Week 3 Part 1 Flashcards
Health financing
A core function of health systems that can enable progress toward universal health coverage
Health care systems are evaluated based on
- access
- cost
- quality
Single payer system
Government funds everyone through taxation
pre-payment model
Sources of funding
- taxation
- premium (BC, ON)
- user fees (out-of-pocket)
Global health systems may be characterized four ways
- national/public health systems
- social insurance
- private insurance
- out-of-pocket models
National/public health system
- universal coverage through taxation
- UK and former colonies
- hard to grow revenue
Social insurance
- compulsory premiums with subsides for non-insured
- France and Germany
Private insurance
- voluntary premiums
- no subsides
Assessing money collection
- equity
- efficiency
- adequacy
- volatility
- sustainability
- acceptability
Risk pooling
An insurance concept whereby risk associated with uncertain and potentially high cost events can be spread evenly among a large number of people
Issues with risk pooling
- adverse selection (people at greater risk are more likely to use)
- moral hazard (more likely to seek care, and more expensive care if it is available)
Health economics
Includes the study of incentives, concerned with models and theories that help explain and predict patterns of behaviour
Incentives from pay structures
- quality of services
- quality (of care)
- cost control
Current spending statistics
- $253.5 billion
- NWT greatest per person
- 11.3 GDP
- 65% government funded
- most on drugs, physicians and hospitals
- NWT spending least on drugs
Ontario premiums
- based on taxable income
- maximum of 900
Federal health transfer payments
- territorial formula financing
- equalization payments
- canada health transfer
- canada social transfer
Hospitals
primarily private, non-for-profit organization
Hospital funding
- block funding (last years)
- line-by-line
- serviced based (types of cases and volume)
- activity based (provided to each patient)
- population based
Rationalization and Mergers
- horizontal is several hospitals under one admin
- vertical is specific programs within a single operation
Long-term care
is over seen by P/T government
no set standard laid out in Health Act
Drug regulation
Patented Medicine Prices Review Board
Physician payment
- fee for service
- capitation or population based (rostered)
- indirect capitation
- global budget
- salary
- specialists compensations
Lean
A program that operates on the principle of finding more efficient ways to deliver all levels of health care by eliminating wasteful practices
