Preface
This is a working handbook for the people who decide how health money is spent — written so that any one chapter can be read on its own, the night before the decision.
Who this book is for
This book is written for senior leaders who work with healthcare and turn budgets into services.
Every serious decision in health and care — what to fund, what to stop, how to pay providers, whether a new technology earns its place, who waits and who does not — is an economic decision, whether or not an economist is in the room. The people who make those decisions deserve the frameworks that make them well.
This book assumes intelligence yet no prior training in economics. Where an idea earns its place, it is explained in plain language.
What it covers, and where it comes from
The book has five parts:
Part 1 — Foundations explains why health is economically strange: why markets that work for groceries misfire for healthcare, how people demand health and care, how it is supplied, and what produces health in the first place.
Part 2 — Evaluation and Evidence is the analyst's toolkit: how to value outcomes, build models, test causal claims, assess medicines, judge affordability, and synthesize a body of evidence.
Part 3 — Systems, Policy and Priorities covers how societies organize, fund, ration, purchase, and share out care — including the workforce that delivers it, the insurance that pays for it, long-term and social care, mental health, and the economics of quality and safety, and how equity and human capability enter the account.
Part 4 — Global and Societal Issues looks at health beyond any one system: how people actually behave, the economics of global health and trade, health on a warming planet, and the economics of reaching the public — social media, communication, and outreach.
Part 5 — Digital, Software, and Technology covers the economics of health technology: innovation, the fast-changing economics of digital and artificial-intelligence-enabled care, the software health systems are built on, robotics, and the data those systems create.
The chapter list is built on the health economics curriculum taught in universities — the fourteen topics of the Economics Network's teaching collection — extended with frontier chapters the classic syllabus predates. The intellectual spine is the discipline's own: Kenneth Arrow's founding insight that medical care is not an ordinary commodity, Michael Grossman's model of health as capital, and Alan Williams's map of the whole field.
Point of view
The book is worldwide. Health systems differ profoundly — tax-funded, social-insurance, private, and mixed; rich and poor — and no single country's arrangements are treated as the default. Named systems appear throughout as exemplars of patterns, not as the way things must be: England's National Institute for Health and Care Excellence when the subject is thresholds, Germany when it is social insurance, the United States when it is private markets and their failures, India and the World Health Organization when it is coverage at scale. Readers are expected to map the principles onto their own jurisdiction.
The book aims to be practical and honest. Health economics is, at bottom, the study of trade-offs under scarcity: every pound or rupee or dollar spent once cannot be spent again, and a "yes" to one patient must sometimes be a "no" to another. The book does not pretend those choices are not happening.
How to read it
Each chapter stands alone, opens with a single-sentence thesis, and follows the same shape: why the topic matters, the core concepts, numbered best practices, three questions to take to your team, a worked example, three sector lenses (start-up, enterprise, government), common failure modes, a maturity model, and a checklist.
If you are new to the field, Part 1 is the natural start.
If you have come for a specific decision — an evaluation to commission, a rationing policy to defend, a digital tool to appraise — go straight to that chapter and follow its cross-references outward.
You do not need to read the book in order.
How it was built, and its limits
This handbook was assembled from public, verifiable sources, and it holds itself to a rule stated plainly in its own specification. Where a figure could not be verified, the text describes the pattern qualitatively. Examples are explicitly fictional, drawn to be realistic teaching cases, not reports of real organizations.
It is a guide to how to think and decide economically — not a clinical guideline, not a statistics textbook, not legal or regulatory authority, and not an encyclopaedia of every country's system. For binding decisions, consult current statute, your regulator's guidance, and your own governance. Used for what it is, it should help you make the choices in front of you more clearly, more fairly, and with your reasons open to view.