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Improving Cost-Effectiveness in the Health Care Sector in Iceland

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  • Hannes Suppanz
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    Abstract

    Health outcomes and the quality of health care in Iceland are very good by international comparison, while income-related health inequality appears to be smaller than in most other countries. However, the health-care system is costly and, according to OECD estimates, public expenditure on health and long-term care could reach 15% of GDP by 2050 if no restraining measures are taken. This highlights the importance of raising cost-effectiveness and spending efficiency more generally. To this end, it would seem advisable to remove impediments to private provision and open up the health sector to competition. At the same time, the introduction of cost-sharing should be considered where it does not exist (as in hospitals), although concerns about equity need to be taken into account. This would relieve the burden on public finances, as would the introduction of spending ceilings, cost-efficiency analysis and activity-based funding arrangements. The high cost of pharmaceuticals should be reduced by promoting competition and the use of inexpensive generic drugs. Améliorer le rapport coût-efficacité dans le secteur de la santé en Islande En termes de comparaison internationale, les résultats et la qualité du secteur de la santé sont très satisfaisants en Islande, tandis que les inégalités en matière de santé liées au revenu semblent moindres que dans la plupart des autres pays. Toutefois, le système des soins de santé est onéreux et il ressort des estimations de l’OCDE que les dépenses publiques consacrées à la santé et aux soins de longue durée pourraient atteindre 15 % du PIB d’ici à 2050 en l’absence de mesures d’économie. D’où l’importance d’améliorer le rapport coût-efficacité et, plus généralement, l’efficience des dépenses. Dans ce but, il apparaît souhaitable de lever les obstacles à la prestation des services par le secteur privé et à l’ouverture du secteur de la santé à la concurrence. Parallèlement, il faudrait envisager la mise en place d’un système de partage des coûts là où il n’y en a pas (comme dans les hôpitaux), tout en prenant en compte de considérations d’équité. Ces mesures, de même que l’instauration de plafonds de dépenses, d’un système d’analyse de coût-efficacité et de mécanismes de financement en fonction des activités, permettraient d’atténuer la charge qui pèse sur les finances publiques. Il faudrait également diminuer le coût élevé des produits pharmaceutiques en favorisant la concurrence et le recours à des médicaments génériques peu coûteux.

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    File URL: http://dx.doi.org/10.1787/235327525311
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    Bibliographic Info

    Paper provided by OECD Publishing in its series OECD Economics Department Working Papers with number 645.

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    Date of creation: 15 Oct 2008
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    Handle: RePEc:oec:ecoaaa:645-en

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    Keywords: health care; public spending; health status; Iceland; spending efficiency; efficacité de la dépense; état de santé; Islande; système médical; dépenses publiques;

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