Seminar Series

2000 - 2001

The Health Services Research Seminars feature nationally and internationally known leaders in health services research speak on current topics. These seminars are free and open to the public.

2000-2001 Schedule

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Abstracts for HSR Series

Roger Battistella
Professor of Health Policy and Management, Sloan Graduate Program in Health Services Administration, Department of Policy Analysis and Management, College of Human Ecology, Cornell University

“The Health Insurance Defined-Contribution Movement: Whether Vouchers or Medical Savings Accounts”

Abstract

An inability to stem inflationary spending is causing major health care purchasers, employers and government, to re-examine the conventional wisdom shaping the way most Americans receive health insurance. Frustration over the failure to control spending is motivating health care purchasers to consider the advantages of providing health insurance on a defined contribution basis. In deciding between vouchers and medical savings accounts as the instrument for a defined benefit strategy, purchasers, for reasons of simplicity and political acceptability, disproportionately will be drawn to vouchers. However, the position taken in this presentation is that, although more controversial, medical savings accounts better serve the public interest because they do more to encourage sustainable long-term savings by giving individuals a powerful financial incentive to assume a vigilant partnership role in cost containment.

Professor Battistella is a nationally recognized policy scholar who has published extensively in all of the leading journals in his field on subjects involving the organization and financing of health services, managed care and health management education. He has extensive international experience, both as a consultant and visiting scholar in a large number of countries. Professor Battistella has been on the faculty of Cornell University's Sloan Graduate Program in Health Policy and Management continuously since the completion of doctoral studies from the University of Michigan in the mid 1960s. For many years he directed the Sloan Program, during which time the program was moved from the Business School to the College of Human Ecology where it now is a component of the Department of Policy Analysis and Management.

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David Cutler
John L. Loeb Professor of Social Sciences in the Department of Economics at Harvard University, Faculty member in the Kennedy School of Government, Research Associate at the National Bureau of Economic Research, Editor, Journal of Health Economics

“Why Are Americans Healthier Than They Used to Be [and Who Cares]?”

Abstract

Since 1950, life expectancy at birth has increased by nearly 10 years, and life expectancy at age 65 has increased by nearly 4 years. In addition to living longer, people are healthier at any age than they used to be. Why has health improved so greatly? What are the implications of this change for society and public policy? This talk, the subject of the book Dr. Cutler is writing this year, will consider these questions. He shows that health improvements result from several factors: high-tech medical interventions; low-tech pharmaceuticals; and behavioral change leading to healthier lives. Underlying each of these factors is a common theme: people value their health highly, and are willing to pay significant amounts, financial or psychic, to be in better health. These findings have important consequences for several issues: the amount of money optimally spent on health care; the length of the working life; and the failure of 'managed care' to meet peoples' expectations.

Dr. Cutler has served as a Senior Staff Economist at the Council of Economic of Advisers and Director of the National Economic Council. David research concentrates in health economics including explanations for increasing health costs, the effect of managed care on medical outcomes,; and measuring the productivity of the medical sector. He is currently on sabbatical at the Center for Advanced Study in the Behavioral Sciences at Stanford University where he is working on the book that his presentation will be part of.

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David H. Gustafson
Robert A Rather Professor of Industrial Engineering, Professor in Preventive Medicine, Founding Director of the Center for Health Systems Research and Analysis, University of Wisconsin-Madison

“The Internet Revolution And Healthcare: Ten Years Of Research On Consumer Health Informatics”

Abstract

This presentation will describe the state of the field of consumer health informatics and give an overview of one extensively studied system (CHESS-the Comprehensive Health Enhancement Support System) as an example of how systems, such as this one, can influence health and health care.

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A Symposium on Cost Effectiveness and Medical Technology

Frank Sloan, PhD, J. Alexander McMahon Professor of Health Policy and Management and Professor of Economics, Duke University

Mark McClellan, MD, PhD, Professor of Economics, Stanford University

Susan Foote, JD, Division Head, Health Policy and Management, School of Public Health

Abstract

The demand for accountability in health care has led to interest in evaluating new technologies on the basis of cost effectiveness and cost benefit analyses as traditional criteria such as efficacy. The use of cost effectiveness for evaluating new medical technologies is being explored by the Health Care Financing Administration and is subject to significant debate, particularly concerning its effect on the development of medical technology. This symposium is designed to explore some of the issues related the use of cost effectiveness analyses. Professor Sloan is a nationally recognized expert in cost effectiveness. As well as doing cost effectiveness analyses, he has studied how cost effectiveness analyses have been used in making coverage decisions by health care organizations. Professor McClellan is recognized for his work using cost benefit analyses and analysis of technological change, particularly for care related to heart attacks. Dr. Foote is recognized for her expertise on the policy process surrounding coverage decisions. Some of the issues the symposium will focus on include

• cost effectiveness analysis methodology and uses in health care decision-making
• the evolution of the field of medical technology assessment,
• role of public and private entities in assessment activities,
• evolution of cost-effectiveness as a concept/development of pharmacoeconomics as a field and the absence of equivalent attention to economics in the device area,
• the divergence between theory and practice/ the evolution of the field and ability to measure cost effectiveness versus the controversies that cost effectiveness that has raised in the public and private sectors, with particular attention to the Medicare program.

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