......Page 195
The USA and the UK......Page 200
References......Page 202
Introduction......Page 204
Definitions of bonded, licensed, and certified health personnel......Page 207
How to find home care agency services......Page 208
Medicare's Home Health Compare......Page 211
Home care personnel......Page 212
How to finance home health care services......Page 213
Financing hospice care services......Page 221
Conclusion......Page 223
References......Page 224
Introduction......Page 226
Definition of health planning......Page 228
The historical development of planning......Page 230
Health Planning Act of 1974......Page 233
Aftermath of the 1974 Planning Law Certificate of Need laws......Page 235
Proponents of CON programs......Page 238
Critics of CON programs......Page 240
The future......Page 241
References......Page 243
Introduction......Page 246
Federal laws and programs......Page 254
Private health insurance industry......Page 259
Shortcoming of insurance......Page 260
Costs and inadequacy of insurance protection......Page 262
Impact of health costs on US business......Page 263
Private business cost initiatives......Page 266
Conclusion......Page 267
References......Page 269
Introduction......Page 272
Health maintenance organizations......Page 274
Definition of prepaid group practice......Page 275
Evolution of HMOs......Page 277
Other forms of managed care......Page 283
Impact on the pharmaceutical industry......Page 286
References......Page 292
Introduction......Page 294
Medicaid......Page 296
Conclusion......Page 315
References......Page 319
Introduction......Page 320
Nature of fraud......Page 321
US initiatives against fraud and abuse......Page 324
Health Insurance Portability and Accountability Act of 1996 (PL 104-191)......Page 301
Balanced Budget Act of 1997 (PL 105-34, Tax) (PL 105-33, Spending)......Page 329
Necessity of US fraud initiatives......Page 334
Medicare fiscal intermediaries and carriers......Page 335
Coding issues......Page 337
Managed care......Page 338
Impact of drug industry activities on public programs - view of DHHS......Page 339
The future......Page 345
References......Page 347
From ancient Greece......Page 348
Burdens and stresses......Page 350
Coalescing of forces for national health insurance......Page 353
What's past is prologue......Page 356
American proposals......Page 360
Conclusion......Page 363
Index......Page 370
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