2.827 Impact Factor. The question then becomes, given, on any particular day, a particular starting point for each of R and the economy, where do we go from here (1f). "openAccess": "1", 2016-2019) to peer-reviewed documents (articles, reviews, conference papers, data papers and book chapters) published in the same four calendar years, divided by the number of these documents in … Thus, when applying such a framework within publicly funded health and social care, we would normally state that a consequence of opportunity cost, and in order to spend a limited budget to maximum effect, we need to know the costs and benefits from various health and care activities (Donaldson et al., Reference Donaldson, Currie and Mitton2002). "lang": "en" Figure 1. The articles are freely accessible until April 2021. future protection). Careers - Terms and Conditions - Privacy Policy. As with all submissions to the JHE (and as stated on our submission page): Articles need to make a significant contribution in answering an interesting and important question in health economics. Is there an amount of economic expansion which might provide benefits to the population so great by which an upward drift in R, with its consequent risks, would be permitted? If marginal benefit (MB) per $/£ spent from, say, an elective heart operation programme is greater than that for an elective hip replacement, then, all else equal, resources should be taken from hips and given to hearts (Olsen and Donaldson, Reference Olsen and Donaldson1998). It could be argued that this has been one of the puzzling things of the coronavirus disease 2019 (COVID-19) pandemic, given that resource scarcity and trade-offs are the very lifeblood of economics. Pandemic literature Public health schools sometimes offer elective courses on health economics that introduce cost-effectiveness, but like … Feature Flags: { Covid Economics, Vetted and Real-Time Papers, launched at the end of March 2020, is a free online CEPR publication. It is necessary because, as indicated, the trade-offs are happening now, but without systematic analysis or public debate. However, trade-offs have been palpable at all levels of decision making. The framework accommodates both perspectives in the health-vs-economy debate whereby, depending on where we are within the marginal analysis framework, either health issues are allowed to dominate or, below some threshold of R and/or background level of infection, health and economic considerations can be traded off against each other. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings. This is also because, beyond a particular level of R (the reproduction rate for the virus) and background prevalence and incidence, the economy and health considerations go hand-in-hand. To aid presentation, assume the MC of reducing R or economic expansion are constant and equal (1e). We envision a long-term role in contributing to an understanding of the effects of the pandemic as well as the effectiveness or value of important policy initiatives to reduce the social and economic costs, including impacts on inequalities… Health and social care have been traded off against each other, with investments in large (often unused) health care capacity at the expense of services and equipment for people in care homes. We do not pre-review papers; please see recent issues of the journal for examples of types of papers we publish. Imagine that resources are so scarce that we have to choose between elective heart and hip surgery programmes – perhaps not such an unrealistic prospect, even in parts of the US and in other well-funded health care systems, going forward in the short-to-medium term. The SARS-CoV-2 virus that causes the coronavirus disease (COVID-19) was first reported in December 2019 in China. } The international scientific board of opinion leaders guarantee high-quality, peer reviewed publications as well as articles for pragmatic approaches in the field of Health Economics. Trade-offs, trade-offs everywhere, but not a health economist in sight. "crossMark": true, The great big marginal analysis: emerging from lockdown, Yunus Centre for Social Business & Health, Glasgow Caledonian University, Cowcaddens Road, GlasgowG4 0BA, UK, School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada, https://doi.org/10.1017/S1744133120000304, Reference Karlsberg Schaffer, Sussex and Hughes, Reference Peacock, Ruta, Mitton, Donaldson, Bate and Murtagh, Reference Peacock, Richardson, Carter and Edwards, Reference Baker, Donaldson, Mason and Jones-Lee, Beyond COVID-19: how the dismal science can prepare us for the future, Cost effectiveness analysis in health care: contraindications. Public health and medical experts tend to focus on health outcomes, such as mortality rates, while ignoring economic costs. "metrics": true, The final diagram (1 h) shows that, when a consequence of any economic expansion is for R to fall back into 0.7–1.0 range, the marginal gains from any such expansion will be too small to justify going past a certain point, beyond which the gains from focussing on R far outweigh those of the economy. Such issues require debate and evidence on at least two key things: the critical range within which concern for R and background infection levels take over any concern even for incremental opening of the economy, a range which may, of course, vary across jurisdictions; and more explicit use of values of health and life which already exist and are used in public policy (Viscusi and Aldy, Reference Viscusi and Aldy2003; Donaldson et al., Reference Donaldson, Baker and Mason2011; Baker et al., Reference Baker, Donaldson, Mason and Jones-Lee2014). 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