...NBER WORKING PAPER SERIES HEALTH CARE FINANCING, EFFICIENCY, AND EQUITY Sherry A. Glied Working Paper 13881 http://www.nber.org/papers/w13881 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 March 2008 I thank Courtney Ward for research assistance and participants at the conference on Exploring Social Insurance, held in Toronto, November 2006. A version of this paper is forthcoming as a chapter in Exploring Social Insurance: Can a Dose of Europe Cure Canadian Health Care Finance? Edited by C. M. Flood, M. Stabile and C. Hughes Tuohy (Kingston, Montreal: Queen's School of Policy Studies, McGill-Queen's University Press). The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peerreviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications. © 2008 by Sherry A. Glied. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. Health Care Financing, Efficiency, and Equity Sherry A. Glied NBER Working Paper No. 13881 March 2008 JEL No. H42,H51,I18 ABSTRACT This paper examines the efficiency and equity implications of alternative health care system financing strategies. Using data across...
Words: 8614 - Pages: 35
...discuss and compare two health care systems in the USA, the GPs and NHS systems, the relation between expenditure on these systems and efficiency of them. Another aim of the essay is to compare heath care systems in different countries and find out whether the dominance of public or private spending is optimal for the society; here the comparison between UK and USA health care system will be appropriate. Question #2 In the USA nowadays the Private Health Insurance system is the major provider of health care cervices. Is this situation adequate to the demands of the tax payers and is it effective for different categories of people who need medical treatment? Should the ratio between private and public sectors in health care be changed and should the organization of both systems be reformed? Let us first of all define what is health. These can be two ways to define it: 1) Negative: the absence of disease 2) Positive: “a state of complete physical, mental and social well-being.” (World Health Organization, 1946). Therefore we can outline two aims of health policy: to improve health and to reduce health inequalities. In terms of the first definition, the US health care system is efficient. In terms of the world-accepted definition, the second one, the US health care system is expensive and in many cases not efficient. Let us analyze the relation between costs and effectiveness in this system. First of all let us trace the development and progress of both health care systems. The basis...
Words: 2096 - Pages: 9
...compare heath care systems in different countries and find out whether the dominance of public or private spending is optimal for the society; here the comparison between UK and USA health care system will be appropriate. Question #2 In the USA nowadays the Private Health Insurance system is the major provider of health care services. Is this situation adequate to the demands of the tax payers and is it effective for different categories of people who need medical treatment? Should the ratio between private and public sectors in health care be changed and should the organization of both systems be reformed? Let us first of all define what is health. These can be two ways to define it: 1) Negative: the absence of disease 2) Positive: “a state of complete physical, mental and social well-being.” (World Health Organization, 1946) Therefore we can outline two aims of health policy: to improve health and to reduce health inequalities. In terms of the first definition, the US health care system is efficient. In terms of the world-accepted definition, the second one, the US health care system is expensive and in many cases not efficient. Let us analyze the relation between costs and effectiveness in this system. First of all let us trace the development and progress of both health care systems. The basis for current health care system was established after the World war II, when private doctors were serving most of the market. The traditional perception of health care as one of the...
Words: 2069 - Pages: 9
...Running head: U.S. HEALTH CARE SYSTEMS Savetta Evans-Driffin Professor Mary Granoff HSA 500 April 28, 2013 Abstract In this paper I will identify and evaluate at least three forces that have affected the development of the health care system in the U.S. I will then speculate on whether or not the forces I identify and evaluate will continue to affect the health care system in the U.S. over the next decade. I will also include another force that I believe will impact the health care system of the nation. Lastly, I will evaluate the importance of technology in health care. 1. Identify and evaluate at least three (3) forces that have affected the development of the health care system in the U.S. Forces that have affected the development of the health care system in the U.S. are geography, language, and finances. One-fourth of the U.S. population lives in rural areas. Compared with urban Americans, rural residents have higher poverty rates, a larger percentage of elderly, tend to be in poorer health and face more difficulty getting to health services. The circumstance of where you live has a significant overall effect on the number of primary-care doctors, specialists, hospitals and other health resources available. In rural communities, lack of transportation and distance to an emergency room or a hospital can be important barriers to receiving prompt treatment. Specialty services, such as treatments for rare diseases or expensive diagnostic...
Words: 1136 - Pages: 5
...SINGAPORE’S INNOVATIVE HEALTH FINANCING SYSTEM Introduction Health care costs are escalating rapidly in many countries. This reflects several factors, such as aging populations, changing disease patterns, high-cost technology and prescription drugs. But, it is also a consequence of health financing systems. Traditional indemnity insurance, which guarantees third-party payment for service provided, contributes to these cost pressures since patients and physicians are shielded from the real cost of those payments. In an effort to contain costs, governments, employers and insurers have modified payment schemes and coverage. This increasingly leads to rationing, restricted consumer choice and, in some cases, denial of care. Singapore’s ‘3M’ health financing system combines universal medical savings accounts (MSAs) with unique supplementary programs to protect the poor and address potential market failures in health financing. The results have been impressive, with excellent health outcomes, low costs and full consumer choice of providers and quality of care. This note describes Singapore’s experience and its possible application to other countries. Background Despite Singapore’s small size, with only 3.22 million residents in a land area of 660 square kilometers, the country has been a stellar economic performer, rising from impoverishment only 40 years ago. Its per capita GDP increased from US$427 in 1960 to US$24,740 in 2000, one of the highest in the world...
Words: 450 - Pages: 2
...Health care system is multifaceted because the system is characterised by variety of aspects. The system involves monitoring the services for social agencies. This process again involves wide range of services because it allows many social workers to coordinate their efforts. Many argue that the multifaceted nature of health care system takes into account high expenditure or the high cost of providing the health care facilities. Health care is financed in U.S through various programs. Financing in U.S is entirely different than other countries. This difference is due to the fact that U.S does not have its national health insurance plan. Government programs, self insured plans and insurance companies are some of the payers involved in financing. U.S does not have national insurance plan for its citizens like other countries but various public programs for the benefit of poor, disabled and elder people are organised. There are basically two approaches to health care financing namely: - Market based financing and government financing. Multiple payer health care system is funded by privately owned health insurance companies and is therefore called as market oriented. It is dependent upon the paying capacity of the beneficiary and accordingly the insurance plan is purchased by the beneficiary. Various health plans cover various health care services but choice depends upon the purchasing power of the beneficiary to a greater extent. Advantages and disadvantages of this system...
Words: 683 - Pages: 3
...healthcare system run by the constituent states and territories if India. Every state in India promotes health and wellness by raising the level of nutrition and standard of living of its people and improves public health. Government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense where drugs are offered free of charge in these hospitals. Government hospitals provide treatment either free or at minimal charges. For example, according to Wikipedia, For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a one-time fee of rupees 10 (around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on financial condition of the patient and facilities utilized by him but are usually much less than the private sector. For instance, a patient is waived treatment costs if he is below poverty line. Another patient may seek for an air-conditioned room if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less compared to the private sector. The cost for these subsidies comes from annual allocations from the central and state governments. In the greater India, the hospitals are run by government, charitable trusts and by private organizations. The government hospitals in rural areas are called the (PHC) primary health center. Major hospitals are located in district head quarters or major cities. Apart from the modern...
Words: 1705 - Pages: 7
...(TITLE PAGE) Abstract: Like the rest of the world, the US is an ageing society (CITE SOMETHING). Between 2000 and 2050, the number of older people is projected to increase by 135% (CITE SOMETHING). Moreover, the population aged 85 and over, which is the group most likely to need health and long-term care services, is projected to increase by 350% (CITE SOMETHING). Over this time period, the proportion of the population that is over the age of 65 will increase from 12.7% in 2000 to 20.3% in 2050; the proportion of the population that is age 85 and older will increase from 1.6% in 2000 to 4.8% in 2050 (CITE SOMETHING). (WRITE 3-4 MORE SENTENCES DESCRIBING THE PAPER) Introduction: There are two points that are noteworthy about this demographic change. First, while a significant proportion of the US is elderly, much of Europe already has a higher proportion of its population that is over the age of 65 (CITE SOMETHING). For example, in 2000, 16.0% of the population in the UK and 16.4% of the population of Germany was over the age of 65. Thus, other countries already have to cope with the impact of an ageing society to a greater extent than the US (CITE SOMETHING). Largely as a result of higher fertility rates and immigration, America’s population, while ageing, is nonetheless likely to remain distinctly younger than other developed countries (CITE SOMETHING). Second, the future strains of population ageing in the US derive not so much from the growth in the elderly population...
Words: 1423 - Pages: 6
...over 15 percent of its population uninsured for health care services.(1) This aspect of American health policy has earned us a reputation of "backwardness"; for both Western Europe and Canada have systems of universal entitlement to health care. Should we adopt the Western European or Canadian models of health care financing and organization? Or should we maintain our present system and recognize that it is a manifestation of American exceptionalism, i.e., of the ways in which the United States is fundamentally different from Western Europe and Canada? Comparative analysts often emphasize the possibilities of adopting elements of health care systems from abroad. But there is also a deeply rooted skeptical variant to this school of thought: those who emphasize the importance of American exceptionalism and who presume that comparative studies of health systems are not useful for policy learning.(2) Both of these responses are probably inappropriate. The second response - that comparative analysis is not useful - insulates us from the experience of other nations. It is ethnocentric; it tends to make us conservative; and, therefore, it supports the status quo in the United States. The first response - that we should adopt the Western European or Canadian models - relies too heavily on the experience of these nations. It is misleading because there are serious limitations in the Western European and Canadian health systems. Moreover, the United States is less backward...
Words: 438 - Pages: 2
...HSA 510 WEEK 8 ASSIGNMENT 3 STRAYER LATEST To purchase this visit following link: http://www.apexseekers.com/product/hsa-510-week-8-assignment-3-strayer-latest/ Contact us at: HELP@APEXSEEKERS.COM HSA 510 WEEK 8 ASSIGNMENT 3 STRAYER LATEST HSA 510 POWERPOINT ASSIGNMENT 3 Assignment 3: The Convergence of Health Care Financing and Economic Trends and Forces Due Week 8 and worth 100 points Note: Use the textbook, course readings, Strayer online library, and other reputable online sources to complete this assignment. Prepare a fifteen to twenty (15 to 20) slide Microsoft® PowerPoint® presentation with detailed scholarly speaker notes in which you: 1. Compare the three (3) current health care financing and funding models (i.e., employee based, government based, and individual based) used with the health care delivery system of the United States. 2. Compare and contrast key economic goals of public and private health insurance plans. Evaluate the success potential of key economic goals in terms of populations covered, services included, financing arrangements, reimbursement strategies, and economic competition policies. 3. Analyze the key effects of labor market, insurance market, and competitive market factors on health care delivery requirements at your current or previous organization of employment. 4. Determine what changes are occurring in the economy or concerning labor and regulatory factors that must be considered in the future. 5. Suggest the key national trends...
Words: 902 - Pages: 4
...MASTER PROGRAM 502 NUR HEALTH CARE DELIVERY SYSTEM Health care system Environment Presented by :EIDAH ALHARTHI, Supervised by : Dr. MELENA Outline : * Introduction * Goals of health care system. * The scope and size of healthcare system. * The basic functions of healthcare system: financing; insurance; payment; delivery (Providers). * Health care system: * A health care delivery system is a mechanism for providing services that meet the health-related needs of individuals. * Goles of health care system: * There are two key objectives of a health care delivery system: * To provide universal access and to deliver services that are cost-effective. * To meet pre-established standards of quality. * Health care services in Saudi Arabia have been given a high priority by the government. During the past few decades, health and health services have improved greatly in terms of quantity and quality. * HOW !! * Gallagher has stated that: “Although many nations have seen sizable growth in their health care systems, probably no other nation (other than Saudi Arabia] of large geographic expanse and population has, in comparable time, achieved so much on a broad national scale, with a relatively high level of care made available to virtually all seg- ments of the population. * According to the World Health Organization (WHO) , the Saudi health care system is ranked 26th among 190 of the world’s health systems. * It comes...
Words: 5140 - Pages: 21
...Several countries provide healthcare for their population. There have been attempts in the US to emulate this program. Several presidents have tried this, but all failed. Recently, President Obama was able to get a bill through a bi-partisan congress requiring all US residents to have some sort of healthcare. While this is not a single payer plan, it can be viewed as a step in the right direction. There were millions in the US without access to affordable care, and now they can at least get a plan that covers basic healthcare. As the years have gone by there have been issues with the program, and how it was implemented. Healthcare is something all should have access to, but the government...
Words: 2134 - Pages: 9
...Health Reform, American Style by Hobson Carroll Today’s health care financing mess requires an American fix. We need a rational solution that recognizes where we have come from in paying and providing for health care in this country, as well as our government, history, culture, economic system and all the other things that define us as a nation. The entire world is struggling with health care financing. Solutions need to be locally relevant, and the United States is no exception. My proposal for reforming core elements in the health care system follows. Everyone Is Charged The Same Amount Currently, the same service from the same provider costs different parties different amounts depending on who is paying. This is patently ridiculous for something society has effectively stated is a right, or at least a social utility. We must require all-payer, transparent pricing from providers for their products and services. Each provider is free to set prices as they deem appropriate, but those prices must be the same to all purchasers. I am referring to a price that represents the true, bottom- line net charge that the provider bills and collects. Payers won’t be able to negotiate with providers for special discounts or pricing concessions for any reason. If a provider agrees to a particular schedule of fees or prices with a given payer, fine. But it then applies to every other payer as well. This doesn’t mean that insurance benefits must cover whatever the provider charges. Schedules...
Words: 1592 - Pages: 7
...Health Care Spending Jackie Shaw HCS 440 December 19th 2011 Health Care Spending The United States spends more on health care than any other country in the world. The current level of national health care expenditures is astounding. “In 2011, the anticipated total of health care government spending in the United States is 1108.2 billion dollars” (Chantrill, n.d.). Over the years the total of health care spending has increasingly amplified; in 1996 $396.78 billion was spent on health care in 2000 $469.80 billion was spent on health care, and in 2009 $989.65 billion was spent on health care (Chantrill, n.d.). Between 1996 and 2009, a period of 13 years, health care spending increased $592.87 billion dollars. In the following I will discuss the level of current national health care expenditures, whether spending is too much or not enough, where the nation should add or cut funds and why, how the public’s health care needs are paid and the future economic needs of the health care system. The level of current national health care expenditures The level of national health care expenditures is considerably high in comparison, to any other country in the world. “Health spending in the United States is much higher than in other countries – at least $2,535 dollars, or 51% higher than Norway, the next largest per capita spender” (Kaiser Family Foundation, 2011, para. 3). In addition in 2009 the United States spent more than 17% of its gross domestic product on healthcare, which...
Words: 1554 - Pages: 7
...Project 2: PUBLIC HEALTH MANAGEMENT ANALYSIS Financing Public Health Care Introduction Ethiopia is the second most populous country in Africa after Nigeria. Over the last decade the country’s economy has registered rapid growth with a GDP of 10.9% annual average growth rate (World Bank, 2015). About 80% of diseases in the country are attributable to preventable conditions related to infectious diseases, malnutrition, and hygiene. The infectious diseases most commonly encountered are: malaria, diarrhea, acute respiratory infections and tuberculosis. Close to 70% of premature deaths are caused by infectious diseases while non-communicable chronic diseases account for 30% of deaths (Federal Ministry of Health (FMoH), 2015). The World Health Organization (WHO) (2015) reports that the life expectancy at birth for Ethiopia is currently 65 (from 45 in 1990), ranking the country amongst the top six countries where life expectancy increased the most. Financing Public Health Care The Ethiopian health care system is structured into a three-tier system: primary, secondary and tertiary level of care. The primary level of care includes primary hospital, health center and health post. The Primary Health Care Unit (a health center and five satellite health posts) provides services to 25,000 people. A primary hospital provides services to an average population of 100,000 while a general hospital serves one million people (FMoH, 2015). The past twenty-year Health Sector Development Program...
Words: 2202 - Pages: 9
