Richard Scheffler

One of Scheffler's subfields of interest is workforce policy. In 2003, he was elected President of the International Health Economics Association (IHEA), which consists of over 2000 members from more than 60 countries, and chaired the IHEA meeting in San Francisco.[16] Scheffler's research has centered on the financing of health systems by various countries and most recently, on workforce shortages particularly in Africa, the United States, and other OECD countries. Utilizing economic models, he has estimated the shortages and surpluses of physicians and nurses not only in the United States but also worldwide. Additionally, his work has highlighted the importance of primary care, nurse practitioners, and physician assistants. He was one of the first economists to consider the effects of utilizing physician assistants in the delivery of healthcare in the United States.[2]

Scheffler has advised a number of countries on workforce policy in regions including Peru, Chile, and Brazil as well as been a visiting scholar at the Rockefeller Foundation in Bellagio, Italy, where he wrote his critically acclaimed book Is There a Doctor in the House? Market Signals and Tomorrow's Supply of Doctors released in 2008 with Stanford University Press.[17] Through his lens of economics and policy, he examined the components that influence the future supply of doctors across specializations and geographic regions. He then proposed a method to improve efficiency and address the doctor shortage. Scheffler also co-authored The Labor Market for Health Workers in Africa regarding the health system in Africa and launched it at the World Bank in DC.[18]

A followup analysis appeared in "Projecting Shortages and Surpluses of Doctors and Nurses in the OECD: What Looms Ahead" published in 2018 in Health Economics, Policy and Law.[19] Scheffler demonstrated that without intervention, imbalances between supply and demand of doctors and nurses would surface. A shortage of nearly 400,000 doctors across 32 OECD countries and nearly 2.5 million nurses across 23 OECD countries in the year 2030 were projected.

"Forecasting imbalances in the global health labor market and devising policy responses" appeared in Human Resources for Health in the same year and applied economic models to the global shortage of health workers.[20] For high- and middle-income countries, a shortage will arise due to demand exceeding supply. For low-income countries, the shortage will exist for both supply and demand; demand is low because these countries lack the economic means to sustainably employ health workers.

Scheffler was recognized with the Carl A. Taube Award by the American Public Health Association in 2004 for his work on mental health economics.[21] His work described the organization and financing of mental health as well as its impact on the cost, quality, and accessibility of mental health services.

Scheffler authored a book published in 2014 by Oxford Press with psychologist Stephen P. Hinshaw at Berkeley.[22] The ADHD Explosion: Myths, Medication, Money, and Today’s Push for Performance changed the way people think about the growth and treatment of attention-deficit/hyperactivity disorder. Highly cited and reviewed, it was called "…complex, thought-provoking, and urgent" by Publishers Weekly.[23]

He also wrote papers on the impact and growth of medication used to treat ADHD in the United States and globally. In "Positive association between initial ADHD medication use and academic achievement during elementary school" published in Pediatrics in 2009, Scheffler and his co-authors found that medicated ADHD children scored higher on math and reading.[24] Scheffler and Hinshaw teamed up once more, along with co-authors, to map out care and treatment for ADHD in "International variation in treatment procedures for ADHD: social context and recent trends," which appeared in Psychiatric Services in 2011.[25]

Scheffler has worked extensively in the areas of social capital and health. He, along with co-authors, laid out the definitions, research overview, and implications of social capital in 2008 Health Economics, Policy, and Law article "Social capital, economics, and health: new evidence"[26] and 2014 Eastern Economic Journal publication "Social Capital and Health: A Concept whose Time has Come."[27]

Mental health and social capital interacted in a 2007 Social Science & Medicine paper, "The role of social capital in reducing non-specific psychological distress: the importance of controlling for omitted variable bias."[28] Scheffler and co-authors discovered a negative association between social capital and psychological distress in those with a below-median income. The study emphasized a need for controlling for non-time-varying omitted variables, as the association was much stronger after that was done. In "The empirical relationship between community social capital and the demand for cigarettes" that appeared in 2006 in Health Economics, Scheffler and co-authors found that smokers smoked fewer cigarettes when subjected to higher social capital from religious groups, but the prevalence of smoking overall in the community is not affected by that.[29]

Scheffler has also co-authored the writing of World Scientific Series in Global Health Economics and Public Policy: Volume 2 with Chapter 6: Measures of Social Capital, published in Singapore.[30] He wrote the foreword and edited the book. He has studied social capital in Indonesia and identified its positive association with good health in "Social capital and health in Indonesia," which appeared in World Development in 2006.[31] His similar finding in Argentina is described in "Social capital and self-rated health in Argentina," published in Health Economics in 2012.[32]

A highlight of his written work was his work for the Organisation for Economic Co-operation and Development to produce a report entitled "Social Capital, Human Capital, and Health: What is the Evidence?" that reviewed social capital and its relationship to physical well-being, psychological health, and education, both at an individual and communal level.[33]

Lastly, Scheffler has given numerous talks on this topic. He launched a series on social capital and health with the goal of improving research on it internationally, with the first meeting in 2006 and biennial workshops hosted at various universities afterwards.[34] Notable seminars of the series include "Social Capital Global Network" in the Institute for Research and Information in Health Economics in Paris in 2008[35] and "Social Capital and Healthy Aging" at the Canadian Centre for Health Economics in Toronto in 2014.[34] In 2016, he led a public lecture called "The relationship between social capital and health: What mechanisms and empirical evidence" at the University of Oxford as a feature of his Astor Visiting Lectureship.[36]

Scheffler has established the empirical link between healthcare mergers and acquisitions and the prices of healthcare services. His 2017 Health Affairs article, "Insurer Market Power Lowers Prices in Numerous Concentrated Provider Markets," discussed the correlation between market concentration and provider prices.[37] In moderately concentrated markets, hospital admission prices and cardiologist, radiologist, and hematologist/oncologist visit prices were lower than in non-concentrated markets due to insurers' bargaining power. However, such price reductions do not translate to lower premiums for consumers. On the consumer side, Scheffler analyzes the effect of higher vertical integration to be a 12 percent rise in marketplace premiums, a 9 percent rise in specialist prices, and a 5 percent rise in primary care prices. This work, "Consolidation Trends In California’s Health Care System: Impacts On ACA Premiums And Outpatient Visit Prices," appeared in Health Affairs in 2018.[38]

A collaboration with the American Antitrust Institute, a nonprofit dedicated to competition regulation and consumer protection, produced a report in 2021 entitled "Soaring Private Equity Investment in the Healthcare Sector: Consolidation Accelerated, Competition Undermined, and Patients at Risk."[39] The report spotlighted evidence of the negative impact of private equity in the healthcare industry. It was cited in the May 19, 2021 hearing of the United States Senate Committee on the Judiciary's Subcommittee on Competition Policy, Antitrust, and Consumer Rights.[40]

Most recently, Scheffler has partnered with Stephen Shortell, Dean Emeritus of the UC Berkeley's School of Public Health, to spearhead research regarding a potential public option insurance plan for California. This culminated in a report, "Golden Choice: California's Public Option" released in 2022, that exhibited how a public option would lower healthcare costs while maintaining quality for state residents.[41] An analysis on LA Care, which acts like a county-based public option, and its impact on premiums in the LA Region, strengthened the argument for such a plan. Scheffler, Shortell, and their research team presented their findings in Sacramento with state legislators, stakeholders, and press, as well as invoked a discussion panel moderated by Deputy Cabinet Secretary Richard Figueroa.[42]