Friday, October 31, 2008

[EQ] High and rising health care costs: Demystifying U.S. health care spending

High and rising health care costs: Demystifying U.S. health care spending

 

Paul B. Ginsburg, President, Center for Studying Health System Change

THE SYNTHESIS PROJECT - RESEARCH SYNTHESIS REPORT NO. 16 - OCTOBER 2008

 

Available online as PDF file [32p.] at: http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.rpt.pdf

 

Why is this issue important to policy-makers?

- In 2006, the United States spent $2.1 trillion, or 16 percent of gross domestic product (GDP), on health care.
  This translates to $7,026 per person annually
  (Reference 1).

- U.S. spending on health care is greater than that of any other developed country, yet unlike other countries, which provide near-universal coverage,
  16 percent of Americans are uninsured
(Reference 2).

-  Without steps to restrain growth, increases in health care spending will eventually consume almost the entire GDP.

 

Policy-makers have a number of options available to restrain health care spending growth, none of which are easy. With research consistently showing that medical technology is the largest cost driver, applying technology more selectively to patients needs to be an element of any long-term approach.

 

To accomplish this, policy-makers could:

·         Increase funding for research on effectiveness. This is the beginning of an approach that supports the appropriate application of medical technology to the patients likely to receive the highest benefit.

·         Reform provider payment systems. Distortions between payments and costs of services lead to undesirable provider incentives to emphasize the most profitable services. These unintended incentives tend to favor services incorporating new technologies.

·         Increase use of consumer financial incentives and support. To the degree that consumers bear some of the financial risk of medical spending, they are likely to be judicious concerning the use of technologies with low value to them as patients. For this to work as intended, however, patients must be provided information on treatment alternatives and their effectiveness, and on the quality of different providers of care, and must face incentives to favor more effi cient providers. Use of this approach is limited by the need to maintain adequate financial protection for the costs of illness or injury.

 

Content:

- Introduction

- Findings

- Implications for Policy-Makers

- The Need for Additional Information

- Appendix I References

 

Policy brief: http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.brief.pdf

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
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[EQ] Exploring the features of universal coverage

Special theme issue: health financing

Bulletin of the World Health Organization - November 2008, Volume 86, Number 11

Website: http://www.who.int/bulletin/volumes/86/11/07-049387/en/index.html

EDITORIALS

Exploring the features of universal coverage
- Guy Carrin, Ke Xu, & David B Evans
Department of Health Systems Financing, Health Systems and Services, World Health Organization, Geneva  Switzerland.
doi: 10.2471/BLT.08.060137
Full article text [HTML] | Full article text [pdf 78kb]

“……Designing and implementing a health financing policy for universal coverage is relatively simple in principle but complex in practice. This issue of the Bulletin explores how it can be done, drawing lessons from several country experiences.

Equity of access to health services of all types is key to universal coverage policy. High levels of out-of-pocket payments, including user fees, are still pervasive in many countries, limiting the ability of people to use service…..”

Universal coverage and health financing from China's perspective
- Shanlian Hu
doi: 10.2471/BLT.08.060046
Full article text [HTML] | Full article text [pdf 93kb]

The positive contributions of global health initiatives
- Prerna Banati & Jean-Paul Moatti
doi: 10.2471/BLT.07.049361
Full article text [HTML] | Full article text [pdf 79kb]

News

Time is ripe for health-care reform. An interview with Paul Krugman
Full Text [HTML] | Full Text [pdf 104kb]

“….The global financial crisis has created an environment that is more favourable to government intervention, social protection and health reform in the United States of America (USA) than in recent years. Paul Krugman, this year’s Nobel economics laureate, talks to the Bulletin about the challenges of pushing through health reform and the shape this could take after the 4 November presidential election….”

Devolved power: key for health care in India. An interview with Michael Tharakan.
Full Text [HTML] | Full Text [pdf 90kb]

RESEARCH

Effect of mutual health organizations on use of priority health-care services in urban and rural Mali: a case-control study
- Lynne Miller Franco et al.
doi: 10.2471/BLT.08.051045
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 803kb]

The impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence?
- Mylene Lagarde & Natasha Palmer
doi: 10.2471/BLT.07.049197
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 836kb]

Coping with out-of-pocket health payments: empirical evidence from 15 African countries
- Adam Leive & Ke Xu
doi: 10.2471/BLT.07.049403
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 858kb]


POLICY & PRACTICE

Universal coverage of health services: tailoring its implementation
- Guy Carrin, Inke Mathauer, Ke Xu & David B Evans
Department of Health Systems Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland.
doi: 10.2471/BLT.07.049387
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 215kb]

“….
Out-of-pocket payments create financial barriers that prevent millions of people each year from seeking and receiving needed health services. In addition, many of those who do seek and pay for health services are confronted with financial catastrophe and impoverishment. People who do not use health services at all, or who suffer financial catastrophe are the extreme. Many others might forego only some services, or suffer less severe financial consequences imposed by user charges, but people everywhere, at all income levels, seek protection from the financial risks associated with ill health…..”


Development assistance for health: should policy-makers worry about its macroeconomic impact?
- Eleonora Cavagnero et al.
doi: 10.2471/BLT.08.053090
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 488kb]

Beyond fragmentation and towards universal coverage: insights from Ghana, South Africa and the United Republic of Tanzania
- Diana McIntyre et al.
doi: 10.2471/BLT.08.053413
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 543kb]

Are current debt relief initiatives an option for scaling up health financing in beneficiary countries?
- M Kaddar & E Furrer
doi: 10.2471/BLT.08.053686
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 470kb]

Resource allocation and purchasing in the health sector: the English experience
- Peter C Smith
doi: 10.2471/BLT.07.049528
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 383kb]

ROUND TABLE

Can coutnries of the WHO Africa region wean themselves off donor funding for health?
- Joses Muthuri Kirigia & Alimata J Diarry-Nama
doi: 10.2471/BLT.08.054932
Abstract [HTML] | Full article text [HTML] | Full article text [pdf 189kb]

Impossible to "wean" when more aid is needed
- Gorik Ooms & Wim Van Damme
doi: 10.241/BLT.08.059485
Full article text [HTML] | Full article text [pdf 118kb]

Response to Ooms and Van Damme
- Joses Muthuri Kirigia & Alimata J Diarra-Nama
doi: 10.2471/BLT.08.060079
Full article text [HTML] | Full article text [pdf 105kb]


The role of aid in the long term
- Felix Masiye
doi: 10.2471/BLT.08.058156
Full article text [HTML] | Full article text [pdf 91kb]

PERSPECTIVES

Financing health promotion in Japan and Mongolia
- Dorjsuren Bayarsaikhan
doi: 10.2471/BLT.08.052126
Full article text [HTML] | Full article text [pdf 153kb]

Can earmarking mobilize and sustain resources to the health sector?
- Phusit Prakongsai et al.
doi: 10.2471/BLT.07.049593
Full article text [HTML] | Full article text [pdf 231kb]

Constraints and obstacles to social health protection in the Maghreb: the cases of Algeria and Morocco
- Driss Zine-Eddine El-Idrissi et al.
doi: 10.2471/BLT.08.053736
Full article text [HTML] | Full article text [pdf 154kb]

PUBLIC HEALTH CLASSICS

The case for public intervention in financing health and medical services
- Jacky Mathonnat
doi: 10.2471/BLT.08.055707
Full article text [HTML] | Full article text [pdf 261kb]

BOOKS & ELECTRONIC MEDIA

Research capacity for mental health in low- and middle-income countries: results of a mapping project
- Feng Wei
doi: 10.2471/BLT.08.053249
Full article text [HTML] | Full article text [pdf 73kb]

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

------------------------------------------------------------------------------------
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Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.