LECTURE+3+-+Org+_+fund+of+HC+syst (1)

LECTURE+3+-+Org+_+fund+of+HC+syst (1) - Lecture 3:...

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Unformatted text preview: Lecture 3: Organization and Funding of Healthcare Systems Health Economics 01:220:316 Prof. Derek DeLia, Ph.D. Health systems in high-income countries Typology 1. National Health Service 1. National Health Insurance 1. Sickness Funds 1. Mixed System Insurance exchanges National Health Service • United Kingdom, Denmark, Greece, Italy, New Zealand, Portugal, Ireland • Universal coverage • Services centrally provided & controlled by the government • Tight control of new technology (CEA emphasized) – Waiting lists are common • Private insurance for some – Supplement/substitute National Health Insurance • Canada, Norway, Finland, Sweden, Spain • Universal coverage • State financed care (aka single-payer ) – Private docs/hospitals • Tight control of new technology (CEA emphasized) – Waiting lists are common • Private insurance for some – Supplement/substitute Sickness Funds • Germany, France, Austria, Netherlands, Belgium, Luxemburg • Nearly universal coverage (>95-99%) • Employers & employees pay into funds • Funds negotiate independently w/providers – More variation/flexibility than NHS or single-payer • Technology regulated but not tightly controlled – Waiting lists not common • Non-sickness fund insurance – Supplement/substitute Mixed systems • USA, Japan, Switzerland, Netherlands, Germany, Israel • Combination of public & private organization • Variation in rules for … – Organization – Financing – Assistance to special populations Health insurance exchanges • Switzerland, Germany, Netherlands – History of sickness funds • Private insurance sold through exchange • Transparent pricing/benefits – Standardized benefits – Supplemental coverage – Tradeoff coverage, managed care, premiums, etc. – Guaranteed issue & renewal – Individual mandate (social solidarity vs. individual rights) • Other features – Centralized risk-adjustment across plans – National pricing rules for providers – Regulation/oversight of providers Part of larger system Healthcare in the United States Source of coverage* Pct Medicare ( mostly elderly ) 13.7% Medicaid/SCHIP** ( mostly lower income or disabled ) 13.0% Private – Total 67.7% Private – employer based 59.5% Military/Veteran’s Administration (VA) 3.8% Uninsured...
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This note was uploaded on 01/13/2011 for the course ECONOMICS 01:220:316 taught by Professor Delia during the Fall '10 term at Rutgers.

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LECTURE+3+-+Org+_+fund+of+HC+syst (1) - Lecture 3:...

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