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Book review Health economics

Ceri J Phillips. Health economics: an introduction for health professionals. Blackwell Publishing, BMJ Books. ISBN 0-7279-1849-4. 150 pp; Cost £24.95 (November 2005)

The best present is the one you didn't know you wanted, but when you have it you wonder how you could have done without it. This is how this book feels.

It is easy to say what it is not. It is not a textbook; no reader will skip off with a happy heart and churn out health economic analyses and book a flight to Stockholm or Oslo. It is not the answer to the world, the universe, and everything. It is not the health economic equivalent of Caesar's response to Cato, an anti-NICE.

Rather it is a gently philosophical, sometimes witty, and always erudite opening into the arcane thinking of health economics for the general reader. It takes a broad view of the importance of economic thinking in the running of health services, and specifically in the running of the National Health Service in the UK. It does not hide in the dark corners of cost-effectiveness, but asks searching questions about how to get the mostest with the leastest, in the bestest way.

Is there an answer? Well, yes and no. It is clearly possible to do better, and Phillips points out some of the incongruities that follow complex budget-based decision-making rather than taking a more holistic view. But there is no getting off the hook of responsibility, personal and collective. In his conclusion, he quotes Chesterton's response to a Times quest for essays on what was wrong with the world: “I am”.

Do a good deed for yourself or someone else: a present for the new year. First, you will enjoy the read, because it is well written. Second, you will know just enough more about health economics to feel informed. Third, you will be able to use that knowledge to ask searching questions about what you and others do and how you do it. Fourth, it will probably send some of you looking for ways to accomplish that.

But this is a book not just for the professional. It is accessible for any reasonably informed reader. Particularly in the UK where so many major changes are taking place in healthcare, it will make you ponder whether this change is the best, in the best of all possible worlds.

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