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

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  • Mark Stabile
  • Sarah Thomson

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, 2013. "The Changing Role of Government in Financing Health Care: An International Perspective," NBER Working Papers 19439, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:19439
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    Cited by:

    1. Dickey, H. & Ikenwilo, D. & Norwood, P. & Watson, V. & Zangelidis, A., 2016. "“Doctor my eyes”: A natural experiment on the demand for eye care services," Social Science & Medicine, Elsevier, vol. 150(C), pages 117-127.
    2. Boone, Jan, 2015. "Basic versus supplementary health insurance: Moral hazard and adverse selection," Journal of Public Economics, Elsevier, vol. 128(C), pages 50-58.
    3. repec:ifs:fistud:v:37:y:2016:i::p:717-747 is not listed on IDEAS
    4. Elise Huillery & Juliette Seban, 2015. "Financial Incentives are Counterproductive in Non-Profit Sectors: Evidence from a Health Experiment," Working Papers hal-01164460, HAL.
    5. David Coady & Nan Geng, 2015. "From Expenditure Consolidation to Expenditure Efficiency; Addressing Public Expenditure Pressures in Lithuania," IMF Working Papers 15/278, International Monetary Fund.
    6. repec:bla:jorssa:v:180:y:2017:i:1:p:141-160 is not listed on IDEAS
    7. 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.

    More about this item

    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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