Comparative Health Systems: A New Framework

Cover
Half-title
Title page
Copyright information
Dedication
Contents
List of Figures
List of Tables
Acknowledgments
List of Acronyms
Introduction
1 Seven Financing Models
	1.1 The Direct Market Model
		1.1.1 Dental Care in Italy and Spain
	1.2 Voluntary Health Insurance
		1.2.1 Voluntary Insurance in the United States
	1.3 Social Health Insurance
		1.3.1 Social Health Insurance in Austria
	1.4 Targeted Programs
		1.4.1 Public Programs in the United States
	1.5 Mandatory Residence Insurance
		1.5.1 Mandatory Insurance in Switzerland
	1.6 The Universalist Model
		1.6.1 Medicare in Canada
		1.6.2 The National Health Service in the United Kingdom
	1.7 Medical Savings Accounts
		1.7.1 Medisave in Singapore
	1.8 Comparing the Seven Models
		1.8.1 Payers and Beneficiaries
		1.8.2 Number and Legal Status of Insurers
		1.8.3 Contribution Methods
		1.8.4 User\'s Freedom of Choice
		1.8.5 The Relationship between Insurers and Providers
		1.8.6 The Role of the State
2 Funding Healthcare: Variants and Hybrid Systems
	2.1 Private Health Insurance
		2.1.1 Policy Measures to Counteract the Cream Skimming
		2.1.2 How to Discourage Healthcare Overconsumption
		2.1.3 Primary, Complementary and Supplementary Private Health Insurance
		2.1.4 The Regulation of the Insurance Market
	2.2 Variants to the SHI Model and the Universalist Model
		2.2.1 SHI Systems: Variants to the Original Bismarck Model
		2.2.2 Opting Out
		2.2.3 Co-payment versus Co-insurance
	2.3 The Segmentation of Healthcare Systems
	2.4 The Netherlands
	2.5 France
	2.6 Germany
	2.7 The United States
	2.8 Comparing Healthcare Financing Systems
3 Healthcare Expenditure and Insurance Coverage
	3.1 Current Expenditure on Health
		3.1.1 Total Healthcare Spending Per Capita
	3.2 The Growth of Healthcare Expenditures
	3.3 The Composition of Health Expenditure
		3.3.1 The \'\'Mandatory\'\' Component
		3.3.2 The Expenditure for Voluntary Health Insurance
		3.3.3 Out-of-Pocket Payments
	3.4 Prevalence of Health Insurance Coverage: The Current Situation
		3.4.1 Universal, Quasi-Universal and Nonuniversal Countries
	3.5 Health Insurance Coverage Over Time
	3.6 The Problem of the Uninsured
		3.6.1 The Problem of the Uninsured in OECD Countries and in the European Union
4 Healthcare Provision: Integrated versus Separated Systems
	4.1 Integrated Model versus Separated Model
		4.1.1 The Separated Model
		4.1.2 The Integrated Model
		4.1.3 The Five Dimensions
	4.2 Insurer-Provider Integration
	4.3 Primary/Secondary Care Integration
	4.4 Gatekeeping
	4.5 Patients\' Freedom of Choice for Providers
	4.6 General Practitioners: Solo versus Group Practice
	4.7 The Integration-Separation Continuum
5 Financing and Provision: Four Families and a Few Outliers
	5.1 The SHI Countries
		5.1.1 Single Fund versus Multiple Funds
		5.1.2 Funds: Freedom of Choice
		5.1.3 Risk Adjustment Mechanisms
		5.1.4 Occupational, Territorial and Corporate Funds
		5.1.5 Calculation of Contributions
		5.1.6 Population Coverage
		5.1.7 Public Subsidies and Targeted Programs
		5.1.8 Similarities and Differences
	5.2 The NHS Countries
		5.2.1 Funding and the Possible Presence of SHI Schemes
		5.2.2 The Provision of Services
		5.2.3 Centralized versus Decentralized NHS
		5.2.4 Nordic Countries versus Southern Europe?
		5.2.5 Spain and Ireland
	5.3 Separated Universalist Systems: Australia and Canada
		5.3.1 Australia
		5.3.2 Canada
	5.4 Mandatory Residence Insurance
		5.4.1 A Recent Model
		5.4.2 Similarities
		5.4.3 Differences
	5.5 The Outliers: Greece, Israel and the United States
		5.5.1 Greece
		5.5.2 Israel
		5.5.3 United States
6 Hospitals, Doctors and Nurses
	6.1 The Hospitals
	6.2 Payment Methods for Hospitals
	6.3 The Number of Practicing Physicians
		6.3.1 The Shortage of Doctors and Recruitment from Abroad
		6.3.2 Women Doctors
		6.3.3 Generalists versus Specialists
	6.4 Physician Payment Methods
		6.4.1 How Doctors Are Paid in Individual Countries?
	6.5 The Nurses
		6.5.1 The Number of Practicing Nurses
		6.5.2 The Relationship between Doctors and Nurses and the Topic of Task Shifting
7 Healthcare Reforms over the Last Thirty Years
	7.1 Reforming Healthcare Systems: Between Legacy and Policy Transfer
	7.2 Pro-competition Reforms
		7.2.1 The Purchaser-Provider Split and the \'\'Internal Markets\'\'
		7.2.2 Competition between Insurers
	7.3 Let Us Integrate! Reforms in Favor of Integration
		7.3.1 The Integration of Sickness Funds
		7.3.2 The Integration of the Provision System
	7.4 Going Local: The Theme of Decentralization
		7.4.1 Reforms in Favor of Decentralization
		7.4.2 Pro-centralization Reforms
	7.5 Strengthening Patients\' Rights
		7.5.1 Freedom to Choose the Provider
		7.5.2 The Waiting-Time Guarantee
	7.6 Going Universal: Extending Health Coverage
		7.6.1 Israel 1994
		7.6.2 Switzerland 1994
		7.6.3 France 1999
		7.6.4 The Netherlands 2006
		7.6.5 Germany 2007
		7.6.6 United States 2010
	7.7 Reform Themes and Political Color
8 Health Politics
	8.1 The Perspective of Health Politics
	8.2 The Importance of the Historical Path
		8.2.1 The Evolutionary Trajectories of Individual Countries
	8.3 The \'\'Why\'\' Question
	8.4 Ideas: The Importance of Values and Ideological Orientation
		8.4.1 National Culture
		8.4.2 The Ideological Orientation of Governments
		8.4.3 Social Health Insurance and Conservative Governments
		8.4.4 Universalist Schemes and Leftist Governments
	8.5 Interests: Pressure Groups and the Clash between Doctors and the State
		8.5.1 Interest Groups in Healthcare
		8.5.2 The Obama Reform and Interest Groups
		8.5.3 The Standoff between Doctors and the Government
	8.6 Institutions: The Importance of Political Institutional Rules
	8.7 Conclusions: Putting Together the Pieces of Health Politics
Conclusions
	Not Just Bismarck against Beveridge: Going beyond the Standard Classification
	All Health Systems Are Hybrid
	The Uninsured: A Problem Not Only in the United States
	Integrated and Separated Provision Systems
	Four Families and Some Outliers
	Five Great Reform Themes
	Health Politics
References
Index