Regulation & Competition in Health Care Markets

Department
  • Master's Program International Health & Social Management
Course unit code
  • IHCM3ECO3203
Level of course unit
  • Master
Semester when the course unit is delivered
  • 3
Number of ECTS credits allocated
  • 5.0
Name of lecturer(s)
  • Dr. Hrobon Pavel, M.S.
  • Dr. Fidler Armin, MD, MPH, MSc
Learning outcomes of the course unit
  • • Students will understand the institutional (domestic European) and global need for health regulation and governance
    • Understand the players and division of responsibility of the global health architecture
    • Based on international comparison, students will understand the challenges and choices policy makers are confronted with as they attempt to regulate financing and delivery of health and public health serivces in the context of ever more scarce resources. Questions of public choice and health ethics will also be raised and discussed
    • Students will understand the institutional (domestic European) and global need for pharma regulation and governance
    • Students will identify and discuss "sunrise" issues in health and debate their respective importance
    • Understand most important regulation issues in statutory health insurance systems and learn ways how to address them
    • Understand trade-offs in definition of covered services
    • Students will identify and discuss "sunrise" issues in health and debate their respective importance
Mode of delivery
  • face-to-face
Prerequisites and co-requisites
  • none
Course contents
  • - Introduction to class and teaching content as well as types of assessment. Introduciton to the concept of regulation and governance, both in terms of health systems but also in the context of global health and global health institutions.
    - WHO, World Bank, GAVI, Global Fund, UNICEF, BMGF
    - Issues and challenges of health system performance in OECD countries. Challenges of Health Financing both in High Income (HIC) and Low and Middle Income (LMIC) countries. Matters of revenue generation within the macroeconomic context, risk pooling, insurance modalities, and service delivery within the context of a functioning health system. Regulation and governance of public and private financiers and providers based on the international experience.
    - The governments toolbox for affecting behavior Pharmaceutical Policy and Regulation
    - Health care view from the industry perspective
    - Introduction of concepts and real life examples of risk selection and adjustment, implicit and explicit definition of covered services and administration of access
    - Group work - selecting principles and tools for definition of basic benefit package
    - Health care view from the industry perspective
    - The changing authorizing environment
    - Regulation and competition - synopsis from global experience
Recommended or required reading
  • All ppt presentations and learning material will be provided either prior or right after class, depending on teaching methodology

    Websites of the respective institutions
    www.euro.who.int/__data/.../RC62BD01-Governance-for-Health-Web.pdf

    Literature will be provided in the course, e.g.:

    Gottrett, Schieber: Health Financing Revisited; World Bank: Paperback; 336 pages; 6.125x9.25 Published March 30, 2006 by World Bank ISBN: 978-0-8213-6585-4; SKU: 16585
    Collier, Paul: The Bottom Billion: Why the Poorest Countries Are failing and what Can Be Done About It, 2007, Oxford University Press
    Dror DM & Preker AS (Editors): Social Reinsurance: A New Approach to Sustainable Community Health Financing, Oct 2002,World Bank & ILO
    Enthoven, AC, Theory and practice of managed competition in health care finance, North-Holland, Amsterdam, 1988b, Chapter 1 p. 1-30.
    Gaynor and Vogt (2000), Antitrust and competition in health care markets', in Culyer and Newhouse (eds), Handbook of Health Economics (2000), 1419-1456.
    Glied, S, Managed care, Chapter 13 in AJ Culyer and JP Newhouse (eds.), Handbook of Health Economics, Elsevier, Amsterdam, 2000, 707-745.
    Kane N, and Turnbull N. 2003. Managing Health: An International Perspective. San Francisco, CA:
    Marree J and PP Groenewegen, Back to Bismarck: Health care systems in transition, Avebury, Aldershot, 1997, Chapter 1 p.3-17
    Outreville, J.-F.: Theory and Practice of Insurance, June 1998, Kluwer
    Academic Publishers,
    Rogers EM. 2003. Diffusion of Innovations, 5th Edition. New York, NY: Free Press.
    Saltman R, Busse R, and Figueras J. 2004. Social Health Insurance Systems in Western Europe. Berkshire, England: Open University Press.
Planned learning activities and teaching methods
  • Teaching will be provided predominantly by the lecturer but time is also allocated for discussion of group and individual exercises.
    Case studies and individual country cases will be discussed and presented by students - which will require both outside class preparation and study as well as a highly interactive class discussion, presentations and role plays.
Assessment methods and criteria
  • To monitor the students’ learning this course will provide ongoing assignments as a basis for feedback and grading (formative assessment) and/or will evaluate the students learning at the end of the course or an instructional unit via exams, final project reports, essays or seminar papers (summative assessment).
Language of instruction
  • English