1 Public / private mix in health care financing Dominique Polton Director of strategy, research and statistics National Health Insurance, France Couverture
2 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
3 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
4 1. Rationale for increasing private financing The growth of health care expenditure is desirable (value of health gains, superior good, innovation, ) The demand for health care is growing (ageing of the population, new technologies, consumer behaviour, ) Fiscal constraints, pressure on competitiveness limit on public financing Private financing could increase the resources devoted to health care without putting pressure on public finance + other arguments: greater choice, responsiveness of the health care system,
5 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
6 2. Forms of private health care financing Forms of private health care financing Funding of current health expenditure Funding of capital investment Out-of-pocket expenditures Private health insurance Private finance initiative
7 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
8 France Canada Slovenia Germany Switzerland Australia Netherlands Spain Portugal New_Zealand Korea Belgium Austria Japan Finland Hungary Denmark Poland Estonia Sweden Czech_Republic Out-of-pocket payments (1/3) Out-of-pocket is the first source of private financing 45,0 40,0 35,0 30,0 25,0 20,0 15,0 10,0 5,0 0,0 PHI and OOP as % of total health spending Source: OECD database
9 Out-of-pocket payments (2/3) Given the distribution of health care expenditure, there is a limit to the level of OOP: a large part of the costs is concentrated on a small proportion of individuals who could not pay their health care bills from their own resources (this is precisely why social insurance exists). Increasing out-of-pocket payments has consequences both for equity It increases vertical inequity (fairness of contribution) It can hinder access to care (which is again why public insurance exists) and efficiency They affect in the same way low value care and high value care They are often higher on less expensive care, which is contradictory with the wish of Gouvernments to move care from hospital to ambulatory care (wrong price signal given to the patient)
10 Out-of-pocket payments (3/3) What could be a «rational» increase of OOP payments? Either design them in a way that enhances efficiency, i.e. differentiated according to the value of care: Examples: brand drugs versus generics (reference price in Germany), choice of a referring doctor (France since 2005), but then they do not provide additional funding (there would be no user charges in a system which is totally cost-effective), Or finance services that are explicitely excluded from the statutory benefits package Which dividing line? Cf below
11 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
12 Coverage by PHI Source: Thomson et al., 2009
13 in commercial insurance in 2006 ( in 2001) Coverage by PHI An heterogeneous situation Ireland Source: OECD, 2004 France - % covered by PHI % % (1) (1) Including free meanstested complementary coverage (7%) Source: Thomson et al., 2009 A rapid growth of coverage in some countries, but not the case everywhere
14 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
15 2.1. Public/private mix of health insurance Different schemes: Separation based on: 1. Coverage of different populations 2. Coverage of different services 3. Access to different providers More integrated roles: 4. Purchase of additional quality 5. Joint financing (coverage of user charges) 6. Financing role / management role Each scheme has advantages and drawbacks, as illustrated by the experience of different countries.
16 Scheme 1: coverage of different populations (1/2) Public insurance Private insurance Population 1 Population 2 Same basket of goods & services Same providers US Germany: 11% of the population NL 2nd pillar before 2006 reform: >30% of the population Ireland before the extension of entitlements to public hospital care: 15%
17 Scheme 1: coverage of different populations (2/2) The population covered by private insurance is (generally) an affluent minority public financing is directed towards those who are more in need of social protection But Fairness of the financial contribution Loss of contributions of high earners for the public system Less support for the public system from upper-income individuals? If the providers have higher tariffs (e.g. Germany) or additional payments (e.g. Ireland) incentives to pay more attention to privately insured patients A scheme of the past?
18 Scheme 2: coverage of different health care services and goods (1/2) Public insurance Private insurance Population Goods & services 1 Goods & services 2 Same providers (or different because of the nature of services) e.g. : US : Medigap NL 3rd pillar, dental care for adults, patient transport, physiotherapy France : single room in private hospitals
19 Scheme 2: coverage of different health care services and goods (2/2) May appear as a more rational approach, allowing explicit and democratic choices on the boundaries of the benefit package that should be publicly financed But How to define the dividing line? Necessary care e.g. Canada : Physician & hospital care versus other services: drugs, physiotherapist, but technological change have shifted services out of hospital Care showing no effectiveness or low effectiveness e.g. France, delisting of drugs Minor risk (in terms of severity of disease) e.g. dental care in several countries (but does it help in terms of sustainability if the dynamic of costs is on chronic and severe diseases e.g. France) Care considered too expensive for the value they bring: e.g. UK: cancer drugs, reimbursement by PHI (BUPA, Axa PPP, ) socially acceptable?
20 Scheme 3: access to different providers (1/2) Public insurance Private insurance Same population Same basket of goods & services e.g. : UK, Ireland : hospital care in private hospitals Provider 1 Provider 2 Voir aussi Italie, Espagne pays scandinaves
21 Scheme 3: access to different providers (2/2) Provides more choice and may lead to a reduction in waiting times in the public health care system since people with PHI are treated outside. But If physicians are allowed to work both in public and private facilities, which is often the case, And if they are better paid in the private sector than in the public sector (which is also often the case), Then they have incentives to develop their private activity rather than invest in the public sector, and possibly to treat their patients better + competition to attract skilled staff
22 Scheme 4: financing additional quality (1/2) Public insurance Private insurance Same population Same basket of goods & services Private insurance allows to bypass waiting lists and get more attention (private bed, consultant treatment, ) Same providers UK, Ireland, Demmark, Spain, France to a lesser extent
23 Scheme 4: financing additional quality (2/2) Provides flexibility for people who are dissatisfied with the public health care system (safety valve reducing the pressure) But Inequity of treatment Same potential perverse consequences than the previous scheme (shared resources between public and private sector): The incentives created may exacerbate public-sector waiting lists instead of reducing them Often indirect subsidies (e.g. in Ireland Insurers have a financial incentive to have their members treated in private beds in public hospitals rather than in private hospitals because until now they did not pay the full economic cost of private beds in public hospitals).
24 Scheme 4: joint financing (copayments) (1/2) Public insurance Private insurance Same population Same basket of goods & services Same providers Public insurance covers a % of the tariff or up to a certain amount Private insurance covers user charges e.g. : France copaymets are the rule - 94% of the population is covered by VHI
25 Scheme 4: joint financing (copayments) (2/2) Might be a way to spread the financial burden with a second layer of coverage (partial solidarity) and maintains a common interest in the quality of the public system But Problems of moral hazard & conflicts of interest between public and private insurance neutralisation by PHI of financial incentives for patients & providers (e.g. copayments, billing above the schedule ) regulation: e.g. banning private insurance for these copayments (Australia), contrats responsables in France Equity & access to care subsidy for the low income population (e.g. CMU, ACS in France) with problems of non take up and efficiency (management costs)
26 Scheme 6: financing vs management (1/2) Public insurance = financing Same population Same basket of goods & services Private insurers = management For some populations: US Medicare / Medicaid: enrollment in managed care organisations For the entire population: NL: 2006 reform Same providers
27 Scheme 6: financing vs management (1/2) This scheme might not be classified in «private financing» since the financing stays publicly organised The exemple of the Netherlands shows that Risk selection by health insurers for basic health insurance can be avoided by a careful design, but the risk adjustment scheme needs constant refining to eliminate perverse incentives for insurers and to ensure fair competition. Concerns have also been expressed over the use of voluntary health insurance (VHI) as a tool to select individuals with expected higher profitability levels (which raises the issue of basic and complementary insurance) The competing insurers have been able to make efficiency gains in some areas (e.g. generic drug prices) and are increasingly putting pressure on hospitals and engaging in selective contracting with health care providers (results are yet to see)
28 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
29 3. Issues raised and possible solutions (1/4) Issues Does private finance simply augment the resources devoted to health care, or does it drain resources from the publicly financed system? Is it a safety valve that reduces pressure on the public system and helps meeting demand, or does it leverage an increase in public expenditure rather than complementing / substituting for it? Does an increased role for private finance erode political support for the publicly financed system? How to set the dividing line between publicly and privately financed health services? VHI is often subsidised by tax deductions for companies. Would the money be better spent in direct resources for the public health care system?
30 3. Issues raised and possible solutions (2/4) Efficiency issues Avoid risk selection (as a source of inefficiency) Response = Regulation of PHI, e.g. NL, Ireland: Community rating, open enrolment and lifetime cover, risk equalization scheme Consider the efficiency of subsidies (explicit or indirect) to PHI Direct (tax relief) but also indirect subsidies (e.g. public funding of coverage of low income people in France, payment of a fraction of full economic costs (Ireland), Response: billing of full economic costs, regulation of management costs,
31 3. Issues raised and possible solutions (3/4) Equity issues Ireland Source: Sarah Thomson and Elias Mossialos, Private health insurance in the European Union, 2009 France PHI non take-up by social class
32 3. Issues raised and possible solutions (4/4) Equity issues Avoid risk selection (as a source of inequity in access to care) Réponse :Regulation of PHI, e.g. NL, Ireland: Community rating, open enrolment and lifetime cover, risk equalization scheme Debate in France : generalisation of complementary health insurance?
33 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
34 2.3 Funding of capital investment Private finance initiative: the least we can say is that there is no unanimous opinion. The world of PFI attracts an almost religious fervour with passionate advocates and equally vociferous detractors. (National Audit Office, 2009). Report of the National Audit Office (February 2003) : a positive view Most construction work under the Private Finance Initiative (PFI) is being delivered on time and at the cost expected by the public sector. Central government has generally obtained a much higher degree of price certainty and timely delivery of good quality built assets, compared to previous conventional government building projects.
35 2.3 Funding of capital investment But the recent reports are less positive. Report of the Treasury select committee (August 2011) The use of PFI has the effect of increasing the cost of finance for public investments relative to what would be available to the government if it borrowed on its own account. Government has always been able to obtain cheaper funding than private providers of project finance but the difference between direct government funding and the cost of this finance has increased significantly since the financial crisis. The substantial increase in private finance costs means that (this) method is now extremely inefficient.( ) PFI will only provide value for money if this differential in the cost of finance, which has significantly increased, is outweighed by savings and efficiencies during the life of a PFI project. Evidence we have seen suggests that the high cost of finance in PFI has not been offset by operational efficiencies.
36 2.3 Funding of capital investment Report of the National Audit Office (August 2011) There has not been a systematic value for money evaluation of operational PFI projects by departments. There is, therefore, insufficient data to demonstrate whether the use of private finance has led to better or worse value for money than other forms of procurement. In France, an experience of PPP to build a new hospital near Paris is now considered as a public scandal (delays, defects, additional costs, ) Issue of governance and negociation skills?
37 Public / private mix in health care financing 1. The rationale for increasing private financing in health care systems 2. Forms of private health care financing 2.1. Out-of-pocket expenditure 2.2. Health insurance Pros and cons of different schemes of public / private mix in health insurance Issues raised and possible solutions 2.3. Funding of capital investment Conclusion
38 To conclude: The rationale for more private financing may look good, but in practice the international experience shows that the benefits of raising additional funds (in a field in which there is probably a willingness to pay) may be offset by adverse impacts on the equity and efficiency of the system. Collective choices, management of the performance of the system to get the best value for money and public financing: this would be the most rational thing to do in theory, but it is theory! In practice our systems are mixed, and the experience shows that a careful design of the relationship between public and private finance is necessary. In this area there is a need for more research, empirical work and benchmarking.
Public and private health insurance: where to mark to boundaries? June 16, 2009 Kranjska Gora, Slovenia Valérie Paris - OECD 1 Outline of the presentation Respective roles of public and private funding
Private Health Insurance in OECD Countries Health Insurance for an Expanded Europe: New Public-Private Options The Prague Symposium 2004 Nicole Tapay(Novartis)* *Based on work performed under OECD private
Social insurance, private insurance and social protection. The example of health care systems in some OECD countries References OECD publications on Health care Swiss Re publications Sigma No 6/2007 on
Private Health insurance in the OECD Benefits and costs for individuals and health systems Francesca Colombo, OECD AES, Madrid, 26-28 May 2003 http://www.oecd.org/health 1 Outline Background, method Overview
POLICY BRIEF Private Health Insurance in OECD Countries September 04 What is the role of private health insurance in OECD countries? Does private health insurance improve access to care and cover? Does
VOLUNTARY HEALTH INSURANCE AS A METHOD OF HEALTH CARE FINANCING IN EUROPEAN COUNTRIES Marta Borda Department of Insurance, Wroclaw University of Economics Komandorska St. No. 118/120, 53-345 Wroclaw, Poland
Voluntary health insurance in Europe a structured introduction into objectives and status-quo Reinhard Busse, Prof. Dr. med. MPH FFPH Dept. Health Care Management, Technische Universität Berlin (WHO Collaborating
Health Care a Public or Private Good? Keith Schenone December 09, 2012 Economics & Institutions MGMT 7730-SIK Thesis Health care should be treated as a public good because it is not an ordinary commodity
Expenditure and Outputs in the Irish Health System: A Cross Country Comparison Paul Redmond Overview This document analyzes expenditure and outputs in the Irish health system and compares Ireland to other
1 Private Health Insurance in OECD Countries Francesca Colombo & Nicole Tapay http://www.oecd.org/health click on OECD Health Project, then on Private Health Insurance Purpose of the Study Assess the role
PUBLIC VS. PRIVATE HEALTH CARE IN CANADA Norma Kozhaya, Ph.D Economist, Montreal economic Institute CPBI, Winnipeg June 15, 2007 Possible private contribution Possible private contribution in the health
PUBLIC & PRIVATE HEALTH CARE IN CANADA by Norma Kozhaya, Ph.D. Economist, Montreal Economic Institute before the Canadian Pension & Benefits Institute Winnipeg - June 15, 2007 Possible private contribution
Health Care Reform in Korea: Key Challenges IMF Conference October 3, 2011 Soonman KWON, Ph.D. Professor of Health Economics & Policy Sh School of fpbli Public Health Seoul National University, South Korea
Health Systems: Type, Coverage and Mechanisms Austria Belgium Bulgaria (2007) Czech Republic Denmark (2007) Estonia (2008). Supplementary private health Complementary voluntary and private health Public
What are the equity, efficiency, cost containment and choice implications of private health-care funding in ABSTRACT This is a Health Evidence Network (HEN) synthesis report on private health-care funding
Social health insurance in Belgium Charlotte Wilgos & Thomas Rousseau Attachés NIHDI Content History Today Values Organizational overview Financial overview Evolutions and challenges Content History Today
Real Ways to Drive Down Healthcare Costs Scott E. Harrington The Wharton School, University of Pennsylvania www.scottharringtonphd.com com Free Market Forum Hillsdale College October 1, 2010 Outline The
INEQUALITIES IN HEALTH CARE SERVICES UTILISATION IN OECD COUNTRIES Marion Devaux, OECD Health Division 2014 QICSS International Conference on Social Policy and Health Inequalities, Montreal, 9-May-2014
TOWARDS PUBLIC PROCUREMENT KEY PERFORMANCE INDICATORS Paulo Magina Public Sector Integrity Division 10 th Public Procurement Knowledge Exchange Platform Istanbul, May 2014 The Organization for Economic
EUROPE 2020 TARGETS: RESEARCH AND DEVELOPMENT Research, development and innovation are key policy components of the EU strategy for economic growth: Europe 2020. By fostering market take-up of new, innovative
Gini Coefficient The Gini Coefficient is a measure of income inequality which is based on data relating to household s disposable income. A Gini Coefficient of zero indicates perfect income equality, whereas
HEALTH INSURANCE COVERAGE AND ADVERSE SELECTION Philippe Lambert, Sergio Perelman, Pierre Pestieau, Jérôme Schoenmaeckers 229-2010 20 Health Insurance Coverage and Adverse Selection Philippe Lambert, Sergio
Indicator What Are the Incentives to Invest in Education? On average across 25 OECD countries, the total return (net present value), both private and public, to a man who successfully completes upper secondary
Indicator On What Resources and Services Is Education Funding Spent? In primary, secondary and post-secondary non-tertiary education combined, current accounts for an average of 92% of total spending in
Hong Kong s Health Spending 1989 to 2033 Gabriel M Leung School of Public Health The University of Hong Kong What are Domestic Health Accounts? Methodology used to determine a territory s health expenditure
(OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools SPOTLIGHT REPORT: NETHERLANDS www.oecd.org/edu/equity This spotlight report draws upon the OECD report Equity
(OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools SPOTLIGHT REPORT: SPAIN www.oecd.org/edu/equity This spotlight report draws upon the OECD report Equity and Quality
2 OECD RECOMMENDATION OF THE COUNCIL ON THE PROTECTION OF CRITICAL INFORMATION INFRASTRUCTURES ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT The OECD is a unique forum where the governments of
Review of R&D Credit invitation for submissions Review of R&D Credit Invitation for Submissions February 2013 Economic and Fiscal Divisions Department of Finance Government Buildings, Upper Merrion Street,
(OECD, 2012) Equity and Quality in Education: Supporting Disadvantaged Students and Schools SPOTLIGHT REPORT: AUSTRIA www.oecd.org/edu/equity This spotlight report draws upon the OECD report Equity and
INEQUALITIES IN HEALTH CARE UTILISATION IN OECD COUNTRIES Marion Devaux, OECD Health Division EU Expert Group Meeting on Social Determinants and Health Inequalities, 21-Jan-2013 1 Equity OECD framework
INTERNATIONAL PRICE COMPARISON: THE CYPRIOT EXAMPLE Athos Tsinontides Health Insurance Organisation CYPRUS CYPRUS Kypros Demographics Population (2004): Gross Domestic Product (GDP): Total Health Expenditure
Indicator What Proportion of National Wealth Is Spent on Education? In 2008, OECD countries spent 6.1% of their collective GDP on al institutions and this proportion exceeds 7.0% in Chile, Denmark, Iceland,
Health Care in Crisis The Economic Imperative for Health Care Reform James Kvaal and Ben Furnas February 19, 2009 1 Center for American Progress Health Care in Crisis U.S. spends twice as much per capita
Income and the demand for complementary health insurance in France Bidénam Kambia-Chopin, Michel Grignon (McMaster University, Hamilton, Ontario) Presentation Workshop IRDES, June 24-25 2010 The 2010 IRDES
Submission to the Health Information Authority on Risk Equalisation in the Irish Private Health Insurance Market August 2010 IMO Submission to the Health Information Authority on Risk Equalisation in the
What Is the Total Public Spending on Education? Indicator On average, OECD countries devote 12.9% of total public expenditure to, but values for individual countries range from less than 10% in the Czech
APPENDIX C HONG KONG S CURRENT HEALTHCARE FINANCING ARRANGEMENTS and Healthcare Expenditures C.1 Apart from the dedication of our healthcare professionals, the current healthcare system is also the cumulative
Social Insurance: Pooling Risks for a More Inclusive Singapore Donald Low Vice President, Economic Society of Singapore Outline A more volatile economy, a more unequal society Why does inequality matter?
Survey on Strategic Human Resource Management in Central Governments of OECD countries (2010) Preliminary Results Paris, 07 November 2011 Cornelia Lercher Main focus: Background and Aim of the Survey Scope
SWECARE FOUNDATION Uniting the Swedish health care sector for increased international competitiveness SWEDEN IN BRIEF Population: approx. 9 800 000 (2015) GDP/capita: approx. EUR 43 300 (2015) Unemployment
From: Education at a Glance 2012 Highlights Access the complete publication at: http://dx.doi.org/10.1787/eag_highlights-2012-en How many students study abroad and where do they go? Please cite this chapter
Please cite this paper as: OECD 2010, Health care systems: Getting more value for money, OECD Economics Department Policy Notes, No. 2. ECONOMICS DEPARTMENT POLICY NOTE No. 2 HEALTH CARE SYSTEMS: GETTING
Health Care Systems: An International Comparison Strategic Policy and Research Intergovernmental Affairs May 21 1 Most industrialized countries have established hybrid systems in which the public sector,
Tax reform: Overview Common elements Eliminate tax preferences Lower rates E.g., National Commission Fiscal Responsibility and Reform Individual rates: 8/14/23%; corporate rate: 26% Tax capital gains and
Medicare Payments And Its Relationship To The U.S. Healthcare System Stuart H. Altman, Ph.D. Sol C. Chaikin Professor of National Health Policy Brandeis University Should Medicare Focus Only on The Functioning
Student loans Goals and European experiences Hans Vossensteyn Center for Higher Education Policy Studies International conference of the Rectorate of the University of Lisbon Increasing accessibility to
Challenges in Combating Pensioner Poverty Helsinki, 4-5 Dec 2006 1st Afternoon Plenary session Design and reform of minimum income guarantee and general public earnings related pension schemes and their
The Role of a Public Health Insurance Plan in a Competitive Market Lessons from International Experience Timothy Stoltzfus Jost All developed countries have both public and private health insurance plans,
From: Government at a Glance 2009 Access the complete publication at: http://dx.doi.org/10.1787/9789264075061-en Delegation in human resource management Please cite this chapter as: OECD (2009), Delegation
Health and Healthcare Systems Lectures 9 and 10 Le Grand, Propper and Smith (2008): Chp 2 Bochel, Bochel, Page and Sykes (2009): Chp 15 Stiglitz (2000): Chp 12 Outline Healthcare, efficiency and equity
Insurance corporations and pension funds in OECD countries Massimo COLETTA (Bank of Italy) Belén ZINNI (OECD) UNECE, Expert Group on National Accounts, Geneva - 3 May 2012 Outline Motivations Insurance
Submission to the Health Information Authority (HIA) on Minimum Benefits Regulations in the Irish Private Health Insurance Market September 2010 IMO Submission to the Health Information Authority (HIA)
PROPOSAL FOR A TAXONOMY OF HEALTH INSURANCE OECD Study on Private Health Insurance OECD Health Project Organisation for Economic Cooperation and Development June 2004 1 SUMMARY 1. This paper proposes a
90 10. STUDENT LOANS IN EUROPE: AN OVERVIEW 1 Marianne Guille Education is expensive. In 1995 the average global effort in favour of education represented 6.7% of GDP in OECD countries, and this effort
Austria Belgium Czech Republic Tax credit of EUR 400 for low pension income up to EUR 17,000; the tax credit is fully phased out once pension income equals EUR 25,000. pension income of maximum EUR 1,901.19.
1 UNITED KINGDOM DEMOGRAPHICS AND MACROECONOMICS Data from 2008 or latest available year. 1. Ratio of over 65-year-olds the labour force. Source: OECD, various sources. COUNTRY PENSION DESIGN STRUCTURE
HEALTH CARE DELIVERY IN BRITAIN AND GERMANY: TOWARDS CONVERGENCE? Background: Two different health care systems Generally speaking, the British and the German health care systems differ not only with respect
Ageing and the Challenge to Finance Health Care in Europe: An Overview and Innovations Reinhard Busse, Prof. Dr. med. MPH FFPH FG Management im Gesundheitswesen, Technische Universität Berlin (WHO Collaborating
Insuring long-term care needs Christophe Courbage Introduction Low public coverage and increasing budgetary constraints prompt a move towards developing insurance solutions to cover LTC. Market evolution
The State of Oral Health in Europe Professor Kenneth Eaton Chair of the Platform for Better Oral Health in Europe 1 TOPICS TO BE COVERED What is the Platform? Its aims and work The report (State of Oral
Quality measures in healthcare Henri Leleu Performance of healthcare systems (WHO 2000) Health Disability-adjusted life expectancy Responsiveness Respect of persons Client orientation Fairness France #1
Number 2 2007 PROVIDER PAYMENTS AND COST-CONTAINMENT LESSONS FROM OECD COUNTRIES Historically the OECD countries have struggled to curb their public spending on health care through the use of both demand-oriented
4. ROLE OF PRIVATE SECTOR IN HEALTH CARE IN INDIA CHALLENGES, OPPORTUNITIES & STARTEGIES * G K Lath Type of Health Care Systems 3 Basic Types Type Finance Sector Delivery Sector Examples I Private Private
Submission to the Australian Government s Competition Policy Review June 2014 Introduction The Australian Healthcare & Hospitals Association (AHHA) welcomes the opportunity to provide a submission as part
International comparisons of obesity prevalence June 2009 International Comparisons of Obesity Prevalence Executive Summary Obesity prevalence among adults and children has been increasing in most developed
Government at a Glance 2015 Size of public procurement Strategic public procurement E-procurement Central purchasing bodies 135 Size of public procurement Public procurement refers to the purchase by governments
For Official Use DSTI/EAS/STP/NESTI(2001)38 DSTI/EAS/STP/NESTI(2001)38 For Official Use Organisation de Coopération et de Développement Economiques Organisation for Economic Co-operation and Development
HEALTH REFORM NOTE 13 APRIL 2011 Private Voluntary Health Insurance under NHI In this note we explore the possible future role of private voluntary health insurance in South Africa (SA) under the proposed
Protection Friends Life Protection Account Key features of Mortgage Income Protection Cover Why is this document important? The Financial Services Authority is the independent financial services regulator.
NOTE: IMMIGRATION TO CANADA 1928-1971 RANK COUNTRY OF ORIGIN TOTALS 1 United Kingdom * 1152415 2 United States of America 527346 3 Italy 471940 4 Germany 370641 5 Netherlands 185664 6 Poland 117244 7 Greece
Healthcare and Population Aging Comisión Nacional de Seguros y Fianzas Seminario Internacional Mexico D.F. 10 11 Noviembre 2003 Howard J. Bolnick, FSA, MAAA, HonFIA Presidente, Sección de Salud, AAI Healthcare
WEEK 10 SUPPLY SIDE REFORM AND REIMBURSEMENT Activity- based funding versus block grants The cost containment thesis was outlined in the previous lecture. In this lecture we examine proffered solutions.
POLICY SUMMARY 1 Addressing financial sustainability in health systems Sarah Thomson, Tom Foubister, Josep Figueras, Joseph Kutzin, Govin Permanand, Lucie Bryndová Addressing financial sustainability in
Indicator How Many Students Finish Tertiary Education? Based on current patterns of graduation, it is estimated that an average of 46% of today s women and 31% of today s men in OECD countries will complete
Approaching health system financing policy decisions: objectives, instruments and the sustainability dilemma Health Systems Financing Programme Division of Country Health Systems Tamás Evetovits Senior