oefentoets Flashcards
why do economists consider health care rationing to be unavoidable
because of scarcity, there are never enough resources to satisfy all human needs
implicit rationing
sets limits to resources but does not allocate scarce resources
explicit rationing
sets limits to resources in combination with choices on how the scarce resources should be allocated
name three instruments used to ration health care in the netherlands
- through co payments: prevents overconsumption
- through the basic benefit package: demand is rationed
- through waiting lists: supply is rationed
3 positive aspects of waiting times
- unnecessary care is prevented
- reduces need for other rationing methods
- the method is equitable
3 negative aspects of waiting times
- can lead to death
- can lead to lower QoL
- the outcome of the treatment can be influenced by the waiting time
optimal waiting timed in systems without financial barriers to care are not zero. Explain this statement
no waiting time will increase the demand by too much. the supply wouldnt be able to keep up with the demand. a small queue is relatively harmless to most patiënts and beneficial for the suppliers
explain how a waiting time guarantee works and the negative effects it may have
- when the maximum waiting time is reached, the hospital will receive a sanction: a fine or negative publicity. It damages their image.
- a negative effect it may have is that low priority patients will have to be helped bevause the maximum had been reached, while high priority patients will have to wait
studies show that waiting times appear to be lower for people with a higher SES compared to people with a lower SES, explain.
- people with a higher SES have better health abilities so they can find their way better in the system
- People with a higher SES have better social networks, so they can use them to gain priority
- People with a higher SES csn express their wishes and needs better
name and define the four criteria used by dutch health care institute ZiN in limiting the basic benefits package
necessity
- is the disease severe enough?
- is the treatment expensive enough?
cost effectiveness
- are the benefits high enough considering the costs
effectiveness
- is the treatment good enough to be included
feasibility
- is it possible to include the treatment?
define proportional shortfall and describe how it is calculated
proportional shortfall = disease lost health years : remaining QALY in absence of the disease
perfect QALY: 1
what is the proportional shortfall threshold jn the netherlands?
50 000
a drug is not reimbursed and its also not allowed to be purchased privatley. how would you label this kind of rationing?
this type of rationing is called hard rationing. This is when private payments are not allowed, only public insurance is allowed in the health system
non price rationing -> primary rationing -> explicit rationing -> hard rationing
the government want to ensure that in the future every man, woman and child can rely on getting the best medical and other facilities available; that their getting them shall not depend on whether they can pay for them or any other factor irrelevant to real need. does this statement makes the use of copayments impossible?
yes, because not everyone can pay their co payments so that immediately invalidates the claim
The NHS is a public system. Within the public system it is possible to buy acces to quicker care. Those who do this have their waiting times to go from 18 weeks to 5 weeks. The normal waiting time goes from 18 weeks to 20 weeks.
Evaluate this policy in terms of efficiency and equity using, defining and briefly explaining the concepts of Pareto optimality and Rawlsian justice
in terms of efficiency, this will maximize the welfare of the people with quicker care more than without acces to quicker care. But it does lower the equity of the system by allowing richer people earlier access.
Pareto optimality says that efficiency can not thrive without equity paying for it.
