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Regulation & Competition in Health Care Markets (IHSM-M3.4)

Department

Master's Program International Health & Social Management

Course unit code

IHSM-M3.4

Level of course unit

Master

Year of study

Fall 2024

Semester when the course unit is delivered

3

Number of ECTS credits allocated

5.0

Name of lecturer(s)

Assoz. FH-Prof. Fouda Ayman, PhD

Learning outcomes of the course unit

To understand the institutional and global need for health regulation and governance.
To identify sources of competition in healthcare.
To recap on the main theoretical dilemma in healthcare: agency theory.
To navigate the main tools used by regulators to govern market players.
To define the current direction of digital health reforms.
To understand the most important regulatory issues in statutory health insurance systems.
To understand trade-offs in the definition of covered services and their practical application.
To learn about the importance of practical administration of access, explore practical ways how to address trade-offs in regulatory issues.

Mode of delivery

-

Recommended optional program components

none

Course contents

Introduction 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 pool-ing, 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 interna-tional 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
Health care view from the industry perspective
The changing authorizing environment
Regulation and competition - synopsis from global experi-ence

Recommended or required reading

Levačić, R. (2009). Teacher Incentives and Performance: An Application of Principal-Agent Theory. Oxford Development Studies, 37(1), 33-46. https://doi.org/10.1080/13600810802660844

Blomqvist, A. (1991). The doctor as double agent: Information asymmetry, health insurance, and medical care. 10(4), 411-432. https://doi.org/10.1016/0167-6296(91)90023-G

Le Grand, J. (2003), Motivation, Agency, and Public Policy: Of Knights and Knaves, Pawns and Queens Oxford: Oxford University Press, xii + 191 pp., £25.00, ISBN: S0-19-926699-9. Journal of Social Policy, 33(3), 503-506. https://doi.org/10.1017/S0047279404217949

Arrow, K, J. (1963). Uncertainty and the welfare economics of medical care. The American Economic Review. 53(5). 941-973.

Quentin, W., Geissler, A., Wittenbecher, F., Ballinger, G., Berenson, R., Bloor, K., Forgione, D. A., Köpf, P., Kroneman, M., Serden, L., Suarez, R., van Manen, J. W., & Busse, R. (2018). Paying hospital specialists: Experiences and lessons from
eight high-income countries. In Health Policy (Vol. 122, Issue 5, pp. 473-484). Elsevier BV. https://doi.org/10.1016/j.healthpol.2018.03.005

McGuire, T. G., & Kleef, R. van. (2018). Risk adjustment, risk sharing and premium regulation in health insurance markets : theory and practice. Academic Press.

Towse, A., & Danzon, P. M. (2010). The Regulation of the Pharmaceutical Industry. The Oxford Handbook of Regulation, 547-571. https://doi.org/10.1093/oxfordhb/9780199560219.003.0022

Maynard, A., & Bloor, K. (2015). Regulation of the pharmaceutical industry: promoting health or protecting wealth? Journal of the Royal Society of Medicine, 108(6), 220-222. https://doi.org/10.1177/0141076814568299

Pezzola, A., & Sweet, C. M. (2016). Global pharmaceutical regulation: the challenge of integration for developing states. Globalization and Health, 12(1). https://doi.org/10.1186/s12992-016-0208-2

Planned learning activities and teaching methods

The course comprises an interactive mix of lectures, discussions and individual and group work.

Assessment methods and criteria

Course-immanent examination or final exam or combination of both examination types.

Language of instruction

English

Work placement(s)

none