B3133 - REGULATION IN HEALTHCARE INSURANCE AND MARKETS

Conoscenze e abilità da conseguire

The aim of the course is to present the fundamental microeconomic justifications of regulatory intervention in the healthcare sector in response to market failures, and to discuss incentive-based remedies and their limitations. The broad topic focuses on health service financing and insurance markets in developed countries. Teaching practice supports theoretical considerations with an in-depth discussion of the institutional features of different forms of intervention in healthcare markets and with the presentation of case-studies regarding the practice of health insurance in various European countries and the US. At the end of the course, the student is expected to reach a detailed knowledge on: 1) the main reasons of market and government failures in the healthcare sector; 2) the trade-offs characterizing public intervention in financing and delivery of health services; 3) the role of economic incentives in regulatory policies; 4) the role, limitations and potential solutions of regulatory intervention in health insurance markets (e.g. including long term care); 6) European countries and US health insurance design and regulatory frameworks.

Contenuti

The course is divided into two distinct parts, each worth 6 credits (30 hours). The first part covers the regulation of healthcare services delivery and is assigned to Professor Matteo Lippi Bruni (MLB). The second part covers the regulation of insurance markets in the healthcare sector and is assigned to Professor Luke Connelly (LC).

Contents

First Part (MLB)

1. Market failures in health care.
2. Regulating market structure: the normative approach to the health care market.
3. The political economy of the health care sector.
4. Provider behavior under different payment mechanisms
5. Payment systems in primary care.
6. Pay for perfomance.
7. Hospital providers under cost-based reimbursement and prospective payments.

Second Part (LC)

1. Introduction to Insurance and Health Insurance
2. The Welfare Economics of Insurance
3. Market Failure in Health Insurance Markets
4. Asymmetric Information in Health Insurance Markets
5. Adverse Selection and Moral Hazard in Health Insurance Markets
6. Life and Limb and the “Judgement Proof” Problem
7. Insurance Market Regulation: Problems of Market and Government Failure
8. Case Studies in Health Insurance

Testi/Bibliografia

Readings/bibliography

First Part (MLB)

Selected chapters from:

Glied, S. and Smith P C. (eds),The Oxford Handbook of Health Economics,Oxford University Press, 2011.

Pauly, M V., Mcguire T G. and Barros, P P. (eds),Handbook of Health Economics, Volume 2, Elsevier, 2012.

Zweifel, P., Breyer, F. and Kifmann, M. (eds),Health Economics, Oxford University Press, 2nded., 2009.

Complementary textbooks:

Jones A M. (ed),The Elgar Companion to Health Economics

Second Part (LC)

Journal papers and book chapters, to be advised.

Metodi didattici

Teaching Methods

First Part (MLB)

Mainly traditional lectures, based on material made available on the course website. Class discussion and individual presentation of a scientific paper chosen by the student at the beginning of the course.

Second Part- (LC)

Traditional lectures, Student-Faculty Discussions (including “journal club”, debate, and discussion of relevant contemporary regulatory/market issues)

Lectures

The course includes traditional lectures, and the essential readings (marked with an asterisk (*), above) which are used to introduce the key concepts and evidence. These will also be supplemented by further reading and online resources, which will be available on the course’s teaching page.

“Journal Club”

In addition to traditional lectures and readings, student participation is a central part of the course design and learning methods. Between one-third-to-one-half of most classroom sessions (apart from the introductory class) will involve the direct participation in discussion and debate. Tasks will include discussions in a “journal club” format: one or more class members will be asked to lead a discussion of a nominated paper; and typically at least one more student will be asked to be the “secondary” discussant of the paper. The role of the nominees is not to provide a presentation of the paper, but to lead the class discussion by preparing questions and comments about the paper. All class members will be expected to have read the paper and to contribute to discussion. The purpose of this approach is primarily to encourage students to bring the course materials to bear on the selected topics (together with their own knowledge and experience, where relevant) to encourage a critical discussion of the course contents and their relevance to contemporary issues.

Debate

Discussions and debate will be encouraged through the “journal club” approach and may also involve the nomination of a contemporary topic for debate. For instance, students may be allocated to “Affirmative” and “Negative” teams and asked to debate a nominated topic using the concepts from the course and their own critical review of the literature.

Modalità di verifica e valutazione dell'apprendimento

Assessment methods

First part (MLB)

Written exam – 85% - Class Presentation 15%

Second part (LC)

There are three elements of assessment:

Contributions to Classroom Discussion/Debate (10%)

Group Debate: Essay and Presentation (30%)

Final examination (60%)

Contributions to Classroom Discussion/Debate (10%)

Contributions to the classroom discussions and debate are worth 10% of the final grade for this course. Contributions to debate obviously involve participation in debate, but the contribution to a debate depends on how much the participant influences a discussion by asking meaningful questions or making thought-provoking points. (This distinction will be discussed briefly in the first lecture.)

Group Debate: Essay and Presentation (30%)

This item of assessment will be conducted in groups. Groups will be allocated by Professor Connelly (the size and number of groups to be partly determined by total enrolment in the course). The groups will be required to produce an essay arguing in the Affirmative or the Negative on a topic nominated by the Professor. The essay grade will comprise half of the total for this assessment item (i.e., will be graded out of a maximum of 15 marks). The Debate will require each group member to present part of the argument (e.g., opening, middle, closing), with alternating presentations by the opposing team (e.g., Team 1 Group Member 1 speaks first, followed by Team 2 Group Member 2, and so on) in the form of a debate. (Members of the same team will be allowed to collude during the course of the debate—except during the presentation of a team member who “has the floor”—if they want to do so.) The presentation/debate component of this assessment item is also worth 15 marks.

Note: as a rule, both the essay and presentation marks will be awarded as group marks. In the event of wide disparities in the performance of team members, though, individual marks for the oral part of this assessment item may be invoked.

Final Examination (60%)

The final essay examination will be of 2 hours duration with 10 minutes’ perusal time. Students will choose two (2) essays from four (4) options, with each essay response to be afforded equal weight for this item. Students will be permitted to bring one double-sided sheet of A4 paper of notes to the examination and to rely upon it during the exam. Calculators and other electronic devices, including phones, are neither required nor permitted to be used during the examination.

Strumenti a supporto della didattica

Detailed syllabus and teaching material will be available on the e-learning website of the course (Virtuale platform)

Orario di ricevimento

Consulta il sito web di Matteo Lippi Bruni

Consulta il sito web di Luke Brian Connelly