Regulation and Health Policy

Week 6: Regulation and Health Policy

The complex health care industry faces challenges in providing efficient and effective services. While providers aim to make a profit, the competitive market in health care does not always function properly. Poorly designed incentives and limited relevant information, for example, can lead to market failures in the availability of health insurance and services. This raises the question: Does the competitive market model fit health care, or is a mixed model of private and public financing and delivery more appropriate?
The purpose of government is to maximize public welfare, and this includes looking out for the health care interests of all of its citizens. One of the government’s most powerful tools is the regulation of health care goods and services, which interferes with free competition. One means for government regulation and policy to address market failures is by promoting innovative strategies such as cost transparency and health insurance expansion.
This week, you explore regulation and health policy as it relates to cost transparency and health insurance expansion. As you examine advantages and disadvantages of cost transparency, you analyze how regulation and policy on this transparency might improve economic efficiency. You also evaluate the economic implications of the health insurance expansion.
Learning Objectives
Students will:
• Analyze advantages of transparency for health care organizations and consumers
• Analyze how cost transparency can improve economic efficiency
• Recommend regulation and policy to compare hospitals based on costs
• Analyze how health insurance expansion relates to the problem of adverse selection
• Evaluate the economic implications of health insurance expansion

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Learning Resources

Required Readings
Getzen, T. (2015). Health economics for the healthcare administrator (Laureate custom edition). New York: Wiley.
• Chapter 14, “The Role of Government and Public Goods” (pp. 319–343)
• Chapter 17, “Economic Evaluation of Health Policy: The Patient Protection and Affordable Care Act of 2010” (pp. 408–424)
Glied, S., & Miller, E. A. (2015). Economics and health reform: Academic research and public policy. Medical Care Research and Review, 1-16.
Healthcare Financial Management Association. (2014b). Price transparency in health care: Highlights from the task force report. Westchester, IL: Author. Retrieved from
Price transparency in health care: Highlights from the task force report. Retrieved from Copyright 2014 by Healthcare Financial Management Association. Reprinted by permission of Healthcare Financial Management Association via the Copyright Clearance Center. For more information on Regulation and Health Policy see this:

Regulation and Health Policy

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