Chapter 11: State healthcare provision

Question 1

Outline 4 key objectivesofstate healthcare provision

Answer 1

protecting the nation’s health:
A healthy and thus productive workforce will promote GDP growth
involves ensuring there is basic medical services and education about healthy living, modern and efficient medical facilities

subsidising the poor:
ensuring that the poorest have access to primary healthcare and hospitalisation where necessary
children and elderly usually priorities

balancing the budget:
Competing needs include education, housing, infrastructure, etc.

following national culture and/or political promises:
State healthcare provision may be part of national culture, and thus not adversely affected by changes in political power
providing state healthcare may be important to remain popular in the next election

Question 2

Describe the 5 various approaches to resource allocation

Answer 2

cost analysis:
compare cost of A vs B and chooses the cheapest
no consideration for outcomes

cost-effectiveness analysis:
cost is compared to non-monetary benefits measured on a 1-dimensional scale, and then a decision is made
no consideration for the utility of the outcomes

cost-utility analysis:
cost is compared relative to changesin mortality (quantity) and quality of life
sensitive to choice of utility function

cost-benefit analysis:
cost is compared to a monetary value placed on the outcome. Highest monetary value of outcome to cost ratio is the best system/intervention
CBA = Cost / Monetary value placed on outcome, usually CBA < 1 recommended
main criticism is attaching a monetary value to life/ health

analysing willingness-to-pay:
measures the willingness/ value that an individual places on a particular system/ intervention,and balances this willingness against other spending given a limited budget

Question 3

Listwaysthestate can incentivise self-provision

Answer 3

insurance premiums reducing taxable income
implement exclusions from state benefits
subsidise the cost of private healthcare

Question 4

Discuss 2 simple funding methodsforstate healthcare

Answer 4

pay-as-you-go system:
establish the degree of state subsidy,to determine contributions from the working population
project coming year’s state outgo(benefits and expenses)
project coming year’s tax revenue
make necessary adjustments

forward funding:
take a view on some future period
establish the degree of state subsidy during this future period
model state outgo during this future period
model population and workforce trends, and tax revenues
create a healthcare fund that will build up the difference in the meantime

Question 5

List some stakeholders that make up the private healthcare sector

Answer 5

pmi insurers,
healthcare professionals,
hospitals,
pharmaceutical companies

Question 6

Are government facilities run non-profit

Answer 6

Yes

Question 7

What is the key item to remember in a “NHS” question?

Answer 7

Stakeholders