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The Changing Role of Government in Financing Health Care: An International Perspective

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  • Mark Stabile

    (University of Toronto)

  • Sarah Thomson

    (LSE - London School of Economics and Political Science)

Abstract

This paper explores the changing role of government involvement in health care financing policy outside the United States. It provides a review of the economics literature in this area to understand the implications of recent policy changes on efficiency, costs and quality. Our review reveals that there has been some convergence in policies adopted across countries to improve financing incentives and encourage efficient use of health services. In the case of risk pooling, all countries with competing pools experience similar difficulties with selection and are adopting more sophisticated forms of risk adjustment. In the case of hospital competition, the key drivers of success appear to be what is competed on and measurable rather than whether the system is public or private. In the case of both the success of performance-related pay for providers and issues resulting from wait times, evidence differs both within and across jurisdictions. However, the evidence does suggest that some governments have effectively reduced wait times when they have chosen explicitly to focus on achieving this goal. Many countries are exploring new ways of generating revenues for health care to enable them to cope with significant cost growth. However, there is little evidence to suggest that collection mechanisms alone are effective in managing the cost or quality of care.

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  • Mark Stabile & Sarah Thomson, 2014. "The Changing Role of Government in Financing Health Care: An International Perspective," Working Papers hal-03460310, HAL.
    • Handle: RePEc:hal:wpaper:hal-03460310
    Note: View the original document on HAL open archive server: https://sciencespo.hal.science/hal-03460310
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    8. Annear, Peter Leslie & Kwon, Soonman & Lorenzoni, Luca & Duckett, Stephen & Huntington, Dale & Langenbrunner, John C. & Murakami, Yuki & Shon, Changwoo & Xu, Ke, 2018. "Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand," Health Policy, Elsevier, vol. 122(7), pages 707-713.
    9. Boone, Jan, 2018. "Basic versus supplementary health insurance: Access to care and the role of cost effectiveness," Journal of Health Economics, Elsevier, vol. 60(C), pages 53-74.
    10. Eric French & Elaine Kelly & Mariacristina Nardi & Eric French & John Bailey Jones & Jeremy McCauley, 2016. "Medical Spending of the US Elderly," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 717-747, September.
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    Keywords

    health; Unated States; cost; efficiency;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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