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May 10-11, 2018

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Couldn't join us for the event? Check out some of the panelists' slide presentations below!

Description

Economic ordeals are interventions that deliberately make access to products or services more difficult in an effort to improve resource allocation. In this vein, making patients wait in long lines to schedule an appointment with a specialist might discourage patients with needs that could be met by less qualified personnel from taking up the specialist’s time, thus freeing up time for those with complex needs. Similarly, putting brand-name medications at the bottom of a long list of options on clinicians’ computers might encourage them to prescribe a generic brand listed closer to the top.

Recent research in development economics, behavioral economics, and health policy suggests that some economic ordeals could help target health resources to patients who are more likely to utilize these resources, without the regressive effects of co-pays and other forms of financial participation on the part of patients. However, making health care deliberately less accessible raises ethical challenges. Is it not the case that ordeals discourage utilization by patients with acute needs? Do these ordeals affect some disadvantaged populations disproportionately? And do deliberate obstacles to health resource utilization violate the human right to health?

This workshop brought together leading scholars in economics, ethics, health policy, public health, medicine, sociology, and law to explore these questions.

This event is organized by Nir Eyal, DPhil, Associate Professor of Global Health and Population, Harvard T. H. Chan School of Public Health, and Anders Herlitz, PhD, Visiting Scientist, Harvard T. H. Chan School of Public Health and Researcher, Institute for Future Studies, Stockholm, Sweden.

Agenda

Day 1: Thursday, May 10

1:30-2:00pm, Registration

2:00-2:15pm, Welcome Remarks

  • Danielle Allen, Director, Edmond J. Safra Center for Ethics and James Bryant Conant University Professor, Harvard University

  • Meredith Rosenthal, Senior Associate Dean for Academic Affairs and C. Boyden Gray Professor of Health Economics and Policy, Harvard T. H. Chan School of Public Health

  • Till Bärnighausen, Senior Faculty, the Wellcome Trust’s Africa Health Research Institute (AHRI) in KwaZulu-Natal, South Africa; Adjunct Professor of Global Health, Harvard T.H. Chan School of Public Health; and Alexander von Humboldt University Professor and Director of the Heidelberg Institute of Public Health (HIPH) in the Faculty of Medicine, Heidelberg University

2:15-3:45pm, Plenary Session

  • Richard Zeckhauser, Frank Plumpton Ramsey Professor of Political Economy, Harvard Kennedy School of Government and Harvard University

  • Jessica Cohen, Associate Professor of Global Health, Harvard T. H. Chan School of Public Health

  • Nir Eyal, Associate Professor of Global Health and Population, Harvard T. H. Chan School of Public Health

  • Moderator: Anders Herlitz, Visiting Scientist, Harvard T. H. Chan School of Public Health and Researcher, Institute for Future Studies, Stockholm, Sweden

3:45-4:45pm, Efficiency: Maximizing Financial and Medical Outcomes

  • Shari M. Erickson, Vice President of Governmental Affairs and Medical Practice, American College of Physicians

  • Elizabeth Emens, Isidor and Seville Sulzbacher Professor of Law, Columbia Law School

  • Kristen Underhill, Associate Professor of Law, Columbia Law School

  • Moderator: Shelly Simana, Visiting Researcher, Harvard Law School

4:45-5:00pm, Break

Coffee and refreshments will be provided.

5:00-6:15, Ethics of Ordeals Research

  • Jessica Cohen, Associate Professor of Global Health, Harvard T. H. Chan School of Public Health

  • Charles Fried, Beneficial Professor of Law, Harvard Law School

  • Daniel Wikler, Mary B. Saltonstall Professor of Ethics and Population Health, Harvard T. H. Chan School of Public Health

  • Moderator: Spencer Hey, Research Scientist, Program on Regulation, Therapeutics, and Law (PORTAL), Brigham and Women’s Hospital and Faculty Member, Center for Bioethics, Harvard Medical School

Day 2: Friday, May 11

8:00-8:30am, Registration

A continental breakfast will be provided.

8:30-9:45am, Distributive Ethics

  • Christopher Robertson, Professor of Law; Associate Dean for Research & Innovation, James E. Rogers College of Law, University of Arizona

  • Daniel M. Hausman, Herbert A. Simon and Hilldale Professor, Department of Philosophy, University of Wisconsin-Madison

  • Anca Gheaus, Ramón y Cajal researcher, Department of Law, Universitat Pompeu Fabra (Spain)

  • Moderator: Meira Levinson, Professor of Education, Harvard Graduate School of Education, and Co-Director, Graduate Fellowship Program, Edmond J. Safra Center for Ethics, Harvard University

9:45-10:45am, Autonomy, Rights, and Dignity

  • Julie L. Rose, Assistant Professor of Government, Dartmouth College

  • Nien-hê Hsieh, Associate Professor of Business Administration, Harvard Business School

  • Anders Herlitz, Visiting Scientist, Harvard T. H. Chan School of Public Health and Researcher, Institute for Future Studies, Stockholm, Sweden

  • Moderator: Lucas Stanczyk, Assistant Professor of Philosophy, Harvard University

10:45-11:00am, Break

11:00am-12:00pm, Modeling Burdens

  • James Hammitt, Professor of Economics and Decision Sciences and Director, Harvard Center for Risk Analysis, Harvard T. H. Chan School of Public Health

  • Reza Yaesoubi, Assistant Professor of Public Health (Health Policy), Yale School of Public Health

  • Moderator: Margaret McConnell, Assistant Professor of Global Health Economics, Harvard T. H. Chan School of Public Health

​12:00-12:15pm, Break to Pick Up Lunch

Lunch will be provided.

12:15-1:30pm, Practical Implications

  • James Sabin, Clinical Professor, Population Medicine and Clinical Professor, Psychiatry at Harvard Medical School; Director, Harvard Pilgrim Health Care Ethics Program

  • Peter Berman, Professor of the Practice of Global Health Systems and Economics, Harvard T. H. Chan School of Public Health

  • Christopher Robertson, Professor of Law; Associate Dean for Research & Innovation, James E. Rogers College of Law, University of Arizona

Learn More

Background on Ordeals in Health Care

Slide Presentations

Co-sponsored by the Harvard T.H. Chan School of Public Health; the Edmond J. Safra Center for Ethics at Harvard University; the Petrie-Flom Center for Health Law, Biotechnology, and Bioethics at Harvard Law School; the Mossavar-Rahmani Center for Business and Government at the Harvard Kennedy School of Government; and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund at Harvard University.


Video

VIDEO: Watch the full conference!

Tags

bioethics   economics   health law policy   public health   regulation   research