health economists: who we are, what we do, and how much we earn michael a. morrisey, ph.d....

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


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


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


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


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


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


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


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


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


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


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


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


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


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


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

health economists: who we are, what we do, and how much we earn michael a. morrisey, ph.d....

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