In 2008, the OECD launched a survey to collect information on the health systems characteristics of member countries. This paper presents the informaton provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending. It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of heallth care suppply and prices. Finally, this document provides information on governnance and resource allocation in health systems (decentralisation in decisionmaking, nature of budget constraints and priority setting). En 2008, l’OCDE a lance une enquete aupres de ses pays membres pour recueillir une information sur les caracteristiques des systemes de sante. Ce document presente l’information fournie par 29 pays en 2009. Il decrit comment chaque pays organise la couverture de la population contre les risques lies a la sante et le financement des depenses de sante. Il depeint l’organisation des soins, a travers le caractere public/prive de l’offre de soins, les modes de paiement des prestataires, le choix de l’usager et la concurrence entre prestataires, ainsi que la regulation de l’offre et des prix. Finalement, il donne une information sur la gouvernance et l’allocation des ressources dans les systemes de sante (decentralisation, nature de la contrainte budgetaire et etablissement des priorites).

/pdf/health-systems-institutional-characteristics-a-survey-of-29-zntnm9w8nk.pdf

Health systems institutional characteristics: a survey of 29 oecd countries

This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions. It also helps to uncover strengths and weaknesses of each country’s health care system and assessing the scope for improving value-for-money. The empirical analysis suggests that there is room in all countries surveyed to improve the effectiveness of health care spending; there is no health care system that performs systematically better in delivering cost-effective health care – big-bang reforms are therefore not warranted; increasing the coherence of policy settings, by adopting best policy practices within a similar system and borrowing the most appropriate elements from other systems will likely be more practical and effective to raise health care spending efficiency.

/pdf/health-care-systems-efficiency-and-institutions-trwejxoum7.pdf

Health Care Systems: Efficiency and Institutions

This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions. It also helps to uncover strengths and weaknesses of each country’s health care system and assessing the scope for improving value-for-money. The empirical analysis suggests that there is room in all countries surveyed to improve the effectiveness of health care spending; there is no health care system that performs systematically better in delivering cost-effective health care – big-bang reforms are therefore not warranted; increasing the coherence of policy settings, by adopting best policy practices within a similar system and borrowing the most appropriate elements from other systems will likely be more practical and effective to raise health care spending efficiency. Systemes de sante : efficacite et institutions Ce document presente un ensemble d’indicateurs afin d’evaluer la performance des systemes de sante. Il presente aussi de nouvelles donnees comparatives sur les politiques et les institutions dans le domaine de la sante pour les differents pays de l’OCDE. Cet ensemble d’indicateurs permet de caracteriser empiriquement les systemes de sante en identifiant des groupes de pays ayant des politiques et institutions comparables. Il permet aussi de mettre en valeur les forces et les faiblesses du systeme de sante de chaque pays et de determiner les gains potentiels d’efficacite. L’analyse empirique montre que dans chacun des pays etudies l’efficacite des depenses de sante peut etre amelioree; qu’il n’existe pas de systeme qui, pour un cout donne, produit systematiquement des meilleurs resultats – des reformes radicales en faveur d’un systeme de sante ne sont donc pas necessaires ; accroitre la coherence des politiques en matiere de sante en adoptant les politiques les plus performantes a l’interieur d’un systeme similaire et en empruntant les elements les plus appropries aux autres systemes s’averera vraisemblablement plus realiste et plus efficace pour ameliorer l’efficacite de la depense en matiere de sante.

This paper studies equilibrium and welfare in a class of regulated health insurance markets known as exchanges. We use detailed health plan choice and utilization data to model individual-level (i) projected health risk and (ii) risk preferences. We combine the estimated distributions of risk and risk preferences with a model of competitive insurance markets to predict allocations and prices

/pdf/equilibria-in-health-exchanges-adverse-selection-versus-4ru7w4l9qn.pdf

Equilibria in Health Exchanges: Adverse Selection versus Reclassification Risk

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60571-7.pdf

Health-care expenditure and health policy in the USA versus other high-spending OECD countries

As the United States resumes debate over options for achieving universal health coverage, policymakers are once again examining insurance systems in other industrialized countries. More recent attention has focused on countries that combine universal coverage with private insurance and regulated market competition. Switzerland and the Netherlands, in particular, have drawn attention for their use of individual mandates combined with public oversight of insurance markets. This paper provides an overview of the Swiss and Dutch insurance systems, which embody some of the same concepts that have guided health reforms adopted in Massachusetts and considered by other states and by federal policymakers. The two systems have many features in common: an individual mandate, standardized basic benefits, a tightly regulated insurance market, and funding schemes that make coverage affordable for lowand middle-income families. Differences include degree of centralization, basis of competition among insurers, availability of managed care, and reliance on patient cost-sharing to influence care-seeking behavior. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other fund publications are available online at www.commonwealthfund.org. To learn more about new publications when they become available, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1220.

The Swiss and Dutch Health Insurance Systems: Universal Coverage and Regulated Competitive Insurance Markets

The Swiss and the Dutch health care systems compared

The Swiss and the Dutch Health Care Systems Compared: A Tale of Two Systems

Comparaison des systèmes de santé suisse et néerlandais

9 Die Volkswirtschaft Das Magazin für Wirtschaftspolitik 11-2009 Die Gesundheitssysteme der Schweiz und der Niederlande enthalten Elemente des auf Enthoven (1978, 1988, 2006) zurückgehenden Modells des regulierten Wettbewerbs (vgl. Kasten 1). Beide Länder haben dieses Modell jedoch in sehr unterschiedlichem Ausmass verwirklicht. Die Grundidee des regulierten Wettbewerbs besteht darin, auf dem Versi­ cherungsmarkt einen staatlich regulierten Wettbewerb zu schaffen, der dann auf den Markt für medizinische Leistungen durch­ schlagen und zu einer effizienten und quali­ tativ hochstehenden Versorgung der Bevöl­ kerung führen soll. Struktur und Marktzutritt

Die Gesundheitssysteme der Schweiz und der Niederlande. Ein Vergleich

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