Susan Griffin and Karl Claxton
Cost-effectiveness analysis (CEA) is intended to help collective purchasers of health care to determine which interventions to prioritize, by ranking them according to the cost of each unit of “health benefit” they produce. The primary focus of this article is on the social decision-making approach where the decision-maker's objective is assumed to be the maximization of health gains subject to a given budget constraint. This article begins with the rationale for presenting a full characterization and analysis of uncertainty within any CEA. An overview of methods that can be used to conduct a CEA that accounts for uncertainty is provided, including the means to present and interpret the results. The benefits and limitations of the methods for analyzing uncertainty are considered in the context of providing information to decision-makers. The article concludes by discussing the additional questions that arise when the need for further research to support those decisions is considered.
Daniel M. Hausman
Evaluating health care institutions and policies should depend on understanding the economic complexities of health care provision and on our values of compassion, choice, efficiency, fairness, and solidarity. These values may conflict, so applying them is difficult. We must also understand the problems with health care allocation, including employing markets. Regulations are needed first because of asymmetric information: doctors know more about treatments than patients and can exploit them. Second, health insurance is a better bargain for those who expect to be sick. Consequently, health insurance policies attract purchasers more likely to make claims. This adverse selection makes claims and premiums skyrocket, healthy people drop out, and private health insurance markets collapse, unless everyone is forced to buy insurance or insurers deny insurance to those with pre-existing conditions. Third is moral hazard: if insurance pays for a health problem, there is less incentive to avoid it or to economize on treating it. Health care policies must be economically sound and morally defensible.
This article reviews the economic literature on the causes and consequences of current trends in food-related chronic diseases (FRCD) from a policy evaluation viewpoint. It focuses on policy interventions on the consumer side in developed countries. It recalls some key facts regarding historical trends in nutrition and FRCD, and highlights individual heterogeneity that is hidden behind aggregate trends. Some estimates of the medical and human capital costs of FRCD are also provided. It then considers the normative rationales for public intervention: market failures, such as the presence of externalities; and failures of consumer rationality. This article brings together some of the available empirical evidence regarding price and information policies and proposes some directions for future research.
Signe-Mary McKernan, Caroline Ratcliffe, and Trina Williams Shanks
Susan L. Averett
Francine D. Blau and Anne E. Winkler
This chapter focuses on women, work, and family, with a particular focus on differences by educational attainment. First, we review long-term trends regarding family structure, participation in the labor market, and time spent in household production, including time with children. In looking at family, we focus on mothers with children. Next we examine key challenges faced by mothers as they seek to combine motherhood and paid work: workforce interruptions associated with childbearing, the impact of home and family responsibilities, and constraints posed by workplace culture. We also consider the role that gendered norms play in shaping outcomes for mothers. We conclude by discussing policies that have the potential to increase gender equality in the workplace and mitigate the considerable conflicts faced by many women as they seek to balance work and family.