From:
Equity, Health & Human Development [mailto:[log in to unmask]] On Behalf Of Ruggiero, Mrs. Ana Lucia (WDC)
Subject: [EQ] Addressing financial
sustainability in health systems
Addressing financial sustainability in health
systems
Sarah Thomson, Research Fellow, European Observatory on
Health Systems and Policies, and LSE Health,
Tom Foubister, Research Officer, LSE Health,
Josep Figueras, Director, European Observatory on Health
Systems and Policies,
Joseph Kutzin, Regional Adviser, Health Systems Financing,
and Head of the WHO Office,
Govin Permanand, Programme Manager/Technical Officer,
Health Evidence Network, WHO Regional Office for Europe,
Lucie Bryndová, Adviser to the Minister of Health, Cabinet
of the Minister,
World Health Organization 2009 on behalf of the
European Observatory on Health Systems and Policies 2009
Available online PDF [49p.] at: http://www.euro.who.int/Document/E93058.pdf
“………The question as to whether health
systems will be financially sustainable in the future is frequently raised in
health policy debate. The problem is often phrased in terms of the ability of
governments and others adequately to finance health care in the face of growing
cost pressures, with population ageing, new technologies and consumer
expectations around health care coverage and quality being the three most
commonly cited challenges.
Although the notion of ‘financial sustainability’
appears to be central to health policy debate, it does not form part of most
health system objectives, including those of the World Health
Organization’s health system performance framework (1). Moreover, there
is little clarity or consensus about the term's meaning, beyond it having
something to do with ‘ability to pay’ or
‘affordability’. Nevertheless, the underlying
‘sustainability’ issue – balancing rising cost pressures
against limited resources – is a concern across countries, all the more
so in the context of the current financial crisis. Inevitably, this means
addressing trade-offs, both within the health sector itself and more broadly
between the health sector and the rest of the economy.
This policy summary aims to shed light on the notion of
financial sustainability and to examine its policy relevance in practical
terms. Without a better understanding of what is meant by financial
sustainability and, importantly, without explicitly linking the issue to
questions such as willingness to pay for health care, the value of the benefits
gained from health spending and how to improve the performance of the health
system, policy responses to sustainability concerns may be misdirected and
yield unintended consequences.
This policy summary shows the limitations of adopting
financial sustainability as a ‘policy goal’, arguing instead that
it should be understood as a 'policy constraint', and translating this notion
into three key policy-relevant questions……….”
Contents
Preface
1 Introduction
2 Understanding the challenge of financial sustainability
in health
3 How much should we spend on health care?
4 What level of health care coverage should we provide?
5 How can we enhance value in the health system?
6 Conclusion
References
* * *
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