UCSF

Beginning with studies of the economic impact of malaria and ending with blood donation policy debates in the 1970s, this dissertation surveys the transformation of the economic analysis of health and the founding of health economics. Applying well-established economic concepts to healthcare and systematically analyzing what made it a topic uniquely suited to the expertise of economists, health economists re-oriented the field away from public health and laid claim to a topic that had previously been the purview of health professionals. Over the course of two decades the economic study of health became more a branch of economics and less a subfield of public health. By examining how the economic study of health first emerged among social scientists and public health workers as part of an advocacy program to attract more resources to health programs, this dissertation also seeks to call attention to relationships between public health and economics.

The chapters of the dissertation identify and examine three important historical developments in the economic analysis of health and healthcare that occurred between the late 1950s and the mid 1970s: the divergence of health economics from public health, the definition of healthcare and not disease as the primary topic of study, and the limits of economic discourse in public policy.

The dissertation also makes an argument supporting the relevance of the history of health economics to the health sciences and history more broadly. The development of health economics was not only a matter of academic discourse and the founding of a new discipline, but was also representative of fundamental economic changes in healthcare and society. Health economics developed as a politically powerful and academically influential discourse over the course of two decades, but the new discipline was not the driver of the economic trends it sought to explain. Health economists’ recognition of the impact of healthcare institutions in contemporary society was representative not only of a turning point in public health and economic discourse, but also indicative of a fundamental shift in the economic and social organization of modern societies and the emergence of the postindustrial economy.