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Health Economics

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Canada's safety valve private travel health insurance. Germany. Evolution of the German system ... In health care it is often waiting lists and limited access ... – PowerPoint PPT presentation

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Title: Health Economics


1
Health Economics Policy3rd EditionJames W.
Henderson
  • Chapter 16
  • Medical Care Systems Worldwide

2
International Comparisons
  • Whos got the best system
  • Key statistics
  • Health care spending
  • Medical outcomes

3
WHO Health Care System Performance, 1997
4
Key Statistics
5
Health Care SpendingAnnual Compound Growth Rates
6
Health Outcomes, 2000
7
Total HCE/GDP, 1970 - 2000
8
Mortality Ratios - Cancer
9
Canada
  • Evolution of the Canadian system
  • Single-payer concept
  • Cost-control measures
  • Binding fee schedules
  • Global budgets for hospitals
  • Regionalization of high-tech services
  • Canadas safety valveprivate travel health
    insurance

10
Germany
  • Evolution of the German system
  • Sickness fund concept
  • Cost-control measures
  • Institutional framework
  • Linking health care spending to income
  • Binding fee schedules
  • System-wide global budgets
  • Germanys safety valveprivate health insurance
    for upper income population

11
Japan
  • Evolution of the Japanese system
  • National health insurance
  • Cost-control measures
  • Uniform fee schedules
  • Service distortions
  • Japans safety valvegifts of appreciation to
    secure treatment

12
France
  • Evolution of the French system
  • System-wide goals
  • Spirit of egalitarianismsolidarity
  • Respect for individual freedomliberty
  • Minimal state interventionlaissez faire
  • Cost-control measures
  • Binding fee schedules
  • Global budgeting restricting adoption of
    high-tech services
  • Frances safety valvesupplementary private
    insurance

13
United Kingdom
  • Evolution of the National Health Service
  • Single-payer concept in a socialized system
  • Cost-control measures
  • Binding fee schedules
  • Hospital trusts
  • PCG budgetholders
  • British safety valveprivate health insurance for
    wait-listed patients

14
Promoting Equality
15
Lessons From Europe
  • Germany
  • System of comprehensive, universal coverage is
    expensive
  • Cost control that includes binding fee schedules
    must also control utilization
  • France
  • Promoting system-wide goals requires tradeoffs
  • Strict budget controls leads to lower investment
  • United Kingdom
  • Strong primary care covers all sorts of ills
  • Strict cost controls can lead to long waiting
    lists

16
The Economics of a Safety Valve
17
Summary and Conclusions
  • National health insurance does not guarantee
    public satisfaction
  • Health care provided at zero cost offers no
    incentive to limit demand
  • Eliminating financial barriers to care does not
    insure equal access to care or eliminate health
    differences across subgroups
  • If prices are not used to allocate scarce
    resources, something else must do so. In health
    care it is often waiting lists and limited access
    to technology
  • Safety valves are critical

18
Public Opinion Polls
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