Health Policy, Health Systems, and Health Economics
Health Policy, Health Systems, and Health Economics
This domain tests how policies are made, how health systems are organized and financed, and how economic evidence is used. Expect questions on universal health coverage, system building blocks, financing, and cost-effectiveness.
Core rules and concepts
- The policy cycle includes agenda setting, formulation, adoption, implementation, and evaluation. Stakeholders, evidence, politics, and values all shape decisions.
- The WHO health system building blocks are service delivery, health workforce, health information, medicines and technologies, financing, and leadership and governance.
- Universal health coverage means all people receive needed quality services without financial hardship. Coverage is not the same as access or effective use.
- Financing models include tax-funded, social health insurance, private insurance, and out-of-pocket payments. Out-of-pocket spending can cause impoverishment.
- Cost-effectiveness analysis compares cost per health outcome, such as cost per QALY or DALY averted. It informs choices but does not by itself decide equity, feasibility, or budget impact.
- Moral hazard and adverse selection are insurance-market problems; risk pooling and mandates can reduce them.
Worked example
Intervention A costs 1,000 per QALY gained; Intervention B costs 4,000 per QALY gained. If the budget is fixed and both are equally feasible, A is more cost-effective. But if B serves a remote group with no alternative and A serves an already well-served group, equity may justify B. The reasoning must separate efficiency from distributional fairness.
Traps that cost marks
Do not treat cost as the same as charge. Do not call an intervention cost-effective merely because it saves money; cost-effectiveness compares value. Do not assume insurance coverage guarantees access. Do not ignore budget impact when scaling up.