Dear Colleagues:

One of the standard criticisms of health care systems with universal coverage is that they lead to “waiting lists.” There are various mechanisms, but the most common idea is that someone is in charge of limiting costs (unlike in the U.S.); that leads to some limits on capacity, and when demand exceeds supply, people have to wait.

This criticism is often overstated, and usually ignores the waits created in the United States by not having insurance. Nevertheless waiting lists, especially for “elective” procedures such as joint replacements, are a major issue in many countries, and the controversies reveal something interesting about health care politics: that “experts” and citizens have quite different views. System managers and expert analysts often argue that faster service would be a convenience for patients, but is not worth the extra expense. In the case of elective surgery, for example, some waits will have little or no effect on patients’ long-term outcomes, so extra spending is unnecessary. At most, the lists need to be prioritized better, to avoid the exceptions. Voters, however, tend not to agree with the experts.

No system can provide everything anyone could want, immediately; that would require huge and expensive extra capacity. One of the core questions for health policy analysis, then, is the effects of delayed access to services. The answer must depend on the delays and the services. Yet careful research on one case can help us understand the factors in any other. Professor Votruba has some fascinating research results on such a case, which should spark a good discussion.

All best regards,
Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies

About Our Guest

Mark Votruba, PhD, is an associate professor with positions in the Economics Department in the Weatherhead School of Management and in the Center for Healthcare Research and Policy in the Case Western Reserve University School of Medicine. Votruba holds additional appointments as a research associate at Statistics Norway and as an adjunct associate professor at University of Stavanger in Norway. He is also a faculty associate at the Shubert Center for Child Studies at Case Western Reserve University.

Votruba’s research spans topics in labor economics, health economics and public finance. One stream of his research explores the implications of job loss for displaced workers, their families and their communities. Another stream investigates the impact of childhood exposures on later-life outcomes. In the area of health economics, Votruba’s research focuses on the causes and consequences of low-quality care in the US healthcare economy. His research appears in a diverse range of journals including The American Economic Review, Review of Economic Studies, Journal of Economic Perspectives, Journal of the European Economic Association, Journal of Human Resources, Demography, Social Science and Medicine, Medical Care and the American Joournal of Obstetrics and Gynecology. His published work on the importance of search frictions in health insurance markets was awarded the Arrow Award for Best Paper in Health Economics by the International Health Economics Association in 2012. His article “Organizational Economics and Physician Practices” was selected for inclusion in the recently published Encyclopedia of Health Economics.

Votruba received his Ph.D. in Economics from Princeton University in 2002. He also holds an MA in Public Policy Studies from the University of Chicago, as well as a BA in Mathematics from Centre College of Kentucky. Votruba instructs courses at both the graduate and undergraduate level. In 2010 and 2014, he was nominated for the Weatherhead Undergraduate Teaching Award for his efforts in Health Care Economics and Public Finance. His graduate courses in Health Economics and Strategy serve the MSM-Healthcare program and the Cleveland Clinic-Weatherhead Executive MBA program. Votruba has served as academic director of the MSM-Healthcare program since its inception in 2014. He was named faculty director of Weatherhead School of Management Graduate Health Programs in 2015. Votruba is also a frequent contributor to the Fundamental of Clinical Medicine courses in the Case Western Reserve School of Medicine and in the Cleveland Clinic Lerner College.

Where We Meet

The Friday Public Affairs Lunch convenes each Friday when classes are in session, from 12:30 p.m. to 1:30 p.m. Our programs are open to all and no registration is required. We usually meet in the Dampeer Room of Kelvin Smith Library.

* Kelvin Smith Library requires all entrants to show identification when entering the building, unless they have a university i.d. that they can magnetically scan. We are sorry if that seems like a hassle, but it has been Library policy for a while in response to security concerns. Please do not complain to the library staff at the entrance, who are just doing their jobs.

Parking Possibilities

The most convenient parking is the lot underneath Severance Hall. We regret that it is not free. From that lot there is an elevator up to street level (labeled as for the Thwing Center); it is less than 50 yards from that exit to the library entrance. You can get from the Severance garage to the library without going outside. Near the entry gates – just to the right if you were driving out – there is a door into a corridor. Walk down the corridor and there will be another door. Beyond that door you’ll find the entrance to an elevator which goes up to an entrance right inside the doors to Kelvin Smith Library.

Schedule of Friday Lunch Upcoming Topics and Speakers:

October 11: Small Steps and Giant Leaps: How Apollo 11 Shaped Understandings of Earth and Beyond. With Steven A. Hauck II, Professor and Chair, Department of Earth, Environmental and Planetary Sciences. ***Alternate Room: Room LL06, Lower Level, Kelvin Smith Library***

October 18: Roe v. Wade in 2019. With B. Jessie Hill, Judge Ben C. Green Professor of Law.

October 25: Brexit Trick or Treat. With Luke Reader, Full-Time Lecturer in English.

November 1: Local News: Yesterday, Today and Tomorrow. With Joseph Frolik, Senior Vice President for Communication, Community Relations and Government Relations, MetroHealth.

November 8: TBA. With Peter Shulman, Associate Professor of History.

November 15: Will We Ever Have Paris? The U.S. and the International Politics of Climate Change. With Matthew Hodgetts, Visiting Assistant Professor of Political Science.

November 22: The (New?) Israeli Government. With Peter J. Haas, Abba Hillel Silver Professor Emeritus of Jewish Studies.

November 29: Thanksgiving break

December 6: Papers Please: Challenging Citizenship in the United States. With Cassandra Burke Robertson, John Deaver Drinko – Baker Hostetler Professor of Law and Director, Center for Professional Ethics.