Quotes from Students Papers 2001
           University of Minnesota, Carlson School of Management
           Topics in Health Economics
           Masters in Health Administration MHA 6-755

“. . . it is surprising and almost counterintuitive that the spending for actual medical care, medications, and medical equipment decreases per year of life after a person has reached old age.  Though we have no formal system of rationing in the U.S., physicians are less likely to provide expensive and likely futile care to older individuals”(Levinsky, 1998).

 Forty percent of all healthcare expenditures are for medical care of the 13% of Americans who are 65 years and older.  On the other hand, young people with AIDS, middle-aged smokers, and heavy drinkers, among other groups, are also very costly consumers of health care, but there are few calls to limit care for such groups (Levinsky, 1998).

Overall, 89% of Medicare’s annual revenue now comes primarily from people who are less than 65 years old . . . and 11% comes from the monthly premiums contributed by elderly beneficiaries (Iglehart, 1999).

— Ron Brockman,

Issues in the Future of Healthcare for Older Americans . . . Understanding the Problem

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. . . Dr. Kermick from Exeter, England, has the perspective that “the human condition is full of decisions that aren’t simple yes/no decisions.  The next generation may be driven by an information technology/designer label/soap opera culture, but much of society will still need a shaman/healer/medicine man/health advocate/friend and will lose him at its peril.”(Fraim, 2000)

—    Lenore Day Lemke,

The Electronic Medical Record – Improving Healthcare Productivity?

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For nearly all available outcome measures, the United States ranked near the bottom of the OECD (industrialized) countries, and the rate of improvement for most of the indicators has been slower than the medical OECD country (Anderson and Poullier, 1999).

Norton’s Bankruptcy Advisor indicates that 330,000 families per year identify illness/injury as the primary reason they file for bankruptcy (May 2000).

 “The first question a hospital administrator asks every day when he or she arrives at work is, ‘What is the census today?’  The administrator is pleased when the census is high and nervous when it is low.  If he or she were interested in the health of the community, a low census would be an opportunity to rejoice because it could imply that the community was healthy” (Anderson and Poullier, 1999).

— Paul Wilson,

Principles of Rational Healthcare

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Sub-Saharan Africa represents 10% of the world’s population (596,272,000) but has 71.4% of the world’s people living with HIV and AIDS (24,500,000 of 34,300,000) (UNAIDS data).

HIV/AIDS has reduced the rate of growth of Africa’s per capita income by 0.7% per year.  Such a reduction is large when compared with the historical growth of 0.4% achieved in 1990-97 (Bonnel, 2000). 

First, HIV/AIDS reduces the stock of human and physical capital because it affects primarily the adult population in its most productive years.  Second, AIDS destroys social capital because it is tearing away at existing institutions.  On a local level, the crisis is destroying the social fabric of communities.  On a national level, AIDS is undermining the capacity of governments to provide basic social services, infrastructure, regulation, and a legal framework.  Finally, and possibly most insidious, by undermining the basic determinants of growth, the absence of growth contributes to the future spread of the disease, and further impacts economic and social development.  So we have a vicious circle whereby HIV/AIDS reduces economic growth and increases poverty, which in truth accelerates the spread of HIV.

 Without improved healthcare, cheaper antiretroviral drugs may do even more harm than good, if life-threatening side-effects are not addressed, or if therapy is interrupted, leading to drug-resistant forms of HIV (OAU Summit on AIDS, 2001).

— David R. Christensen,

A Study of HIV and AIDS in Sub-Saharan Africa

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 In a telephone survey of 13,000 American adults, “. . . seventy percent of these ‘health seekers’ reported Internet data influenced their decisions on how to treat an illness or condition, 50% said it led them to a more in-depth conversation with their physician or to get a second opinion, and almost 30% said it influenced their decision to visit a doctor” (Lure).

 Dr. C. Everett Koop, the former Surgeon General of the United States, believes that “while the science of medicine has flourished, the art of medicine, which is largely the art of communication and relationship building, has languished” (Lieberman, 1999).

 In addition to potentially unreliable and inaccurate information, the Internet can be a concern as a source of health information because consumers are often looking for health information at times of high emotional stress, perhaps in response to a terrifying diagnosis. As a result, they can be susceptible to grasping onto on-line health information that provides hope rather than reliable clinical information.  This problem is further enhanced because in today’s highly litigious environment, doctors often take hope away from patients by presenting all possible scenarios in an effort to ensure that they are covering themselves from potential litigation.

 —    Melanie Furness,

The Economic Impact of the More Informed Healthcare Consumer

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These principles [Ed. Equity and universality of access to health care] are sacred as politicians are “more likely to get away with canceling Christmas than . . . canceling Canada’s health insurance program” (Kracker).

 —    Susan Wannamaker,

Canadian Health Care:

 Delivery System to Social Identity

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