6 dr tim evans executive director of public affairs

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6 Dr Tim Evans, Executive Director of Public Affairs at the IHA, speaking at an IoD seminar on "The New NHS: Modern, Dependable?", London, 3 May 2000. Taxation is the most efficient means to pay for health care. Wrong. Any system can be inefficient. 5 Although OECD members funded through social insurance have higher average total expenditure on health, tax funding can be as inefficiently spent as any other type of funding. The Netherlands and Germany illustrate that cost control can be effective in insurance systems (Mossialos and Le Grand, 1999). When considering technical efficiency, it is the systems and incentives under which providers, payers and patients operate that are important. Mossialos and Dixon (2002), hypothesise that higher spending could be owing to greater transparency, less political interference, greater connection between contributions and benefits, and the existence of single or multiple insurers in social insurance systems. Fairness / equity in financial contribution is vital . Wrong. In a modern, publically financed, social welfare system, it is wrong to look at health care in isolation. Many forms of transfer payment can be made to ensure that households retain sufficient income to live. Equity in access to high quality care is what really matters. Co-payments in France weigh heavily on the poor. Wrong. Although co-payments are a regressive means of financing (Wagstaff and Van Doorslaer, 1993, 1999, 2000), there is a system of exemption for the poor. A similar system of means-tested co-payment may be introduced in Switzerland soon. The UK Private sector is insignificant. Wrong. The scope of the UK private sector is significantly wider than we are commonly led to believe. According to the Independent Healthcare Association, the UK independent healthcare sector, although small by comparison with the NHS still manages as a whole to have: 220 acute hospitals, 70 acute mental health hospitals, and 15883 residential and nursing homes. It provides more than 430,000 health and social care beds. “It provides more than 80% of all residential long-term care, 33% of medium secure mental healthcare and about 20% of all acute elective (non- urgent) surgery. The NHS and social services actually fund some of this provision, for example the mental healthcare and more than 75% of residential and nursing home places - and this was the situation before the Government's recent announcement of increased partnership between NHS and independent sector provision. Collectively it is one of the country's top ten employers, employing over 750 thousand people. This is no small contributor to the economy." 6 It should also be noted that more than 3.5 million trade unionists now enjoy the benefits of private health cash and medical insurance schemes. Not all of the beneficiaries of private sector care are insured. In 2001, nearly 250,000 paid out of pocket for acute hospital operations.
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8 FUNDING SYSTEMS 1. General taxation (the UK).
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  • Fall '18
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