health economists: who we are, what we do, and how much we earn michael a. morrisey, ph.d....
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Health Economists:Health Economists:Who We Are, What We Do,Who We Are, What We Do,and How Much We Earnand How Much We Earn
Michael A. Morrisey, Ph.D.Michael A. Morrisey, Ph.D.University of Alabama at University of Alabama at
BirminghamBirminghamandand
John Cawley, Ph.D.John Cawley, Ph.D.Cornell UniversityCornell University
Thanks to:Thanks to:
AcademyHealtAcademyHealthh
iHEAiHEA
Advisory Advisory Committee:Committee: Roger FeldmanRoger Feldman Richard ArnouldRichard Arnould Kate BundorfKate Bundorf Michael HaganMichael Hagan David KnutsonDavid Knutson Kristine MetterKristine Metter Sharron ArnoldSharron Arnold
Surveying Issues:Surveying Issues:
Web based survey:Web based survey: Invitation & two follow-up emails issuedInvitation & two follow-up emails issued October 21 – November 21, 2005October 21 – November 21, 2005
Sample Universe:Sample Universe: All U.S. members of iHEA All U.S. members of iHEA All members of AcademyHealth All members of AcademyHealth Health Economics Interest GroupHealth Economics Interest Group Unduplicated total . . . . . . . . . . . . . . . . . . . . . Unduplicated total . . . . . . . . . . . . . . . . . . . . .
1,4391,439 Response Rate. . . . . . . . . . . . . . . . . . . . . . Response Rate. . . . . . . . . . . . . . . . . . . . . .
32 %32 %
Do You Consider Yourself To Be:Do You Consider Yourself To Be:
A.A. A health economistA health economist 53%53%
B.B. An economist who works in healthAn economist who works in health21%21%
C.C. NeitherNeither 26%26%
For this presentation we exclude For this presentation we exclude those answering neither.those answering neither.
Who Are Health Economists?Who Are Health Economists?
Gender & AgeGender & Age Race & Race &
EthnicityEthnicity Marital StatusMarital Status Dual Career Dual Career
StatusStatus
- Gender -- Gender -
0
10
20
30
40
50
60
70
Male Female
62%
38%
- Age -- Age -
4%
37%
29%27%
4%
0%
10%
20%
30%
40%
22-30 31-40 41-50 51-60 61+
Age Group
Are More Women Entering the Are More Women Entering the Field?Field?
36%41%
46%
25%
36%
0%
20%
40%
60%
22-30 31-40 41-50 51-60 61+
Age Age GroupGroup
Percent WomenPercent Women
- Race & Ethnicity -- Race & Ethnicity -
AsianAsian 10.5 10.5 %%
Black or African-Black or African-AmericanAmerican
1.3 1.3 %%
WhiteWhite 88.2 88.2 %%
Hispanic or LatinoHispanic or Latino 4.1 4.1 %%
Not Hispanic or Not Hispanic or LatinoLatino
95.9 95.9 %%
- Marital Status and Dual - Marital Status and Dual Careers -Careers -
13%
81%
6%
0%
25%
50%
75%
100%
NeverMarried
CrrentlyMarried
FormerlyMarried
Dual Career Couples:Dual Career Couples: 70% 70%
Of Dual Career Of Dual Career Couples:Couples: 27% dual academic27% dual academic 10% dual economics10% dual economics
- Education and Training -- Education and Training -
Degrees & fields of studyDegrees & fields of study Formal field offered/takenFormal field offered/taken Health dissertationHealth dissertation Top econ schools for health Top econ schools for health
economistseconomists
- Degrees Received -- Degrees Received -
PercentPercent
Masters onlyMasters only 33
Doctoral onlyDoctoral only
Ph.D.Ph.D.
OtherOther8787
33
Doctoral PlusDoctoral Plus
- MD- MD
- RN- RN
- JD- JD
33
11
00
Professional Professional onlyonly
22
- Ph.D. Field of Study -- Ph.D. Field of Study -
71.8%
18.6%9.6%
0%
25%
50%
75%
100%
Economics HSR+ Other
84.2% in 1989
- Formal Health Economics - Formal Health Economics Field -Field -
Of those with an academic doctoral degree --Of those with an academic doctoral degree --
Health economics field offered . . . . . 33%Health economics field offered . . . . . 33%
Health economics field completed. . . 30%Health economics field completed. . . 30%
Completed a health dissertation. . . . . 76%Completed a health dissertation. . . . . 76%
Schools Awarding 5 or More PhDs Schools Awarding 5 or More PhDs in Economics to Health in Economics to Health
EconomistsEconomists Wisconsin -16Wisconsin -16 Chicago -11Chicago -11 Michigan -9Michigan -9 Yale -9Yale -9 Harvard - 8Harvard - 8 MIT - 8MIT - 8 Washington - 8Washington - 8
CUNY - 7CUNY - 7 Maryland - 7Maryland - 7 Berkeley - 6Berkeley - 6 Stanford - 6Stanford - 6 Boston U - 5Boston U - 5 Washington U - 5Washington U - 5
St LouisSt Louis
48 % of PhDs in 48 % of PhDs in economics reported by economics reported by health economists health economists granted by these 13 granted by these 13 schoolsschools
How Are Health Economists How Are Health Economists Employed?Employed?
Employment by sectorEmployment by sector Time spent in research, Time spent in research,
etc.etc. Hours worked per weekHours worked per week Time spent consultingTime spent consulting External funding External funding
expectationsexpectations Amount of teachingAmount of teaching
Where Do Health Economists Where Do Health Economists Work?Work?
Academia64%
Government12%
Nonprofit15%
For Profit9%
Of Those in Academia…Of Those in Academia…
17%
6%
16%
17%
18%
26%
0% 5% 10% 15% 20% 25% 30%
Other
Public Policy
Business
Arts & Sci.
Medicine
Public Health
24% are in Economics Departments
Economics departments may be in A&S or B-Economics departments may be in A&S or B-SchoolsSchools
Faculty Rank of Those in Faculty Rank of Those in Academia…Academia…
4%
38%
23%
34%
0% 10% 20% 30% 40%
Other
Assistant
Associate
Full
51% Tenured51% Tenured 35% Tenure 35% Tenure
TrackTrack 14% ~ Tenure 14% ~ Tenure
Track Track
8% Dept Chair8% Dept Chair 15% Center 15% Center
DirectorDirector
Of Those in Government & Private Of Those in Government & Private Sector…Sector…
0% 5% 10% 15% 20% 25% 30% 35%
Other
Foundation
Insurer
NGO
Trade Assoc.
Pharaceutical
Provider
Contract Research
Consulting
State Gov't
Federal Gov't
35% also have an academic appointment
How Do We Spend Our How Do We Spend Our Professional Time?Professional Time?
0% 20% 40% 60% 80% 100%
Academia
Government
Private sector
ResearchTeachingMgt/AdmOther
How Much Of Our Time Do We How Much Of Our Time Do We Spend?Spend?
HoursHours
Per Per WeekWeek
AcademAcademiaia
Gov’tGov’t PrivatPrivate e
SectoSectorr
<40<40 10%10% 12%12% 11%11%
40-4940-49 2929 6262 3131
50-5950-59 4343 2424 4646
60+60+ 1818 33 1313
Overall Mean = 47.2 hours Overall Median = 50 hours
How Much Consulting Do We Do?How Much Consulting Do We Do?
Average Average Days/YeaDays/Yea
rr
Median Median Days/YeaDays/Yea
rr
All All RespondentsRespondents
10.710.7 55
Academic Academic RespondentsRespondents
15.215.2 1010
Average consulting income of those with any: $19,445
How Much Grant/Contract How Much Grant/Contract Coverage?Coverage?
ExpectedExpectedMean Mean
[Median][Median]
ActualActualMean Mean
[Median] [Median]
3-year 3-year AverageAverage
All All AcademicsAcademics
28% 28% [20%][20%]
39% 39% [30%][30%]
Medical Medical SchoolSchool
49% 49% [50%][50%]
61% 61% [70%][70%]
Public Public Health Health
48% 48% [50%][50%]
62% 62% [70%][70%]
31 % report explicit rewards or penalties tied to salary coverage
How Much Did We Teach in Last 2 How Much Did We Teach in Last 2 Years?Years?
MedianMedian PercentaPercentage = 0ge = 0
Undergrad Courses Undergrad Courses TaughtTaught
11 46 %46 %
Graduate Courses Graduate Courses TaughtTaught
22 22%22%
Doctoral CommitteesDoctoral Committees 11 41%41%
* Excludes readings and independent study courses
Academics only.Academics only.
What Does It Take To Get What Does It Take To Get Promoted?Promoted?
Percentage of respondents Percentage of respondents considering activities essential considering activities essential or recommendedor recommended
Research/Teaching/ServiceResearch/Teaching/Service In Which Journals to PublishIn Which Journals to Publish
What Does It Take to Get What Does It Take to Get Promoted?Promoted?
77
60
18
88
30
18
85
85
91
0 25 50 75 100
Service
Grants
Teaching
AcademicsGovernmentPriv Sector
Percent Essential or Percent Essential or RecommendedRecommended
What Does It Take to Get What Does It Take to Get Promoted in Academia?Promoted in Academia?
0 25 50 75 100
Service
Grants
Teaching
A&SBusinessPublic HealthMedicine
Percent Essential or Percent Essential or RecommendedRecommended
Where to Publish to Get Where to Publish to Get Promoted?Promoted?
0 25 50 75 100
Medical J
Health Policy J
Hlth Services J
Health Econ J
Economics J
AcademicsGovernmentPriv Sector
Percent Essential or Percent Essential or RecommendedRecommended
Where to Publish to Get Promoted Where to Publish to Get Promoted in Academia?in Academia?
0 25 50 75 100
Medical J
Health Policy J
Hlth Services J
Health Econ J
Economics J
A&SBusinessPublic HealthMedicine
Percent Essential or Percent Essential or RecommendedRecommended
How Much & Where Do We How Much & Where Do We Actually Publish?Actually Publish?
Articles and Book Articles and Book ChaptersChapters CareerCareer Last 5-YearsLast 5-Years
Mix of JournalsMix of Journals
How Much Do Academics Publish?How Much Do Academics Publish?
10.6 8.8
29.9
17
84.6
22.1
0
25
50
75
100
Career Last 5 Years
AssistantAssociateFull
Mean Number of Articles and Book Chapters
In Which Journals Do Academics In Which Journals Do Academics Publish?Publish?
Entire Entire CareerCareer
Last Last 5-5-YearsYears
Economics JournalsEconomics Journals 13.3%13.3% 8.9%8.9%
Health Economics Health Economics JournalsJournals
10.710.7 11.611.6
Health Services Research Health Services Research JournalsJournals
14.914.9 27.427.4
Health Policy JournalsHealth Policy Journals 26.626.6 15.815.8
Medical JournalsMedical Journals 34.434.4 36.336.3 Percentages within these categories onlyPercentages within these categories only
How Much & Where Do Non-How Much & Where Do Non-Academics Publish?Academics Publish?
GovernmentGovernment Career: 19 Career: 19 Last 5 Years: 8.2Last 5 Years: 8.2
Private SectorPrivate Sector Career: 22.5Career: 22.5 Last 5 Years: 9.6Last 5 Years: 9.6
37%
24%
18%
6%
15%
20%
12%
38%
20%
9%
0% 50%
Medical
HlthPolicy
HSR
HlthEcon
Econ
Private Gov't
What Sort of Training Do We Want What Sort of Training Do We Want for New Hires?for New Hires?
Economics Ph.D. with Health Economics Ph.D. with Health FieldField
Economics Ph.D. with Health Economics Ph.D. with Health InterestInterest
Economics Ph.D. with No HealthEconomics Ph.D. with No Health Health Services/Health Policy Health Services/Health Policy
Ph.D.Ph.D. MDMD
Acceptable Training for New Acceptable Training for New Health Economist HireHealth Economist Hire
0
25
50
75
100
AcademicsGovernmentPrivate
Percent AcceptablePercent Acceptable
Acceptable Training for New Acceptable Training for New Health Economist Hire in Health Economist Hire in
AcademiaAcademia
0
25
50
75
100
A&SBusinessPub HlthMedicine
Percent AcceptablePercent Acceptable
Our Perceptions of Professional Our Perceptions of Professional ExperienceExperience
On publications for promotionOn publications for promotion On pressure to cover full On pressure to cover full
indirectsindirects On likelihood of changing jobs On likelihood of changing jobs
soonsoon On parental leaveOn parental leave On journal/conference/grant On journal/conference/grant
reviewsreviews On professional lifeOn professional life
The quality of publications counts The quality of publications counts more for promotion and tenure at more for promotion and tenure at
my institution than does the my institution than does the quantity of publications.quantity of publications.
15%
39%
17%
25%
4%
0%
10%
20%
30%
40%
50%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
I am pressured to bring in I am pressured to bring in grants/contracts than cover the grants/contracts than cover the
full indirect rate at my institution.full indirect rate at my institution.
19% 20%
14%
26%
20%
0%
10%
20%
30%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
There is a greater than 50% There is a greater than 50% chance that I will be employed by chance that I will be employed by
another organization within 3 another organization within 3 years.years.
8%
13%
21%
38%
20%
0%
10%
20%
30%
40%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
The culture in my department is The culture in my department is such that colleagues feel such that colleagues feel
pressured to decline parental leave pressured to decline parental leave ... for fear it would hurt their ... for fear it would hurt their
chances for tenure and/or chances for tenure and/or promotion.promotion.
2%
7%
35% 34%
22%
0%
10%
20%
30%
40%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
Overall, I am satisfied with the Overall, I am satisfied with the review process at health review process at health
economics journals.economics journals.
2%
48%
27%
20%
3%
0%
10%
20%
30%
40%
50%
60%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
Overall, I am satisfied with the Overall, I am satisfied with the review process for papers review process for papers
considered for inclusion at health considered for inclusion at health economics conferences.economics conferences.
6%
61%
22%
9%2%
0%
10%
20%
30%
40%
50%
60%
70%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
Overall, I am satisfied with the Overall, I am satisfied with the review process for review process for
federal/foundation grants & federal/foundation grants & contracts.contracts.
3%
40%
30%
20%
7%4%
44%38%
14%
1%0%
10%
20%
30%
40%
50%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
Federal Foundation
Overall, I am satisfied with my Overall, I am satisfied with my current employment.current employment.
36%
50%
7% 5%2%
0%
10%
20%
30%
40%
50%
60%
StronglyAgree
Agree Don't Know Disagree StronglyDisagree
What Do We Earn?What Do We Earn?
Mean annual incomesMean annual incomes By type of employerBy type of employer Academic rank & contractAcademic rank & contract Type of academic schoolType of academic school
Mean consulting incomeMean consulting income Income and Consulting RegressionsIncome and Consulting Regressions
Sample RestrictionsSample Restrictions
Self-designated health economists or Self-designated health economists or economists working in healtheconomists working in health Academic doctoral degree holders onlyAcademic doctoral degree holders only Employed onlyEmployed only
Exclude: self-employed, retired, unemployedExclude: self-employed, retired, unemployed Responded to all relevant questionsResponded to all relevant questions
222 usable observations in regressions222 usable observations in regressions 145 academics145 academics 77 non-academics77 non-academics
Earnings DefinitionEarnings Definition
“ “In the last 12 months, how much did In the last 12 months, how much did you earn from your primary you earn from your primary employer (including summer employer (including summer support, bonuses, and profit sharing support, bonuses, and profit sharing but not housing allowance)?”but not housing allowance)?”
Earnings by Type of EmployerEarnings by Type of Employer
MeanMean S. D.S. D. NN
AcademicAcademic $117,5$117,57373
(43,04(43,048)8)
162162
GovernmentGovernment $104,7$104,78686
(25,01(25,018)8)
3030
Not-for-profitNot-for-profit $122,4$122,47272
(39,50(39,504)4)
3636
For-profitFor-profit $170,9$170,96262
(76,45(76,456)6)
2222
AllAll $119,0$119,04040
(48,00(48,005)5)
251251
Academic Earnings by Rank & Academic Earnings by Rank & DegreeDegree
Economics Ph.D.sEconomics Ph.D.s Other Doctoral Other Doctoral DegreesDegrees
9-Month9-Month 12-12-MonthMonth
9-Month9-Month 12-12-MonthMonth
AssistanAssistant t ProfessoProfessorr
$82,315$82,315(29,196)(29,196)
N=21N=21
$84,100$84,100(23,961)(23,961)
N=16N=16
$94,116$94,116(22,258)(22,258)
N=12N=12
$91,777$91,777(21,100)(21,100)
N=18N=18
AssociatAssociate e ProfessoProfessorr
$91,847$91,847(25,867)(25,867)
N=16N=16
$108,42$108,4288
(20,851)(20,851)
N=16N=16
------ $96,167$96,167(16,448)(16,448)
N=6N=6
Full Full ProfessoProfessorr
$150,64$150,6455
(34,786)(34,786)
N=28N=28
$171,35$171,3577
(49,085)(49,085)
N=21N=21
$105,00$105,0000
(22,913)(22,913)
N=3N=3
$135,60$135,6000
(29,177)(29,177)
N=5N=5
Earnings By Academic UnitEarnings By Academic Unit
A & SA & S B-B-SchoolSchool
SPHSPH MediciMedicinene
9-9-monthmonth
9-9-monthmonth
12-12-monthmonth
12-12-monthmonth
AssistaAssistant nt ProfessProfessoror
$71,91$71,9177
(19,331)(19,331)
N=12N=12
$110,5$110,56161
(32,996)(32,996)
N=10N=10
$77,58$77,5888
(28,478)(28,478)
N=9N=9
$90,42$90,4288
(15,628)(15,628)
N=14N=14
AssociaAssociate te ProfessProfessoror
$83,16$83,1677
(23,353)(23,353)
N=6N=6
------ $102,1$102,16767
(13,763)(13,763)
N=12N=12
$111,7$111,73636
(20,824)(20,824)
N=4N=4
Full Full ProfessProfessoror
$144,0$144,00000
(47,571)(47,571)
N=9N=9
$135,3$135,30505
(32,637)(32,637)
N=10N=10
$151,6$151,65353
(39,859)(39,859)
N=13N=13
$194,5$194,50000
(54,881)(54,881)
N=8N=8
Consulting Income DefinitionConsulting Income Definition
“ “Over the past three years, how Over the past three years, how much did you earn per year outside much did you earn per year outside of your primary employment (e.g., of your primary employment (e.g., book royalties, consulting or expert book royalties, consulting or expert witness fees, etc.)?witness fees, etc.)?
Consulting Income - AcademicsConsulting Income - Academics
Percentage of academics reportingPercentage of academics reporting any consulting income in past 3 years:any consulting income in past 3 years: 82.8%82.8%
Mean annual consulting income ofMean annual consulting income of those reporting any:those reporting any: $20,602$20,602
(28,590)(28,590)
Median annual consulting income ofMedian annual consulting income of those reporting any:those reporting any: $10,000$10,000
RegressionsRegressions
ln Wage = f(education, experience, ln Wage = f(education, experience, employer employer
type, effort, publications, type, effort, publications,
employment characteristics, employment characteristics,
demographics)demographics) Estimated separately for academics and non-Estimated separately for academics and non-
academicsacademics
Probit Consulting = f( “ )Probit Consulting = f( “ ) ln Conditional Consulting $ = f( “ )ln Conditional Consulting $ = f( “ )
Regression Highlights - AcademicsRegression Highlights - Academics
10 more publications increased income at 10 more publications increased income at a decreasing rate:a decreasing rate: With 10 pubs – 10 more increased income With 10 pubs – 10 more increased income
7.2%7.2% With 50 pubs – 10 more increased income With 50 pubs – 10 more increased income
5.5%5.5% With 100 pubs – 10 more increased income With 100 pubs – 10 more increased income
3.4%3.4% Greater percentage of time allocated to Greater percentage of time allocated to
research increased income:research increased income: 10% more research time per week associated 10% more research time per week associated
with 2.5% higher incomewith 2.5% higher income
Regression Highlights - AcademicsRegression Highlights - Academics
No effect of Econ vs HSR vs Other No effect of Econ vs HSR vs Other DegreeDegree
Marginal MD – 43% higher incomeMarginal MD – 43% higher income Marginal masters/professional degree – Marginal masters/professional degree –
no effectno effect
Degree from Top 5 econ dept – 18.5% Degree from Top 5 econ dept – 18.5% higher incomehigher income Top 6-20 econ dept – no effectTop 6-20 econ dept – no effect
Regression Highlights - AcademicsRegression Highlights - Academics
Years since degree – no effectYears since degree – no effect
Years with current employer – income Years with current employer – income declines at a decreasing rate for first declines at a decreasing rate for first 15.8 years15.8 years
Average hours worked per week – no Average hours worked per week – no effecteffect
Regression Highlights - AcademicsRegression Highlights - Academics
Compared to an Arts & Sciences Econ. Compared to an Arts & Sciences Econ. Dept.:Dept.:
B-School – 18.4% higher incomesB-School – 18.4% higher incomes Public health – no effectPublic health – no effect Medicine – no effectMedicine – no effect
No effects of demographicsNo effects of demographics
Regression Highlights - AcademicsRegression Highlights - Academics
Administrative Position – 16% higher Administrative Position – 16% higher incomeincome
Tenured – 21% higher incomeTenured – 21% higher income
No Effects of:No Effects of: Academic rankAcademic rank Non-tenure trackNon-tenure track 9-month contract9-month contract
Regression Highlights: ConsultingRegression Highlights: Consulting
Model does not predict who Model does not predict who consults!consults!
Higher consulting income associated Higher consulting income associated with:with: HSR degree HSR degree Male Male Fewer hours workedFewer hours worked More publicationsMore publications
ConclusionsConclusions
Few differences across schools, Few differences across schools, degrees, rank and 9 – 12 month degrees, rank and 9 – 12 month contractcontract
But:But: Top-5 econ program mattersTop-5 econ program matters B-School mattersB-School matters Tenure mattersTenure matters Administrative position mattersAdministrative position matters Marginal MD mattersMarginal MD matters
Paid for performancePaid for performance