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The Supply
of Health
Services
Supply of health care goods and services is
 different from other commodities because
    it is composed of MULTIPLE INPUTS.
• Cars need steel, rubber, wires and
  garments and uses labor to have an end
  product – a CAR

• Health care goods and services are inputs
  that need to be combined with each other
  to produce an end product – BETTER
  HEALTH
For a sick person to be healthy, he needs the
ff inputs:


• An expert advice from a physician/health
  personnel
• Hospital/clinic facilities
• Pharmaceuticals
• Medical technology
• Manpower
   – MD, RN, RM, DMD, PT

• Health infrastructure
   – Facilities needed to carry out the delivery of health services
     (clinics, hospitals, health centers)

• Drugs
   – OTC, prescription, herbal drugs

• Others
   – Other inputs which may be required to produce health like
     research and trainings.
Manpower
• Highly-skilled manpower is the most important input in
  the supply of health services.
• Often there is a trade-off between abundant supply and
  high quality manpower.
• Physicians play a crucial role.
• 80% of all spending are influenced by physicians’
  decisions.
Role of physicians
1. They recommend a particular course of action for their patients
   – Patient don’t have perfect knowledge of their conditions and
     would require the expertise of health professionals.
2. Physicians while making crucial decisions for the patients, also
   participate in actual delivery of health services
   – Surgery
   – Giving immunizations
   – consultations
• Unlike other inputs, manpower takes a
  long time to produce.

• It takes years to be a typical specialist
  physician practitioner in the Phil from high
  school onwards.
• Highly specialized manpower tend to self-
  regulate.
• PRC
• Different specialty organizations
• Regulatory boards
• Specialist physician groups “auto-regulate”, meaning
  they regulate the production of themselves. This may
  be used to:
   – Assure the quality and skills of specialists
   – Distribute specialist manpower more effectively and
     efficiently (in different parts of the country)
   – “ward off” potential competitors in a certain
     geographic medical practice area.
Health Facilities
• Hospitals, Clinics, Labs, Ambulatory
  Centers etc.
• Supply of Hospital Services
  – Service Capacities
  – Geographic Distribution
  – Emphasis on Technology
  – Hospital Networking
Different categories for health facilities:
Technology and Specialization
• Technology improvement in diagnostics and therapeutics has
  improved the outcomes of medical intervention.

• Specialization in specific areas and at all levels of hospital
  manpower has increased the accuracy of diagnoses and
  therapeutics

• It also improved the outcomes of medical and surgical
  intervention
Hospital Capacity and
Geographic Distribution
• As of early 2000
  – 1,942 hospitals (registered in Phil Hospital
    Association)
  – 90,766 beds
  – 80 million Filipinos

  – 1 hospital bed = 850 Filipinos
Hospital Capacity
• The better the preventive and promotive health
  programs, the more likely it is that there will be less
  people seeking hospitalization

• Demand side
   – Population and the effectiveness of the preventive and
     promotive health programs


• Supply side
   – Depends on the capabilities of each and every hospital bed
     who depends on other input like adequacy and competence
     of medical manpower, medical technology, pharmaceuticals,
     among others
Pharmaceuticals (Branded and Generics) and
other medical supplies
• 10-12% of sales are generics and 88-90%
  are
     branded
Drugs as Other Inputs
• Cost components:
   1. Research and development
      • Most expensive
      • Cost of “inventing” or “innovating” new drugs
      • For a new drug to be introduced in the market, company
        takes $800 M in research and development
       • To recover a pharmaceutical firm’s R&D expenses, “patents” are
         awarded to drugs.
       • For 15 yrs, no one is allowed to produce and market a certain drug-
         monopoly
       • This gives the company the capability of pricing the drug high
• After the patent period expires, monopoly over the drug stops and
     the drug becomes “generic.”
   • This entitles others to produce and sell the same drug, allowing
     competition to set in.
   • This unpatented drug then becomes a cheap alternative.
2. Drug manufacturing cost-raw materials, packaging
3. Marketing cost
4. Distribution cost
Supplier-Induced Demand
• Physicians decides what a patient needs-is
  also the supplier of the product/service
  – Ex. A pediatrician during consultation,
    decides or recommends for a baby patient a
    vaccine which the pedia may also be
    supplying

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THE SUPPLY OF HEALTH SERVICES

  • 2. Supply of health care goods and services is different from other commodities because it is composed of MULTIPLE INPUTS.
  • 3. • Cars need steel, rubber, wires and garments and uses labor to have an end product – a CAR • Health care goods and services are inputs that need to be combined with each other to produce an end product – BETTER HEALTH
  • 4. For a sick person to be healthy, he needs the ff inputs: • An expert advice from a physician/health personnel • Hospital/clinic facilities • Pharmaceuticals • Medical technology
  • 5. • Manpower – MD, RN, RM, DMD, PT • Health infrastructure – Facilities needed to carry out the delivery of health services (clinics, hospitals, health centers) • Drugs – OTC, prescription, herbal drugs • Others – Other inputs which may be required to produce health like research and trainings.
  • 6. Manpower • Highly-skilled manpower is the most important input in the supply of health services. • Often there is a trade-off between abundant supply and high quality manpower. • Physicians play a crucial role. • 80% of all spending are influenced by physicians’ decisions.
  • 7. Role of physicians 1. They recommend a particular course of action for their patients – Patient don’t have perfect knowledge of their conditions and would require the expertise of health professionals. 2. Physicians while making crucial decisions for the patients, also participate in actual delivery of health services – Surgery – Giving immunizations – consultations
  • 8. • Unlike other inputs, manpower takes a long time to produce. • It takes years to be a typical specialist physician practitioner in the Phil from high school onwards.
  • 9.
  • 10. • Highly specialized manpower tend to self- regulate. • PRC • Different specialty organizations • Regulatory boards
  • 11. • Specialist physician groups “auto-regulate”, meaning they regulate the production of themselves. This may be used to: – Assure the quality and skills of specialists – Distribute specialist manpower more effectively and efficiently (in different parts of the country) – “ward off” potential competitors in a certain geographic medical practice area.
  • 12. Health Facilities • Hospitals, Clinics, Labs, Ambulatory Centers etc. • Supply of Hospital Services – Service Capacities – Geographic Distribution – Emphasis on Technology – Hospital Networking
  • 13. Different categories for health facilities:
  • 14. Technology and Specialization • Technology improvement in diagnostics and therapeutics has improved the outcomes of medical intervention. • Specialization in specific areas and at all levels of hospital manpower has increased the accuracy of diagnoses and therapeutics • It also improved the outcomes of medical and surgical intervention
  • 15. Hospital Capacity and Geographic Distribution • As of early 2000 – 1,942 hospitals (registered in Phil Hospital Association) – 90,766 beds – 80 million Filipinos – 1 hospital bed = 850 Filipinos
  • 17. • The better the preventive and promotive health programs, the more likely it is that there will be less people seeking hospitalization • Demand side – Population and the effectiveness of the preventive and promotive health programs • Supply side – Depends on the capabilities of each and every hospital bed who depends on other input like adequacy and competence of medical manpower, medical technology, pharmaceuticals, among others
  • 18. Pharmaceuticals (Branded and Generics) and other medical supplies • 10-12% of sales are generics and 88-90% are branded
  • 19. Drugs as Other Inputs • Cost components: 1. Research and development • Most expensive • Cost of “inventing” or “innovating” new drugs • For a new drug to be introduced in the market, company takes $800 M in research and development • To recover a pharmaceutical firm’s R&D expenses, “patents” are awarded to drugs. • For 15 yrs, no one is allowed to produce and market a certain drug- monopoly • This gives the company the capability of pricing the drug high
  • 20. • After the patent period expires, monopoly over the drug stops and the drug becomes “generic.” • This entitles others to produce and sell the same drug, allowing competition to set in. • This unpatented drug then becomes a cheap alternative. 2. Drug manufacturing cost-raw materials, packaging 3. Marketing cost 4. Distribution cost
  • 21. Supplier-Induced Demand • Physicians decides what a patient needs-is also the supplier of the product/service – Ex. A pediatrician during consultation, decides or recommends for a baby patient a vaccine which the pedia may also be supplying