09 - Other Healthcare Systems Flashcards
What are were the peer nations that we compared extensively in our analysis of healthcare systems?
Germany, Sweden, the UK, and the USA
Rank healthcare spending as a fraction of GDP from the highest to the lowest?
United States (16.6%)
Germany (11.7%)
Sweden (10.9%)
United Kingdom (10.2%)
What are some interesting qualities of the Swedish model?
Private insurance is limited, and only 1% of spending is private and it is usually for co-payments and reduced wait times for specialists and elective care.
Regional areas are responsible for healthcare, a much lower level of government vs. Canada.
Most healthcare providers are directly employed by the healthcare system
What are some interesting qualities of the German model?
You must have public or private insurance, most people have public insurance.
Sickness funds only receive money if they provide good healthcare, so they negotiate prices with providers for large groups of people, helps reduce price per person.
There is no gatekeeping, people can visit specialists without seeing a family physician.
Costs are contained with user fees to help reduce demand. Prevents unnecessary use of healthcare
What are some interesting qualities of the healthcare system in the UK?
Very centralized with national healthcare systems and cover more things vs. Canada
Like Canada, general practitioners act as gatekeepers to specialists.
Local Purchasing Bodies operate like sickness funds, and they negotiate contracts with service providers (hospitals, specialists, etc.)
What are some interesting characteristics of the American healthcare system?
A market-oriented approach with competition based on quality and price. (low price=low quality)
Many are uninsured or underinsured
High co-pays and deductibles, overreliance on specialists, variable quality of care, unnecessary medical intervention/tests
Only 49% of people are covered by publically funded programs.
What is American Medicare?
It covers people above 65 and disabled.
After 65 or disabled, services are cheaper (75% discount), but not free. Great if you have good pension benefits.
What is Medicaid (USA)?
A shared federal and state program for certain groups of very poor people, but they have 100% coverage. This only covers 10% of Americans and 60% of the poor are excluded
What is the Affordable Care Act (Obamacare)?
Obamacare expanded access to both public and private insurance for the uninsured and under-insured.
It guarantees that people will be covered for pre-existing conditions. and it forced people to have some type of medical insurance.
How much do OECD countries spend on healthcare as a percentage of their GDP?
Most countries spend 9-11% of their GDP on health. The United States is an outlier (16.8%)
What performance indicators can be used to compare the quality of care?
Access to care: affordability and timeliness
Care Process: preventative, safe, and coordinated care. Patient engagement and preferences
Administrative Efficiency: documentation and bureaucratic tasks required of patients and providers
Equity: the focus is on income-related disparities
Health Care Outcomes
Rank the peer countries by healthcare system performance from best to worst.
UK
Germany
Sweden
Canada
USA
Was the United States always an outlier when it comes to healthcare spending as a percentage of GDP?
No, healthcare spending in the United States rapidly diverged from other OECD nations. It spends almost 150% more than second place.
What is the Health Access and Quality (HAQ) Index?
It is based on mortality rates from causes that are not fatal in the presence of effective medical care. This allows us measure the effectiveness of a given healthcare system.
Rank peer nations by avoidable mortality rates from best to worst.
Sweden
Canada
Germany
UK
USA
