Financing Health Care New Ideas for a

This book is the first volume in a completely new public health book series, edited by the Institute of Health Economics (IHE) in Edmonton, Canada.Written by leading experts in the field, Financing Health Care: New Ideas for a Changing Society offers a comprehensive overview of possible health care financing from an international perspective.Starting with various funding methods, this important reference work also features sections on different health care payment and purchasing mechanisms, as well as equity issues.This book is an invaluable resource for all medical and allied health professionals, and those working in health care industries, insurance, and economics.

At present Mingshan Lu is Professor at the Department of Economics, Faculty of Social Science at University of Calgary/Canada. Her research focuses on health economics, health care financing and economics of substance abuse. Besides a number of excellence awards she received numerous outstanding research grants, for example from the Institute of Health Economics or the Alberta Heritage Foundation for Medical Research in Canada.

Dr. Jonsson is director and CEO of the Institute of Health Economics, and professor at the University of Alberta, Public Health Sciences. For 20 years he was a professor of Health Economics at the Karolinska Institute, Stockholm, Sweden. Dr. Jonsson was also director of the Swedish Council on Health Technology Assessment (SBU), worked for WHO Euro, was a Health Policy Advisor at the Ministry of Health in Hanoi, Vietnam. His main field of research has been in health economics: cost-effectiveness analysis, and health technology assessment. Jonsson has co-edited 2 well-selling Wiley-VCH titles during his SBU times, "Treating and Preventing Obesity" and "Treating Alcohol and Drug Abuse".

Preface	p. IX
List of Contributors	p. XI
Introduction	p. 1
Health Systems Reform	p. 1
Aging Populations and Advanced Medical Technology	p. 2
Decentralization	p. 3
The Content of this Book	p. 4
References	p. 15
Social Health Insurance Government Funding of Health Care	p. 17
Introduction	p. 17
Health Services, Health Insurance, and Market Failure	p. 18
Different Models for Government Funding of Health Care	p. 28
Conclusion: The Future of Social Health Insurance in Canada	p. 36
References	p. 37
Private Financing Outside the Publicly Funded System	p. 49
Introduction and the Evolution of Private Financing in Canada	p. 49
Reviewing Economic Theory and Evidence on Parallel Public and Private Financing Structures	p. 51
OECD Evidence on Private Financing	p. 65
Overall Conclusions and Directions for Further Study	p. 75
References	p. 78
Prescription Drug Financing	p. 81
Introduction	p. 81
Drug Expenditures and Financing in Canada and Abroad	p. 82
Unique Aspects of Pharmaceuticals and the Pharmaceutical Sector	p. 88
Considerations for Pharmaceutical Financing Reform	p. 96
Conclusion	p. 100
References	p. 100
The Economics of Consumer-Directed Health Care	p. 105
Introduction	p. 105
Consumer-Preventive Care Decisions	p. 107
Selection and Cross-Subsidization	p. 111
Health Care Demand and Non-Linear Prices	p. 114
Empirical Studies of Consumer-Directed Health Care	p. 118
Conclusion	p. 120
References	p. 121
Medical Savings Accounts: Promises and Pitfalls	p. 125
Introduction	p. 125
MSA Financing Internationally	p. 127
MSA Financing and System Performance	p. 133
Conclusions	p. 143
References	p. 144
Physician Payment Mechanisms	p. 149
Introduction	p. 149
A Basic Model of Health-Care Provision and Consumption	p. 150
Traditional Fee-For-Service (FFS)	p. 155
Capitation and Fully Prospective Payments	p. 159
Mixed-Payment Systems	p. 165
Concluding Remarks	p. 171
References	p. 172
Risk Adjustment in Health Care Markets: Concepts and Applications	p. 177
Overview	p. 177
Introduction	p. 177
Theory	p. 181
Estimation Issues	p. 194
Country Experience with Risk Adjustment	p. 205
Conclusions	p. 218
References	p. 218
Inducing Quality from Health Care Providers in the Presence of Adverse Selection	p. 223
Introduction	p. 223
The Basic Adverse Selection Problem	p. 224
Dealing with Adverse Selection	p. 228
The Regulator Can Observe Quality, but Consumers Cannot: Choosing What to Report	p. 232
Consumers Can Observe Quality and the Regulator Can Observe "Signals" about Consumers' Types: Risk Adjustment	p. 237
Concluding Remarks	p. 241
References	p. 242
Equity in Health and Health Care in Canada in International Perspective	p. 245
Overview	p. 245
Introduction: Canada's Health Care System and Equity	p. 245
Income-Related Inequity in Access to, and Delivery of, Care	p. 246
Inequalities in Health and Health Outcomes	p. 257
Conclusion and Discussion	p. 264
References	p. 266
Index	p. 273
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Financing Health Care New Ideas for a Changing Society

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