Ch 11: State healthcare

Question 1

WHO’s New Universalism goal’s key objectives

Answer 1

• Quality of healthcare - Healthcare systems need to be effective, efficient and allow medical decisions to be made by medical professional and the patient
• Cost and financing - Cost of healthcare should not be a barrier to access.
• Social acceptability - Healthcare should be responsive to the needs and or wants of the population. Healthcare needs to be universal

Question 2

Overall objectives of government’s provision of healthcare

Answer 2

• Protecting the nation’s health
• Subsidising the poor
• Balancing the budget
• Following social culture and/or political promises

Question 3

State faces number of challenges in designing, managing and financing a healthcare system (6)

Answer 3

• Demographic challenge - Aging population, increased healthcare requirements leading to increased costs
• Technological challenge - Innovation in medical treatment and delivery of healthcare is increasing demand for healthcare, determining how new tech is accessed and who gains access is key feature of healthcare system
• Challenge of Sisyphus - Constant budget pressure caused by aging pop and focus on innovation.
• Burden of disease - General health status of population may increase costs of providing healthcare (high HIV prevalence)
• Access to skilled medical professionals - Cots and duration of medical training is extensive, they may leave for other countries after completing their (often subsidised) training.
• Competition or regulation in healthcare - Market failure leads to the need for market regulation . Balance needs to be struck between level of regulation and competition.

Question 4

Resource allocation approaches

Answer 4

• Cost analysis - Simplest method, only assesses costs in order to estimate budgets and sustainability over time
• Cost-effectiveness analysis (CEA) - costs relative to the non-monetary benefits of healthcare system
• Cost-utility analysis (CUA) - assesses the cost relative to changes in quality of life and mortality
• Cost-benefit analysis (CBA) - Puts monetary value on cost and outcomes of healthcare system

Question 5

Willingness to pay description

Answer 5

• Measure the value that an individual places on a health system or medical scheme. Attempts to determine how an individual balances the costs of healthcare, improvements in quality of life and increases in life expectancy.

Question 6

Two ways to measure WTP

Answer 6

• Direct method (contingent valuation) - Conducted through questionnaires
• Indirect method - determined t6hrough observing behaviour and identifying how much they are willing to pay for medical treatment.

Question 7

Methods of State healthcare support

Answer 7

• Means testing
• Provision of treatments/services
• Lump sum cash payment
• Regular income
• Amount of benefit - Salary-related or flat benefit
• Differentiation - align benefit with need

Question 8

Funding approaches for state sponsored healthcare systems

Answer 8

• Pay-as-you-go (PAYG) system - current working population effectively pays the total costs for those currently needing benefits
• Forward funding - longer term view, anticipate future benefit costs and build up a provision for these costs before they arise

Question 9

Incentives for self-provision

Answer 9

• Tax relief on premiums for appropriate insurances
• Exclude some or all of pop from certain aspects of the state benefit system
• Offer reduction in general taxation where appropriate insurance is in place
• Reduce cost of private purchase of healthcare services by direct subsidy to the providers