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Faculty Insights

Where Risk Meets Health Economics: A Q&A with WSB Affiliate John Mullahy

By Clare Becker

November 14, 2019

John Mullahy is a professor in the Department of Population Health Sciences at the University of Wisconsin–Madison and has been an affiliate faculty member in the Department of Risk and Insurance at the Wisconsin School of Business since March 2018. He holds additional affiliate positions at UW–Madison with the La Follette School of Public Affairs, the Institute for Research on Poverty, the Center for Demography and Ecology, and the Center for Financial Security. He is also an honorary professor of economics at the National University of Ireland, Galway, and a research associate at the National Bureau of Economic Research.

WSB sat down with Mullahy at his office in the Wisconsin Alumni Research Foundation building to talk about his connection with WSB, why health economics matters, and how teaching keeps him inspired.

WSB: Tell us about your relationship with WSB’s Department of Risk and Insurance.

John Mullahy
Professor John Mullahy

Mullahy: It really just naturally evolved in that direction. I am an economist by training—health economics is my field—and there has been an overlap, an investment by the Risk department in health economics activities, which is evidenced in the background and research interests of some of the relatively newer faculty like Justin Sydnor and Anita Mukherjee.

It all started when I first came to know Margie Rosenberg, who has had longstanding collaborations with my department, and then last year was invited to be a WSB affiliate by Joan Schmit. I also had worked with a number of their students over the years, both in classroom teaching and on dissertation committees. It’s really been wonderful thus far. They are an extraordinarily talented group of people who work on really interesting questions.

WSB: You’ve said that within health economics, your work fits within the description of “value-based healthcare” but less on the insurance side of things. Can you explain what you mean by that?

Mullahy: Sure. Value-based healthcare can mean everything from provider payments to health system restructuring to insurance design. My work centers on the question of, what does it mean to deliver healthcare that has more value? What good things are you getting in return for the cost? If we want to say that we’ve accomplished something that was value-enhancing, we better have some evidence to back it up. While much of my earlier work was devoted to understanding costs, my recent work has focused more on the outcomes side. If you’re not getting either a better quality of care or better health outcomes, then you’re probably not getting what you would like to be getting out of your healthcare system.

WSB: Can you give me an example of this?

Mullahy: Health is multifaceted. How can we think of health as having one outcome when there’s actually a bunch of different outcomes? For example, suppose there’s a new drug that appears to reduce bad cholesterol significantly. Problem is, it seems also to cause adverse side effects, so some parts of your health are getting better while others may be getting worse. How do you think about whether this new drug is delivering value when there are a lot of other moving parts? That’s what much of my work over the last few years has focused on—for example, trying to understand chronic conditions when people have multiple chronic conditions.

That’s one of the reasons health economics as a field is an exciting place to be: the academic work and the real-world decisions are oftentimes much more intimately tied together than you might find in some other academic disciplines. Think of a hot button topic like national health policy reform. If you want to learn something about Medicare or prescription drug pricing, there’s research out there that can usefully inform these types of huge questions. By “huge,” I mean both dollars spent and lives that are on the line.

WSB: Can you talk a bit about the teaching side of your work?

Mullahy: In a health economics faculty role, you’ve got to be a bit of a utility infielder because so much is happening so quickly. I still really like teaching a lot—I like going into a classroom and being energized by my students who have so many different perspectives on health economics. Hopefully, I’m delivering that energy back in return as well. My classes will typically have students from population health, risk and insurance, economics, pharmacy, nursing, and other departments. We’re all here to learn together.

I also really like being part of campus service committees. I enjoy finding ways to make good things happen at the school and campus levels.

WSB: Thank you, John. It’s been great to chat with you. It’s also been hard not to be distracted by the visual feast that is your office—the Cinema Paradiso film poster and the cabinets marked “Oldish” and “Newish.”

Mullahy: Cinema Paradiso is one of my all-time favorite movies. And everyone who comes in here remarks on those cabinets; they seem to attract a lot of attention. I don’t think I’ll ever be able to retire—I’d have to clean out 22 years of this “stuff.”

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