Suchergebnisse

Israel : partial health care reform as laboratory of ongoing change / David Chinitz and Rachel Meislin -- Change and continuity in Dutch health care : origins and consequences of the 2006 health insurance reforms / Kieke G.H. Okma and Hans Maarse -- Reform and re-reform of the New Zealand system / Toni Ashton and Tim Tenbensel -- Health care reforms in Singapore / Meng-Kin Lim -- Consumer-driven versus regulated health insurance in Switzerland / Luca Crivelli and Iva Bolgiani -- Taiwan's national health insurance system : high value for the dollar / Tsung-Mei Cheng -- Conclusions : debates, reforms, and policy adjustments / Kieke G.H. Okma and Luca Crivelli

"This book presents the health reform experiences over the past three decades of twelve small and medium-sized nations that are not often included in international comparative studies in this field. The major conclusion of the study is that despite many similarities in policy goals, policy challenges and in the menu of policy options for countries that seek to offer universal coverage to their population, the health reforms of the nations in this book did not converge into one direction or model. However, we found several widespread policy experiences that are relevant for others, too. For example, user fees are unpopular everywhere. Governments often try to soften the consequences by exempting large groups of users, thus largely defeating the very purpose of those fees. As a second example, the introduction of new payment modes for medical care -- like the shift from fee for service to case-based payment -- took much longer than originally expected everywhere, and also failed to deliver their promises of improved transparency or efficiency gains. A third example is that proposals are for universal coverage often ignore the challenges of implementing new financing models that elsewhere took decades if not centuries to develop. The conclusions contain both empirical findings and theoretical conclusions of interest to policy-makers and scholars of international comparison. It is accessible for academics, healthcare managers and students as well as a wider audience of readers interested in the changes in healthcare across the world"--Publisher's website

The Urban Resident Basic Medical Insurance (URBMI) is a core component of the ongoing health financing reform towards universal insurance coverage in China. This paper reviews the introduction of URBMI in six Chinese cities, based on comparative institutional analysis and use of publicly available data. In the early 21st century, the Chinese government announced plans for universal health insurance. Rather than one populationwide scheme, however, it designed several separate schemes for specific populations, with a fair degree of autonomy and independent administrative responsibilities of the regions and large cities. In this study, we have selected six cities with different levels of economic development and fiscal resources. The cities also differ, as we will show, in their target populations, financing level, insurance coverage and benefits level, management of health services and referral rules. Following an analysis of the similarities and differences in the institutional features of the various URBMI schemes and an exploration of the underlying causes, we analyze the challenges and policy implications facing China as it moves towards universal coverage. To reduce the inequality in financing and benefits of insurance across cities, for example, we conclude that the central government should give priority to less-developed cities in the distribution of subsidies. Other concerns that require some form of collective action are the extension of the benefit package with outpatient care for all, strengthening primary care and developing a rational referral system. Two major challenges for the longer term are the establishment of wider risk pools for thehealth insurance and the merger of segmented insurance programs.

The Urban Resident Basic Medical Insurance (URBMI) is a core component of the ongoing health financing reform towards universal insurance coverage in China. This paper reviews the introduction of URBMI in six Chinese cities, based on comparative institutional analysis and use of publicly available data. In the early 21st century, the Chinese government announced plans for universal health insurance. Rather than one populationwide scheme, however, it designed several separate schemes for specific populations, with a fair degree of autonomy and independent administrative responsibilities of the regions and large cities. In this study, we have selected six cities with different levels of economic development and fiscal resources. The cities also differ, as we will show, in their target populations, financing level, insurance coverage and benefits level, management of health services and referral rules. Following an analysis of the similarities and differences in the institutional features of the various URBMI schemes and an exploration of the underlying causes, we analyze the challenges and policy implications facing China as it moves towards universal coverage. To reduce the inequality in financing and benefits of insurance across cities, for example, we conclude that the central government should give priority to less-developed cities in the distribution of subsidies. Other concerns that require some form of collective action are the extension of the benefit package with outpatient care for all, strengthening primary care and developing a rational referral system. Two major challenges for the longer term are the establishment of wider risk pools for thehealth insurance and the merger of segmented insurance programs.

This book offers a timely account of health reform struggles in developed democracies. The editors, leading experts in the field, have brought together a group of distinguished scholars to explore the ambitions and realities of health care regulation, financing, and delivery across countries. These wide-ranging essays cover policy debates and reforms in Canada, Germany, Holland, the United Kingdom, and the United States, as well as separate treatments of some of the most prominent issues confronting policy makers. These include primary care, hospital care, long-term care, pharmaceutical policy, and private health insurance. The authors are attentive throughout to the ways in which cross-national, comparative research may inform national policy debates not only under the Obama administration but across the world