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Review: Credit Crunch Health Care (Cam Donaldson)

Credit Crunch Health Care – How economics can save our publicly funded health services

Paperback, 160 pages, ISBN: 9781847427526, published 16 February 2011

Amazon / Google Books / The Policy Press

Cam Donaldson has chosen to use his powers of prophecy for good in his new book ‘Credit Crunch Health Care’. Its publication, earlier this year, came just 4 weeks after the Health and Social Care Bill 2011 was presented to parliament here in the UK – a bill widely viewed as a big step towards privatisation of the NHS. Donaldson’s book sets out to tell us all why, and how, we must fight to maintain publicly funded health services. And it does a damn good job.

From the opening sentences, the author’s views are clear. However, they are not allowed to dominate the proceeding 120 pages, which are filled with basic economic theory and bulletproof facts and figures. The reader is introduced to concepts such as market failure, marginal benefit and cost-effectiveness analysis; concepts underlying the efficiency arguments in favour of publicly funded health services. Throughout, the book is unfalteringly relevant and up-to-date, citing current policy issues such as Obamacare and GP commissioning. The book is by no means perfect. Donaldson’s candidly titled chapter, ‘The fiscal future of health care: an economist’s rant’, and his explanation of PBMA (programme budgeting and marginal analysis) is a little convoluted and less clear than the rest of the book. However, these shortcomings do not detract from the book’s key message; that publicly funded health services must be defended on economic grounds. The true value of this book lies in its content’s accessibility, readability and concision. The reader is not assumed to have a prior knowledge of economic theory and as a result the book becomes accessible to anyone with an interest. The book also succeeds in stripping away unnecessary intellectual baggage, with which economists’ writings are often laden. As such, it stands alone as a necessary and sufficient introduction to health economics for commissioners, managers, doctors, nurses and academics alike.

The relevance of this book, at this time, is undeniable. As commissioning responsibilities change hands in the UK, and Americans demand universal coverage, there is a need for non-economists to grasp the concepts presented so plainly in this book. ‘Credit Crunch Health Care’ could be read by anybody and everybody involved in the provision of health care in the UK and worldwide. And I believe it should.


  • Chris Sampson

    Founder of the Academic Health Economists' Blog. Senior Principal Economist at the Office of Health Economics. ORCID: 0000-0001-9470-2369

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