Detail publikace

Health System Financing in the EU: Current Practices and the Ageing Challenge

Autor: PhDr. Lucie Bryndová , David Prušvic, Matěj Bajgar, Alena Maaytová, Jana Procházková, Tomáš Roubal, Jan Šolc
PhDr. Kateřina Pavloková , David Prušvic, Matěj Bajgar, Alena Maaytová, Jana Procházková, Tomáš Roubal, Jan Šolc
PhDr. Jan Zápal Ph.D., David Prušvic, Matěj Bajgar, Alena Maaytová, Jana Procházková, Tomáš Roubal, Jan Šolc
Typ: Odborné knihy
Rok: 2009
Číslo: 0
ISSN / ISBN: ISBN 978-80-85047-39-4
Publikováno v: Ministerstvo zdravotnictví ČR
Místo vydání: Praha
Klíčová slova:
JEL kódy:
Citace: Zápal et al (2009). Health System Financing in the EU: Current Practice and the Ageing Challenge. Prague, Ministry of Health of the Czech Republic
Granty: GACR 402/08/0501 (2008-2010) Politická ekonomie veřejných rozpočtů
Abstrakt: As the heated debate about the impact of ageing on health care spending continues, we point out that the discussion misses half of the problem, namely the revenue side of the health care sector. For this reason we focus mainly on health care financing, giving special attention to the likely impact of population ageing on health care revenue.
We first discuss the available means of health care financing and their impact on the degree of risk pooling, the income equity of health care payments and the age distribution of health care payments. The last aspect in particular then allows us to make a preliminary conjecture about the impact of ageing on health care revenue.
We then summarise the current health care financing practices in all EU countries and Switzerland. The summary is based on country profiles conducted for the study. Majority of the country profiles were reviewed by national authorities, mainly ministries of health, during the late 2008 and early 2009 period. Knowing how each country finances its private and public health care sector then allows us to make country-specific predictions about the future development of funds flowing into the health care sector.
Finally, for a representative subset of countries in the study (Czech Republic, Denmark, Estonia, France, Italy, Netherlands, Switzerland, United Kingdom) we try to predict the future path of public health care expenditure and revenue using a macroeconomic model and demographic prediction for each country. More specifically, we follow the generational accounting literature and estimate the future path of public health care revenue and expenditure. The exercise then tells us whether the future development of health care revenue and expenditure is something to be concerned about and, if so, the extent of the problem.
Overall, our results are a mix of positive and negative news. The good news is that there is no reason to panic. Although our results suggest increasing deficits in public health care sectors, they do not seem to pose an insurmountable obstacle. Careful long-term planning, foresight and a fair amount of political determination can overcome much larger challenges. Another piece of positive news is that no single European country is left facing the challenge alone. Despite the great deal of heterogeneity in health care financing on the European level, most of the financing systems share a single basic characteristic – reliance on public as opposed to private sources. Whether this proves to be a strength or weakness over the coming decades only time will tell. But if one believes in strong international synergies of political efforts the deficit problem is nothing to lose sleep over.
The bad news is that over the coming decades we are entering a world of much larger redistribution. The generational accounting results suggest that the future demographic changes will markedly increase the dependence of older cohorts on the solidarity of younger ones regarding the financing of health care sectors. This result, all too familiar from the pension literature, carries with equal weight into the health care literature.
Ke stažení: Health System Financing in the EU: Current Practices and the Ageing Challenge
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