A New Paradigm for Health Economics? We Have Three Already!

  • Robert G. Evans
Keywords: paradigm


Figure I depicts a set of inter-sectoral financial flows that represent central features of the organization and financing of health care systems.

But It is primarily a set of accounting relationships, a gross anatomical description that provides no “physiology” explaining how the various components interact, or how those interactions might change in response to anatomical changes.  What difference does it make, in terms of patterns of service delivery and cost, of distribution of burdens and benefits among the population, or of population health status, if the mixes of financing and funding flows in Figure 1 are re-arranged?  These questions, sometimes overt, often covert, are everywhere at the heart of debates over health policy.