Pakistan is attributed to the lack of access to basic health care services, poverty, lack of health infrastructure and personnel, illiteracy, women’s low status, inadequate water supplies and sanitation. In the urban areas, access to health care clinics and facilities is not a problem, though the general state and quality of public services is very poor. On the other hand, in the rural areas, people live far from hospitals and basic health care units. It is for this reason that most women give birth at home with the assistance of a midwife or lady health worker. Illness pushes people into poverty through lost wages, high spending for treatment and recurring treatment for their illnesses. One of the main causes of illness in the rural areas of Pakistan is poor water and sanitation systems. Some studies indicate that a significant portion of the rural poor incomes is spent on preventable common diseases linked to contaminated water and unsanitary living conditions. Thus, the severity of health-related poverty is closely reflected in the country’s poor health indicators. Poverty is thus both a consequence and a cause of ill health. There are 127,859 doctors and 12,804 health facilities in the country to cater for over 180 million people. In 2007 there were 85 physicians for every 100,000 persons in Pakistan, or in other words, one doctor for 1,225 people. There are only over 62,000 nurses all over Pakistan who are supplemented with a strong force of 96,000 Lady Health Workers (primary health care providers). There were 13,937 health institutions in the country including 945 hospitals (with a total of 103,285 hospital beds), 4,755 dispensaries, 5,349 Basic Health Units (mostly in rural areas), 903 Mother and Child Care Centres, 562 rural health centres and 290 TB centres. Pakistan’s total health expenditures amounted to 3.9 percent of gross domestic product (GDP) in 2005, and per capita health expenditures were $49. The government provided 24.4 percent of total health expenditures, with the remainder being entirely private, out-of-pocket expenses. Millennium Development Goals are eight international development goals that all 192 United Nations member states and at least 23 international organisations have agreed to achieve by the year 2015. They include reducing extreme poverty, reducing child mortality rates, fighting disease epidemics such as AIDS, and developing a global partnership for development. Our real NGO’s are also focusing on some of the infectious diseases like malaria, tuberculosis, HIV/ AIDS, dengue fever, maternal and child health. Dengue fever is a viral disease associated with urban environments. It is also known as Break Bone fever. The presence of fever, rash, and headache (and other pains) is particularly characteristic of dengue. Malaria is a problem faced by the lower class and some of the upper-class people in Pakistan. The unsanitary conditions and stagnant water bodies in the rural areas and city slums provide excellent breeding grounds for mosquitoes. The symptoms of malaria vary from person to person. The characteristic symptom of malaria is fever accompanied by flu like illness, muscle ache, headaches and chills. Diarrhoea, nausea, vomiting and cough are also observed in some cases. Mother’s health in Pakistan remains neglected due to a multiplicity of factors—social, economic, and political. Many women lose their lives in the process of giving births to their children and this means that, in Pakistan, pregnancy is not safe in its effects on the mother, new-born and household. The overall development process also ignores of what is needed to improve the welfare of the vulnerable group such as the expecting mothers. Pakistan, therefore, represents an unacceptably high maternal mortality setting and needs an immediate attention for substantial and sustained reduction in the risk of dying during pregnancy.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in the production and consumption of health and healthcare. In broad terms, health economists study the functioning of healthcare systems and health-affecting behaviours such as smoking. Health economists evaluate multiple types of financial information: costs, charges and expenditures.
Uncertainty is intrinsic to health, both in patient outcomes and financial concerns. The knowledge gap that exists between a physician and a patient creates a situation of distinct advantage for the physician, which is called asymmetric information.
Externalities arise frequently when considering health and health care, notably in the context of infectious disease. For example, making an effort to avoid catching the common cold affects people other than the decision maker.
The demand for healthcare is a derived demand from the demand for health. Healthcare is demanded as a means for consumers to achieve a larger stock of "health capital." The demand for health is unlike most other goods because individuals allocate resources in order to both consume and produce health.
The above description gives three roles of persons in health economics. The World Health Report states that people take four roles in the healthcare:
1. Contributors
2. Citizens
3. Provider
4. Consumers
Michael Grossman's 1972 model of health production has been extremely influential in this field of study and has several unique elements that make it notable. Grossman's model views each individual as both a producer and a consumer of health. Health is treated as a stock which degrades over time in the absence of "investments" in health, so that health is viewed as a sort of capital. The model acknowledges that health is both a consumption good that yields direct satisfaction and utility, and an investment good, which yields satisfaction to consumers indirectly through fewer sick days. Investment in health is costly as consumers must trade off time and resources devoted to health, such as exercising at a local gym, against other goals. These factors are used to determine the optimal level of health that an individual will demand. The model makes predictions over the effects of changes in prices of healthcare and other goods, labour market outcomes such as employment and wages, and technological changes. These predictions and other predictions from models extending Grossman's 1972 paper form the basis of much of the econometric research conducted by health economists.
Although assumptions of textbook models of economic markets apply reasonably well to healthcare markets, there are important deviations. Many states have created risk pools in which relatively healthy enrolees subsidise the care of the rest. Insurers must cope with adverse selection which occurs when they are unable to fully predict the medical expenses of enrolees; adverse selection can destroy the risk pool. Features of insurance market risk pools, such as group purchases, preferential selection ("cherry-picking"), and pre-existing condition exclusions are meant to cope with adverse selection.
Insured patients are naturally less concerned about healthcare costs than they would if they paid the full price of care. The resulting moral hazard drives up costs, as shown by the famous RAND Health Insurance Experiment. Insurers use several techniques to limit the costs of moral hazard, including imposing co-payments on patients and limiting physician incentives to provide costly care. Insurers often compete by their choice of service offerings, cost sharing requirements, and limitations on physicians.
Consumers in healthcare markets often suffer from a lack of adequate information about what services they need to buy and which providers offer the best value proposition. Health economists have documented a problem with supplier induced demand, whereby providers base treatment recommendations on economic, rather than medical criteria. Researchers have also documented substantial "practice variations", whereby the treatment also on service availability to rein in inducement and practice variations.
Some economists argue that requiring doctors to have a medical license constrains inputs, inhibits innovation, and increases cost to consumers while largely only benefiting the doctors themselves.
Mental health economics incorporates a vast array of subject matters, ranging from pharmacoeconomics to labour economics and welfare economics. Mental health can be directly related to economics by the potential of affected individuals to contribute as human capital. In 2009 Currie and Stabile published "Mental Health in Childhood and Human Capital" in which they assessed how common childhood mental health problems may alter the human capital accumulation of affected children. Externalities may include the influence that affected individuals have on surrounding human capital, such as at the workplace or in the home. In turn, the economy also affects the individual, particularly in light of globalization. For example, studies in India, where there is an increasingly high occurrence of western outsourcing, have demonstrated a growing hybrid identity in young professionals who face very different sociocultural expectations at the workplace and in at home. Mental health economics presents a unique set of challenges to researchers. Individuals with cognitive disabilities may not be able to communicate preferences. These factors represent challenges in terms of placing value on the mental health status of an individual, especially in relation to the individual's potential as human capital. Further, employment statistics are often used in mental health economic studies as a means of evaluating individual productivity; however, these statistics do not capture "presenteeism", when an individual is at work with a lowered productivity level, quantify the loss of non-paid working time, or capture externalities such as having an affected family member. Also, considering the variation in global wage rates or in societal values, statistics used may be contextually, geographically confined, and study results may not be internationally applicable.
Health and health care are dominant economic and political issues in the United States and many other countries. This dissertation contains two essays addressing different subjects within the field of health economics. The first essay is labour market oriented: “An Economic Analysis of the Effects of Obesity on Wages.” It examines the effects of overweight and obesity on the wages of men and women. The second essay, “An Economic Analysis of the Impact on Health Care of Certain Medicare Provisions of the Balanced Budget Act of 1997” examines changes in the treatment of Medicare patients in light of reimbursement changes brought about by the Balanced Budget Act of 1997. This analysis contained in “An Economic Analysis of Obesity on Wages” improves on previous work by using a dataset that can allow health effects to be better examined. Three series of regressions are performed, where log wage income is regressed on a series of variables including categorical variables based on body mass index. In contrast to some previous research, this analysis finds that the wages of obese individuals are not depressed by excess weight. It is possible that, because of the increasing prevalence of overweight and obesity over the last 20 years, any associated stigma has dwindled. “An Economic Analysis of the Impact on Health Care of the Balanced Budget Act of 1997” examines the effects of one of the provisions of the Balanced Budget Act of 1997. Specifically, the analysis examines the implementation of the Post-Acute Care Transfer policy, a change to Medicare Part A, caused the length of stay for patients grouped in certain targeted diagnosis related groups (DRGs) to increase, keeping with the goal of the policy change. In analysing the short-stay patients, the data show that patients who were grouped into the pilot DRGs and were transferred after 10/01/98 (the effective date of the policy) were not in the hospital longer than before 10/01/98, implying that hospitals might not have been exploiting a financial loophole, as thought by the Health Care Financing Administration, now the Centres for Medicare and Medicaid Services.
In conclusion, after having a conversation with a head consultant DR. Fernando I believe that healthcare should be accessible for those who choose to make unwise choices themselves as they are still indirectly paying for the service through taxes. A reason why people choose to make the choices they do could be down to reasons such as depression, which could be tackled by consuming alcohol which negatively affects your liver. Another reason could be habitual behaviour and addiction, an individual may be addicted to smoking and therefore having a cigarette could reduce their stress and anxiety levels by fulfilling their need of nicotine. Therefore, I disagree with the statement made.