Unbiased Analysis of Today's Healthcare Issues

Archive for the 'International Health Care Systems' Category

Free Health Care in the UK ‘A Thing of the Past’?

The UK’s National Health Service (NHS) is well known for providing free care to all its citizens. However, will £0 out-of-pocket payments be a thing of the past? Maybe so according to a recent survey of UK Members of Parliament (MPs). Pharmafile reports: In response to the question “if the challenges facing the NHS are […]

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P4P in the UK

General Practitioners (GPs) in the UK NHS are paid a mixture of capitation, lump sum allowances, and a pay-for-performance bonus. The P4P element, the Quality and Outcomes Framework (QOF), rewards GPs according to their performance on a large number of indicators. QOF payments represented up to 20% of GPs ’ income in the first year […]

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Health Care Workers and Informal Payments

In many developing countries, making informal payments to health care workers is common.  Lewis (2000) estimates the frequency of informal payments in selected Asian and Central/Eastern European countries as: Armenia: 91%; Azerbaijan: 78%; Kyrgyz Republic: 75% Poland: 78%; Russia: 74% Vietnam: 81%; Do these payments work?  Would people be better off if these bribes were made […]

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Should single-payer countries subsidize private insurance?

In many countries with universal public health insurance, the government also provides subsidies for private insurance.  Examples of this practice include Australia, Spain and the United Kingdom.  Why do they do this?  Is it a good idea? There are arguments on both sides. Public subsidies are good.  Public subsidies for private insurance can stimulate the […]

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Health care crisis in Spain?

Due to its recent economic woes, Spain has imposed a number of austerity measures including significant cuts to social services and health care.  The Economist reports that “expenditure was reduced by 13.7% in 2012 and by 16.2% in 2013 (including social services). Some regions imposed additional cuts as high as 10%.” Cuts to health care […]

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Physician Visits in Germany

Will the Affordable Care Act’s reduced reimbursement rates for providers serving the publicly insured make the U.S. look like Germany?  Maybe.  Let me explain why. Background on health insurance in Germany A JHE study by Hendrik Schmitz provides some insight regarding the German health insurance system and a reform in 1997. German physicians are remunerated […]

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Sustainability of Canadian Health Care System in Doubt?

Canada’s spends far less on health care on health care than the U.S.  According to the CIA World Factbook, in 2010 Canada spent 11.3% of its GDP on health expenditures compared to 17.9% of GDP in the U.S.  Nevertheless, a Society of Actuaries (SOA) report claims that Canada may be in a tenuous fiscal situation.  […]

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Long-Term Care in 5 European Countries

Trends in long-term care spending and use has been rising over time.  The graphs below, from Nadash et al. (2012) demonstrate this trend between 2000 and 2008. Annual Expenditures Long-Term Care Expenditures   Annual Enrollment in Long-Term Care Programs Today, I review the long-term care systems in five European countries: Austria, England, France, Germany, and […]

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Use Of Comparative Effectiveness Research By Four European Health Authorities

How do different European health authorities use comparative effectiveness research (CER) to determine drug coverage and pricing?  A recent Health Affairs article by Cohen, Malins and Shahpurwala answer just this question.  Here is a table summarizing the mission and priorities of health authorities in England, France, Germany and the Netherlands.   Source: Joshua Cohen, Ashley […]

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International Strategies for Skilled Nursing Facility Reimbursement

In the past, I have written about how Medicare pays for Skilled Nursing Facilities (SNF).  Medicare uses a case-mix adjusted per diem rate.  This approach, however, isn’t the only manner payers can use to reimburse nursing facilities.  Consider how Australia pays for nursing care under their Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP): […]

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