Don’t forget to invest 30 mins of your time!

There is good evidence that 30 minutes of moderate exercise each day will reduces risk of chronic diseases. Master or Doctoral degree is your future, but do not forget doing exercise half hour per day is also part of your future. Regular physical activity can:

  • improves the strength of heart which makes the heart to work more efficiently during exercise and at rest. The more activity people do, the greater is their capacity for exercise and the stronger is the heart which keeps away any heart problem. This leads to reducing of high blood pressure, controlling blood cholesterol levels, controlling diabetes by improving the body’s ability to metabolize glucose.
  • helps weight reduction by mobilizing excess fat from the body.
  • indirectly encourages people to quit smoking for maintaining proper health and fitness.
  • improves flexibility and builds muscle.
  • decreases total and LDL cholesterol (“bad cholesterol”)
  • raises HDL cholesterol (“good cholesterol”)
  • increases energy store in the body
  • increases tolerance to anxiety, stress and depression
  • controls / prevents the development of diabetes
  • decreases risk of orthopedic injury by improving flexibility
  • helps building healthy bones, muscles and joints.
  • reduces the risk of colon cancer

Many scientific evidence have shown that physical inactivity as a significant contributing factor causing premature death and also contribute to overall morbidity. These risks can be reduced simply by doing regular exercise.

If you are really busy person, you might do not have time even for 30 minutes to be away from your desk or computer, then do an alternative type of exercise such as climbing the stairs for about 15 minutes . If the stairs in your office is not high enough, then choose another type of sports that suit you. See the the option in the following figure. Let’s do now!

Advertisements

May 31, 2008 at 11:14 am 3 comments

MEMBURU BEASISWA


Memburu Beasiswa, Upaya Merubah Nasib

“Anak petani yang ingin sekolah tinggi”

Masih teringat dengan jelas pesan orang tuaku, waktu itu aku masih duduk di bangku sekolah dasar. Katanya, “Kalau mau ubah nasib, Nak, kamu harus sekolah yang tinggi. Kalau tidak, yaa, kamu akan jadi petani seperti bapakmu ini nantinya.”
Saya kira, tidak ada hal yang istimewa dengan kata-kata itu bagi kebanyakan orang, namun bagi saya hal itu cukup mengusik pikiran. Artinya, kalau saya tidak sekolah sampai ke perguruan tinggi, nasib saya tidak akan berubah: akan jadi petani meneruskan profesi leluhur, banting tulang di tengah sawah di bawah sengatan matahari dan cucuran keringat dengan hasil panen tidak seberapa bila dihitung dengan cost dan pengorbanan yang harus dikeluarkan.

Berminggu-minggu kata-kata tersebut tidak hilang dalam benak.’Sekolah yang tinggi’, ‘perguruan tinggi’, ‘jadi petani’, ‘ubah nasib’, itulah beberapa ‘keywords’ yang terus menghantuiku saat itu. Beberapa deretan pertanyaan lain juga bermunculan, berdialog dengan jiwa sendiri terjadi begitu sering. “OK, OK, siapa sih yang ngak mau merubah nasib, siapa yang mau jadi petani terus, siapa yang ngak mau sekolah sampai ke perguruan tinggi. Tapi bagaimana caranya? Apakah punya duit untuk menyekolahkan aku?” Kalau dihitung dari hasil panen selama ini, ditambah job sampingan orang tuaku lainnya, paling banter aku hanya mampu bersekolah sampai SMA, tidak lebih dari itu!

Banyak bukti sudah. Selama ini yang tamat dari SMA saja (di kampungku nun jauh di Aceh) bisa dihitung dengan jari, apalagi tamatan perguruan tinggi. “Kalau hanya tamatan SMA, lebih baik tidak sekolah saja,” keluh aku pada waktu itu. Bagiku, itu hanya menambah citra negatif tentang anak sekolah: tiga tahun umur habis di SMP dan tiga tahun lagi habis di SMA, paling bisa cuma …, dan tidak ada skill khusus yang membuat berbeda dengan anak yang tidak sekolah. Sangat kontras, kalau enam tahun dihabiskan di pesantren, perubahannya begitu nyata. Mereka mampu jadi imam, memberi khotbah, membaca kitab-kitab berbahasa Arab “gundul”, menguasai tata bahasa Arab dengan baik dan mampu menafsirkan ayat-ayat Al-Quran dengan begitu baik…

Memang, kampungku pada saat itu punya tradisi pesantren yang kuat. Secara rata-rata, anak-anak cerdas kebanggaan dan kesayangan orang tua dikirim ke pesantren, menuntut ilmu akhirat. Sangat jarang yang dikirim ke sekolah. Pada saat itu belum ada satupun “tukang insinyur”. Sekolah bagi sebagian orang itu tidak hanya identik dengan keduniawian dan dunia sekular, tapi juga identik dengan duit dan mahal. Tidak banyak orang tua yang sanggup menyekolahkan anaknya.
Pada suatu pagi, aku memutuskan dan berikrar, (more…)

May 24, 2008 at 4:59 pm 21 comments

Hello world!

Welcome to WordPress.com. This is your first post. Edit or delete it and start blogging!

May 23, 2008 at 12:04 pm Leave a comment

Leukaemia: A very costly disease and needs a very long treatment phases (Personal Experience)

Part I (Draft)

Background
In the second week of Ramadhan 2006, my youngest daughter seems different, not so active, easily tired and quite often had a high fever. My wife did not bring her to hospital or clinic because she assumed that Gina will be fine by taking Paracetamol. Indeed, she was getting better after taking drug but the fever just relapses for one or two days. My wife called me to inform this situation for a number of times. At that time, I was in Jakarta attending AusAID scholarship predeparture program.

(more…)

May 19, 2008 at 1:15 am Leave a comment

Resource Allocation Phenomenon in a Decentralized Environment

Submitted to APACPH Newsletter February 2008, vol.1.
by Asnawi Abdullah

Many countries in the Asia Pacific region have implemented decentralized health services to region or district level. The degree of decentralization might be different from one country to another. However, it seems there are similarities in how budgets are allocated to different programmes and services. In theory, under a decentralized health system, with local government having a range of options in planning, financing and service delivery, resource allocation becomes better in terms of both technical and allocative efficiency. Under decentralization, district level has more discretion to allocate the budget as their own priority without any obligations to follow rigid guidelines from a central government.

(more…)

May 19, 2008 at 1:00 am Leave a comment

Why is Yardstick competition useful in setting hospital reimbursement?

HEALTH ECONOMICS TOPICS
>Introduction
A very large portion of health budget are spent to hospital. Therefore, since last two decades, many country try to find out the appropriate mechanism to reimbursement hospital. Since the number of hospitals are limited and have at least some monopoly power, it seems market competition is not work for hospital. With market power, hospital tend to provide services at a certain level where they can get maximum profit. As a result of monopoly, welfare lost tend to occur. To overcome this problem (inefficiency) Yardstick competition are introduced. Yardstick competition try to replicate perfect competition under monopoly situation. How Yardstick competition work and the way the system try to reduce the cost will explain below. The paper start by explaining very brieftly about monopoly.

Monopoly
Most hospitals face down slope demand curve. It mean that they have some degree of monopoly power. Therefore, hospital try to decrease the quantity of health care services in order to maximize the profit. In the case, the quantites are reduces to Qo with the price at Po. Where if hospital has acted as competitive firms, they should expanded their production at the point of R, where Marginal Cost equal to Demand with the price of Co. From social perspective, under monopoly market, hospitals create welfare loss as much as represented by MAR.

Yardstick Competition
Yardstic competition, try to replicate perfect competition under monopoly market. This method assumes that all hospital are able to invest in cost-reducing technology in effort of reducing Average Cost. A hospital is reimbursed at the average of treatment cost of all other hospital in the market. Payer observes the average of marginal cost of all paticipant of market regularly, then introduce a new average. This procedure continue until the average of marginal costs no longer falls. At this point, price become equal to MC. Theoritically, this result is same as the result of perfect competition.

Reaction of Hospital to Yardstic Competition
The average and marginal treatment cost are constant and initially treatment costs are Co. Hospitals are reimbursed as much as Co. Each hospital has to provide of teatment at which MC is equal to market price. In order to make a profit, the hospital can invest in cost-reducing technology, incurring fixed costs, to lower marginal treatment cost of production to C* and the hospital finds a new AC curve as given by the curve AFC+C*. The firms can invest for further cost reduction until MC of investement exceed MR gained by the investment. The new output occur is equal to demand price, which is at B, then optimal provision becomes Q1 and the price fall to P*. Then if the marginal costs of the firm is still above C*, the firm will lose the amount represented by vertikal line area. To compase government provides a lump-sum subsidy to that hospital. However, if the hospital succeed in lowering marginal cost to C1, the hospital gain incremental pofit represented by horizontal line area.

In conclusion
Under retrospective payment system, hospital have no incentive to reduce cost and to increase efficiency. In contrast, under yardstick competition, hospitals are pushed to be cost concious and cost containment by improving efficiecy. Yardstick competition lead to optimal equilibrium which is know as Nash equilibrium. A situation where each firm does the best that it can, given the decision of others. It is equlibrium because once choice are made no firm has any motive to change its action. However, this system work if there is no collusion

June 15, 2006 at 10:12 am Leave a comment

Is economic helpful in assessing efficiency in health care sector?

Is economic helpful in assessing efficiency in health care sector?

Introduction
The main concern of economic is how to use limited resources efficiently, including health resources. Efficiency in economic is achieved through market mechanism, which is at the point where demand and supply are equilibrium. This equilibrium can be achieved under certain conditions or assumptions. A number of important assumptions will describes belows. Such condition is rare occur in health sector, therefore market is failure in health care sector. I will explain how this failure occur both from demand sides and supply sides, and briefly discussed a number of specific strategies to overcome the failure.

Market and Efficiency

Efficiency in economic market can be achieved when supply and demand are equilibrium. This usually can be achieved if the degree of competition in market is high enough. Under high competition, in order to survive, the suppliers or firms should allocate resources to most efficient use. Each firm try to keep prices as low as possible to attract consumers or buyer. The prices (P) are set equal to marginal cost (MC). It means that P and MC is equivalent to demand (D). If the market operate under this condition, then efficiency, particularly efficiency in consumption can be achieved. By this, it means that benefits to community or social efficiency are maximized. Under this condition, marginal social benefits (MSB) are equivalent to marginal social costs (MSC).

This could be happenned under certain conditions, such as supplier are prices takers, no barrier to entry market. Form demand sides, purchaser try to maximize utility and they have soverignity and perperct knowledge what they want to buy. I will descriabe briefly such conditions and show how these assumptions are failure in health sectors. Description both from supply sides and demand sides

Supply Sides

Price-taker is one of crucial condition in free market. Firm should be price-takers in all product and factor market. There is no one firm that able to influence the price of good or services. They compete based on price. This only occur if there are many producer selling product or providing services. Each firm only produce or provide a tiny fraction of total ouput or particularly good or services. Producers and purchaser are well informed about price.

However, in health sector, price-takers are rerely occur. If so, only for very simple product or services. Usually, some firms or providers able to influence the price in the market. For example, a pharmaceutical industry that has a patent right to produce certain medicine. That firm have market power to influence the price. This creates market failure.

In addition, this monopoly is a also very commond occur in other health services. This is mainly related with supplier that are very limited. In some area, there are a number of supplier, but in other areas, it is very limited. Then patient do not have many choice. Moreover, there are a very few close subtitute of services.

If there is a provider want to enter the market, they face many barriers. Professional body is very powerful and licence is needed to enter market. Consequently, under this monopoly will transform consumer surplus to producer surplus. However, the lost cost in consumer is bigger than gain in producer surplus. Therefore, there is an overall lost to cociety or deadweight loss.

Demand sides

In the perpect market, the purchaser have soverignty. They have information about the product and able to judge the cost and benefit of product or services and purchase those services where benefits exceed cost.

However, in health sector, there is asymetric information between providers and patients. Patients very difficult to judge the the benefit of health care. Even after pateint received the treatment, they can not sure whether the treatment has worked. Under this situation, it is very difficult to define indifferent curves. This will create market failure. When demand side instition is fail, then resources allocation perform by new institution through agency relationship. Under limited knowledge, patients rely on health care professional. They act as agency on behalf of patients. However, the agency relation is not perfect. There is a tendency to over supply and induced demand over consume. This is particularly true if agency know that financial risk is not by consumer. In short this will create inefficieny and market failure.

Conclusion
In short market failure in health care can be explain from demand and supply sides. Market failure from demand side mainly related with asymetric information. When demand sides intitution is fail, then resource allocated by new institution through agency relation. However, the relation is not perfect. Then market also fail

June 10, 2006

June 15, 2006 at 10:10 am Leave a comment

Older Posts


Archives

Recent Comments

Blog Stats

  • 8,134 hits