Money and Medicine: The Evolution of National Health Expenditures

The book "Money and Medicine" provides a unified narrative of medical spending from ancient times to the present, tracing an S-shaped growth curve that rose rapidly after 1900 as science made therapies more effective and expensive. It illustrates international trends in forty-three countries and suggests why spending is so much higher in the United States than other countries.

Format: Hardback
Length: 344 pages
Publication date: 21 December 2022
Publisher: Oxford University Press Inc

A comprehensive historical analysis that spans from ancient times to the present and predicts future trends in healthcare spending. While there have been numerous accounts of medicine's evolution, few have examined the dynamics of expenditures across decades and centuries. Economists have yet to fully explore the profound transformation that occurred during the twentieth century, as payments shifted from solo physician practices to health systems, and the lasting impact of social practices accumulated over millennia on future health spending. In Money and Medicine, Thomas E. Getzen offers a unified narrative of medical spending, spanning from ancient Egypt and Babylonia to the present day. Drawing on a wealth of historical reports, data, and documents, Getzen focuses on a single ratio—the share of income devoted to medical care—to trace the evolutionary path of medicine. Through this lens, he reveals an S-shaped growth curve that accelerated rapidly after 1900, driven by advancements in science that made therapies more effective and expensive. The curve experienced a period of inflection as national health systems emerged and expansion peaked in the 1960s, followed by a gradual deceleration after 1975. International trends in forty-three countries are graphically illustrated, supported by analysis that suggests a parsimonious financial model. Notably, significant lags are observed between medical innovation or macroeconomic shocks and corresponding changes in national health expenditures. Getzen delves into the explanations for inertial responses to the 2008 financial crisis and the COVID-19 recession, provides a method for projecting trends over the next fifty years, and explores why healthcare spending is significantly higher in the United States compared to other countries. As rising costs and unequal distribution of medical care continue to generate a sense of crisis in many nations, Money and Medicine underscores the importance of looking beyond the immediate challenges to address the long-term sustainability of healthcare systems.

Weight: 646g
Dimension: 244 x 160 x 28 (mm)
ISBN-13: 9780197573266