COST CONTAINMENT AND ACCESS TO CARE: THE SHANGHAI HEALTH CARE FINANCING MODEL

2008 ◽  
Vol 53 (01) ◽  
pp. 27-41 ◽  
Author(s):  
WEIZHEN DONG
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Cost Containment ◽  
Access To Health Care ◽  
Health Care Cost ◽  
Health Care Expenditure ◽  
Health Care Financing ◽  
Insurance Scheme ◽  
Health Care Reforms ◽  
Medical Savings Account

The medical savings account (MSA) model of health care financing is viewed as a health care cost containment strategy. Yet, health care expenditure in Shanghai has increased sharply since the adoption of the MSA system. This paper looks into the health care reforms in Shanghai, especially since the introduction of the MSA scheme. From the Labor Insurance Scheme and Government Insurance Scheme to the Medical Savings Account scheme, ordinary Shanghai residents have not benefited from the most recent health care reforms. They have found medical care much less affordable. Disparity in access to health care access has become more evident than ever. Meanwhile, health care cost has increased sharply. China has benefited from an emphasis on prevention and primary care, but the government's recent policies give a high priority to catastrophic disease. This is not a cost-effective approach. Shanghai's health care system needs to break socioeconomic class boundaries if it is to construct a harmonious society. Shanghai's decision makers and various stakeholders have the resources and wisdom to face the challenge.

Micro-Level Analysis of Distributional Changes in Health Care Financing in Finland

1998 ◽  
Vol 3 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Jan Klavus ◽  
Unto Häkkinen
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Structural Changes ◽  
Health Care Expenditure ◽  
Health Care Financing ◽  
Simulated Data ◽  
Health Care Reforms ◽  
Income Data ◽  
Severe Recession ◽  
Care System

Objectives: In the early 1990s the Finnish economy suffered a severe recession at the same time as health care reforms were taking place. This study examines the effects of these changes on the distribution of contributions to health care financing in relation to household income. Explanations for changes in various indicators of health care expenditure and use during that time are offered. Method: The analysis is based partly on actual income data and partly on simulated data from the base year (1990). It employs methods that allow the estimation of confidence intervals for inequality indices (the Gini coefficient and Kakwani's progressivity index). Results: In spite of the substantial decrease in real incomes during the recession, the distribution of income remained almost unaltered. The share of total health care funding derived from poorer households increased somewhat, due purely to structural changes. The financial plight of the public sector led to the share of total funding from progressive income taxes to decrease, while regressive indirect taxes and direct payments by households contributed more. Conclusions: It seems that, aside from an increased financing burden on poorer households, Finland's health care system has withstood the tremendous changes of the early 1990s fairly well. This is largely attributable to the features of the tax-financed health care system, which apportions the effects of financial and functional disturbances equitably.

Impact of restricting access to health care services on Syrian refugees in Jordan: evidence from cross-sectional surveys

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ibraheem Khaled Abu Siam ◽  
María Rubio Gómez
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Cost ◽  
Syrian Refugees ◽  
Cross Sectional ◽  
Content Type ◽  
Care Access ◽  
Care Services

Purpose Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan. Design/methodology/approach This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact. Findings The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake. Originality/value Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

Waiting for Reform: Developments in the Law of Health Care Access and Finance: 1992–1993

1994 ◽  
Vol 22 (1) ◽  
pp. 63-71
Author(s):  
Timothy S. Jost
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Financing ◽  
The United States ◽  
Financing System ◽  
American Health Care System ◽  
Care Access ◽  
The Law ◽  
The One

The last year, June 1992 through September 1993, has seen a great deal of ferment with respect to access to and financing of health care in the United States. The elections of 1992 portend dramatic changes in the American health care system, and vigorous debate regarding both expansion of access to health care and transformation of the health care financing system is taking place at the federal and the state levels. In fact, however, the time period covered here produced remarkably few changes in the law, particularly at the federal level. The one piece of Medicare and Medicaid legislation passed by Congress in the fall of 1992, H.R. 11, was vetoed by President Bush immediately after the election. The Omnibus Budget Reconciliation Act (ORBA) of 1993 contained a host of minor adjustments to the Medicare and the Medicaid programs, but only the Medicaid asset transfer provisions and extensions to the self-referral provisions of the fraud and abuse laws, discussed below, are of import to us.

Health Care in the United States: Access, Costs, and Quality

1987 ◽  
Vol 20 (02) ◽  
pp. 197-201
Author(s):  
John F. Hoadley
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Delivery ◽  
Cost Containment ◽  
Access To Health Care ◽  
Health Care Cost ◽  
Care Delivery ◽  
The United States ◽  
Political Issue

Fact: As a nation, medical care expenditures represent 10.6% of the gross national product. The portion of the nation's medical care dollar coming from federal sources declined slightly (42.6% to 41.4%) between 1981 and 1984, but this share is more than 15 percentage points above the comparable figure from the years prior to 1965 (Anderson, 1985).As these numbers illustrate, paying for health care is a very expensive proposition in the United States, consuming a higher proportion of our nation's resources than is true for most developed nations. While we have strongly resisted any move to a government-run system of health care delivery, the above numbers also show clearly that the federal government pays for a substantial share of all health care in this country.Three major themes have dominated the health policy agenda during recent years: access to health care, cost containment, and quality of care. The fates of these issues have waxed and waned over the years as changes in health care delivery, federal budgetary politics, and shifting public opinion have altered the environment over time. In the 1960s, access was the key issue, as Democratic administrations used government programs to make health care more readily available to all Americans. As inflation levels soared in the 1970s, cost containment was forced onto the agenda, resulting in a series of attempts to reduce federal expenditures on hospital care. Finally, by the mid-1980s, cost containment pressures were modifying slightly; we have recently witnessed a return to access issues and the emergence of quality as a new political issue.

Substantive Equality in South African Health Care: The Limits of Law

2000 ◽  
Vol 4 (2) ◽  
pp. 111-131 ◽  
Author(s):  
Charles Ngwena
Keyword(s):  
Health Care ◽  
South African ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Reforms ◽  
Structural Inequality ◽  
Care Services ◽  
Substantive Equality ◽  
African Health ◽  
Access To Health

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.

Health Care Cost Containment in Large American Cities

1989 ◽  
Vol 18 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Perry Moore
Keyword(s):  
Health Care ◽  
Cost Containment ◽  
Local Governments ◽  
Health Care Cost ◽  
The United States ◽  
Public Agencies ◽  
The Public ◽  
Survey Results ◽  
The Cost ◽  
American Cities

This research provides information about the health care cost containment efforts of local governments and agencies across the United States, particularly in large American cities. Survey results indicate that while the public sector lags behind the private sector, public agencies are beginning to match the cost containment efforts of private employers. While initiation of these efforts represents considerable recent progress, their tangible benefits are not yet apparent.

Sign in / Sign up

Export Citation Format

Share Document