Indirect Costs and Discounting in Health Care Decision-Making: The Role of Distortionary Taxation

This paper focuses on the results of a survey of chief executive officers and consumer board members of Ontario hospitals and community health centres regarding the role of consumers in health care decision making. The opinions of both the chief executive officer and consumer board member respondents were elicited regarding the value of consumer input in decision making for the organizations studied. Results indicate that consumer board members feel that their input into organizational decision making is valued, chief executive officers value the input of consumers, and consumer involvement in decision making is increasing. More women are now involved on boards of the organizations studied, but visible minority representation remains low on hospital boards. Consumer board members feel that their decision making is influenced by providers on the board.

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Indirect Costs and Discounting in Health Care Decision-Making: The Role of Distortionary Taxation

The B E Journal of Economic Analysis & Policy ◽

10.1515/1538-0645.1512 ◽

2006 ◽

Vol 5 (1) ◽

Author(s):

Liqun Liu ◽

Andrew J Rettenmaier ◽

Thomas R Saving

Keyword(s):

Health Care ◽

Health Program ◽

Indirect Costs ◽

Rate Of Return ◽

Present Value ◽

Distortionary Taxation ◽

Care Decision ◽

Selection Of ◽

Gross Rate

AbstractTwo important unresolved issues in the evaluation of health care programs are the treatment of indirect costs and the selection of the appropriate discount rate. This paper emphasizes the role of distortionary taxation in addressing these issues. It establishes that: (i) indirect government-paid costs should be treated differently from indirect privately-paid costs; (ii) direct and indirect government costs of a health program should be discounted by the gross rate of return, while consumers' monetary valuations of the program's effects, less direct private costs, should be discounted at the net rate of return; and (iii) the present value of total government costs should be multiplied by a marginal cost of funds before it is comparable to the present value of net private benefits.

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Agenda-setting in health reform:the role of community

Australian Health Review ◽

10.1071/ah010161 ◽

2001 ◽

Vol 24 (1) ◽

pp. 161 ◽

Cited By ~ 4

Author(s):

Rosemary Aldrich ◽

Gavin Mooney

Keyword(s):

Health Care ◽

Decision Making ◽

Health Care Reform ◽

Community Involvement ◽

Agenda Setting ◽

Health Reform ◽

Health Care Decision ◽

Reform Agenda ◽

Care Decision

This paper presents a number of issues surrounding the setting of agendas for health care reform. We argue the needfor increased community involvement, as well as the necessity to wrest health-care decision-making from health careprofessionals, or at least to ensure that such decision-making is informed by community values.We attempt to answer a few questions: who sets the health reform agenda and who should set it, how is the agendaset and why is this critical, when and where is the agenda set, and how should the agenda be set in the future?

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