Welfare, choice, and solidarity in transition: reforming the health sector in eastern Europe
Gespeichert in:
| Hauptverfasser: | , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Cambridge [u.a.]
Cambridge Univ. Press
2001
|
| Ausgabe: | 1. publ. |
| Schriftenreihe: | Federico Caffè lectures
|
| Schlagworte: | |
| Online-Zugang: | Sample text Publisher description Table of contents Inhaltsverzeichnis |
| Beschreibung: | XIII, 365 S. |
| ISBN: | 0521790360 |
Internformat
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Datensatz im Suchindex
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|---|---|
| adam_text | Contents
List of figures page x
List of tables xi
Acknowledgements xiv
1 Introduction 1
Part I Points of departure
Introduction to part I 12
2 The general principles of reform 13
Ethical postulates 15
The desired attributes of institutions and coordination
mechanisms 24
The desired proportions of allocation 37
Concluding remarks 43
3 The characteristics of the health sector 47
A general overview 47
Provision and financing: classification 69
Payment system incentives 79
4 Some international experiences 100
The economic mechanisms in the industrialized
democracies 100
A special case: the US health sector 122
5 The health sector in Eastern Europe: the initial state 135
The economic mechanism of classical socialism 135
Redefining the right to provision 140
vii
viii Contents
The separation of financing from provision 143
Financing 147
Delivery: public institutions 156
Delivery: legal private activity 160
Doctors earnings and gratuities 164
Economic indices for the health sector and population
health status 175
Part II Guidelines for reform
Introduction to part II 188
6 The demand side: financing, benefits, and organization of
insurance 191
The guiding ideas behind the recommendations 191
The financing of basic care 195
Redistribution through financing 200
Co payments 213
The basic benefit package 216
Organization of insurance: ownership, decentralization,
and managed competition 227
The scope and financing of supplementary care 246
The role of employers 255
7 The supply side: delivery system ownership, organization,
and contracting 262
Encouraging private initiative 262
Strengthening the quasi market elements in the public
sector 271
8 The interaction of supply and demand: pricing, payment,
hard budget constraints, and overall health sector
development 275
Reasonable prices 275
The hard budget constraint and other incentives 284
Doctors pay: the medical profession and the reform 301
Neutrality between sectors 309
Who decides about health sector development? 314
Contents ix
9 Concluding remarks 323
The role of factors beyond the economic mechanism 323
The supporters and opponents of reform 327
Evolutionary and constructivist development 328
References 343
Index 360
Figures
2.1 Value choices page 23
2.2 Relation between income per capita and public pension
spending 39
3.1 Types of integration 77
3.2 Trade offs in setting the consumer co insurance rate 82
3.3 Trade offs in setting the provider cost sharing rate 94
5.1 Deficit of social health insurance funds, Croatia, Hungary,
and Slovenia, 1994 1998 150
5.2 Sources of health care financing, Eastern Europe, 1997 156
5.3 Hungary, actual and predicted health spending data
during the transition, 1990 1997 181
5.4 Resources in health care provision, Eastern Europe,
1995 1997 183
5.5 Standardized male mortality rates, Eastern Europe 186
6.1 Average health care costs per insured, by age groups,
Czech Republic, 1997 202
6.2 Alternative ways of decentralizing the insurance system 232
6.3 Financing flows under different decentralized insurance
schemes 235
8.1 Hungary, public share of total health spending during the
transition, 1990 1997 321
9.1 Preference for system of health care financing, by age,
Bulgaria, 1995 336
x
Tables
2.1 Institutional choices: support for state, market, and
mixed solutions in Hungary page 27
3.1 Prices and volume in health expenditure growth, OECD
countries, 1980 1990 66
3.2 Provision and financing: classification of alternative
mechanisms 72
3.3 Incentive effects of payment system policy instruments 98
4.1 Predominant ownership forms of health care providers,
OECD countries, 1992 102
4.2 Supplementary ownership forms in health care services,
selected OECD countries, 1990s 103
4.3 Supplementary forms of financing health care services,
selected OECD countries, 1992 104
4.4 Real GDP per capita, health expenditure as percentage
of GDP, and public share of health expenditure, 1992,
an international comparison 106
4.5 Selected reforms implemented in OECD countries since
1984 114
4.6 Out of pocket payments, selected OECD countries, 1997 116
4.7 Provider payment systems, selected countries, late
1990s 117
4.8 Risk adjustment and risk sharing, selected countries,
1972 2000 119
4.9 Public opinion on health care, selected countries, 1998 121
4.10 Ownership composition of the health sector, United
States 123
xi
xii List of tables
4.11 Changing ownership of hospital beds, United States,
1980 1996 124
4.12 Distribution of employees among types of health plans,
United States, 1987 1995 126
4.13 Growth of health expenditure, OECD countries, 1960
and 1997 131
5.1 Right to health care, Eastern Europe, late 1990s 142
5.2 Shift toward the German model of social insurance,
Eastern Europe 146
5.3 Size of the health care contribution and distribution of
the contribution between employers and employees,
Eastern Europe, late 1990s 149
5.4 State guarantees for maintaining the solvency of social
health insurance funds, Eastern Europe 151
5.5 Share of private health insurance, Eastern Europe 153
5.6 Presence, absence, size, and sphere of co payments,
Eastern Europe, late 1990s 155
5.7 Responsibilities for budget allocations, Eastern Europe,
1998 158
5.8 Nonstate sector of health care services, Hungary, 1996,
selected data 161
5.9 Share of private health care providers, Eastern Europe,
1997 163
5.10 Distribution of health employees, by sectors, Czech
Republic, 1997 164
5.11 Share of private specialist providers, Hungary and
Czech Republic 165
5.12 Physicians earnings compared with earnings by all
employees, 1992 1999, an international comparison 167
5.13 Physicians earnings compared with those of other
professionals, 1996 1999, an international comparison 168
5.14 Average gratuity prices of medical care, Hungary,
1999 171
5.15 Opinions on medical gratuities, among doctors and
among the public, Hungary 173
5.16 GDP and health spending, Eastern Europe, 1990 1994 176
List of tables xiii
5.17 Health spending per capita, OECD countries,
1970 1994 177
5.18 Actual and predicted health spending, Eastern
European countries, 1990 1994 178
5.19 Infant mortality, life expectancy at birth, and crude
death rate, Eastern Europe, 1990 1997 185
6.1 Distribution of health expenditures financed by social
insurance, Hungary, 1995 205
6.2 Distribution of health expenditures financed by social
insurance, Slovenia, 1998 206
6.3 Distribution of social insurance contributions, Czech
Republic, 1994 207
8.1 Payment systems, Eastern Europe: survey according to
payment alternatives, 1997 287
8.2 Payment systems, Eastern Europe: survey according to
three levels of healthcare, 1997 288
8.3 Status of physicians, Eastern Europe, 1998 302
8.4 Predicted values for public share of total health
spending, Eastern Europe, 1990 1994 320
9.1 Attitudes regarding the trade off between welfare
spending and lower taxes, Hungary, Czech Republic,
and Poland 331
9.2 Distribution of opinions about competition among
health insurers and the level of social insurance
contributions, Hungary 332
9.3 Age distribution of those preferring competition among
health insurers, Hungary, 1999 333
9.4 Proportion of competition supporters, Hungary, by
educational attainment, 1999 333
9.5 Knowledge of and attitude towards health reform,
Croatia, by income groups, 1994 335
|
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| spelling | Kornai, János 1928-2021 Verfasser (DE-588)115604685 aut Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe János Kornai and Karen Eggleston 1. publ. Cambridge [u.a.] Cambridge Univ. Press 2001 XIII, 365 S. txt rdacontent n rdamedia nc rdacarrier Federico Caffè lectures Gesundheitsreform / Osteuropa Health care reforms -- Europe, Eastern Medical policy -- Europe, Eastern Health planning -- Europe, Eastern Medical care -- Europe, Eastern Gesundheitswesen (DE-588)4020775-4 gnd rswk-swf Gesundheitspolitik (DE-588)4113743-7 gnd rswk-swf Osteuropa Osteuropa (DE-588)4075739-0 gnd rswk-swf Osteuropa (DE-588)4075739-0 g Gesundheitswesen (DE-588)4020775-4 s Gesundheitspolitik (DE-588)4113743-7 s DE-604 Eggleston, Karen Verfasser aut http://www.loc.gov/catdir/samples/cam031/00045500.html Sample text http://www.loc.gov/catdir/description/cam021/00045500.html Publisher description http://www.loc.gov/catdir/toc/cam022/00045500.html Table of contents HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009910977&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Kornai, János 1928-2021 Eggleston, Karen Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe Gesundheitsreform / Osteuropa Health care reforms -- Europe, Eastern Medical policy -- Europe, Eastern Health planning -- Europe, Eastern Medical care -- Europe, Eastern Gesundheitswesen (DE-588)4020775-4 gnd Gesundheitspolitik (DE-588)4113743-7 gnd |
| subject_GND | (DE-588)4020775-4 (DE-588)4113743-7 (DE-588)4075739-0 |
| title | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe |
| title_auth | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe |
| title_exact_search | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe |
| title_full | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe János Kornai and Karen Eggleston |
| title_fullStr | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe János Kornai and Karen Eggleston |
| title_full_unstemmed | Welfare, choice, and solidarity in transition reforming the health sector in eastern Europe János Kornai and Karen Eggleston |
| title_short | Welfare, choice, and solidarity in transition |
| title_sort | welfare choice and solidarity in transition reforming the health sector in eastern europe |
| title_sub | reforming the health sector in eastern Europe |
| topic | Gesundheitsreform / Osteuropa Health care reforms -- Europe, Eastern Medical policy -- Europe, Eastern Health planning -- Europe, Eastern Medical care -- Europe, Eastern Gesundheitswesen (DE-588)4020775-4 gnd Gesundheitspolitik (DE-588)4113743-7 gnd |
| topic_facet | Gesundheitsreform / Osteuropa Health care reforms -- Europe, Eastern Medical policy -- Europe, Eastern Health planning -- Europe, Eastern Medical care -- Europe, Eastern Gesundheitswesen Gesundheitspolitik Osteuropa |
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