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

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

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Lecture 3: Organization and Funding of Healthcare Systems Health Economics 01:220:316 Prof. Derek DeLia, Ph.D.
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Health systems in high-income countries Typology 1. National Health Service 1. National Health Insurance 1. Sickness Funds 1. Mixed System Insurance exchanges
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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
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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
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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
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Mixed systems USA, Japan, Switzerland, Netherlands, Germany, Israel Combination of public & private organization Variation in rules for … Organization Financing Assistance to special populations
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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
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Healthcare in the United States Source of coverage* Pct Medicare ( mostly elderly ) 13.7% Medicaid/SCHIP** (
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