Financing health care in the European Union: challenges and policy responses
Sarah Thomson, Thomas Foubister and Elias Mossialos
World Health Organization 2009, on behalf of the European Observatory on Health Systems and Policies
Available online as PDF file [224p.] at: http://www.euro.who.int/document/E92469.pdf
“…….Health care systems across the European Union face a common challenge: the high cost of health care. Governments strive to ensure that cost pressures do not undermine values such as universal coverage and equitable financing and access.
Focusing on the three health care financing functions - collection, pooling and purchasing - as well as on coverage, this book analyses the organization of health care financing in the Member States of the European Union, discusses the principal financing reform trends of recent years, and assesses their capacity to help ensure fiscal sustainability.
The book includes a useful annex detailing the health care financing systems of each of the 27 Member States of the European Union. It will inform the deliberations of policy- and decision-makers, both within and beyond the European Union, faced with reconciling rising costs with equitable and sustainable health care…..”
Content:
Introduction
1. The problem of sustainability
1.1. Distinguishing economic and fi scal sustainability
1.2. Addressing the fiscal sustainability problem
1.3. Health care expenditure in context
2. Health care financing in the European Union
2.1. Frameworks for analysis
2.2. Descriptive analysis of fi nancing arrangements
3. Health care financing reforms: options, trends and impact
3.1. Maximizing collection and changing the mix of contribution mechanisms
3.2. Addressing fragmented pooling
3.3. Expanding entitlement to public coverage and defining benefits
3.4. From passive reimbursement to strategic purchasing of health services
4. Conclusions and policy recommendations
4.1. Which reforms are most likely to enhance sustainability?
4.2. Is there an optimal method of financing health care?
4.3. Policy recommendations
References
Annex: summaries of health care fi nancing by
The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Offi ce for Europe, the Governments of Belgium,
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