Financing is the crucial part of any health care system; everything else revolves around it, Ullrich Hoffmeyer, senior consultant at national Economic Research Associates in the UK, has told a European workshop on health reforms, sponsored by Pharmaceutical Partners for Better Healthcare, the London School of Economics and the Directorate General XII of the European Commission. Last month, PPBH published the proceeding of the workshop.
Dr Hoffmeyer described a study by NERA into the health care systems in 13 countries (the G7 nations plus the Netherlands, New Zealand, Sweden and Switzerland), and the options they have for designing and implementing structural reforms. The health care systems of the 13 countries fall into the following four groups:
- national health systems, of which the UK is the prime example, and others are Spain, New Zealand and Italy; - regional health services, which constitute a variant of the national health services, and operate in Sweden and Canada. These systems solve one problem admirably but create another. Everyone is insured, but the problem is in budget-setting. Since the Ministry of Finance or the Treasury decides how much to spend on health care each year, it has a detached interest about whether this is actually enough to cover the expected costs of the population's needs. So waiting lists appear, there is rationing of care and technology, and a deterioration of the system if the available funds are not enough to cover the needs of the population.
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