Recap

Question 1

Healthcare financing is concerned with:

Answer 1

Raising funds for healthcare and purchasing of healthcare, in an efficient and equitable manner

Question 2

The healthcare triangle shows

Answer 2

The importance of fund-pooling and efficient use of the accumulated funds

Question 3

Define OOP payments for healthcare

Answer 3

Any payments made by patients or anyone on behalf of the patients for utilising healthcare

Question 4

The principle of equity in healthcare financing through social insurance:

Answer 4

Richer people should pay proportionally more than poorer people into the healthcare fund

Question 5

Which area of supply-demand graph corresponds to consumer surplus?

Answer 5

Consumer surplus is measured by the area under the demand curve and above the line representing the purchase price of the good.

Question 6

What is consumer surplus?

Answer 6

Consumer surplus is the total benefit from the consumption of a good, minus the total cost of purchasing it.

Question 7

The capitation payment generally considers:

Answer 7

The demographic structure and socioeconomic conditions of the target population of the areas under consideration

• capitation is most suitable for primary healthcare

Question 8

Interpreting price elasticity of demand

Answer 8

• PED is always negative (increase in price leads to decrease in quantity demanded)
• When PED is greater than one, demand is elastic. This can be interpreted as consumers being very sensitive to changes in price: a 1% increase in price will lead to a drop in quantity demanded of more than 1%. When PED is less than one, demand is inelastic. (absolute values)

Question 9

In relation to healthcare financing, explain:
- source
- mechanism
- collection agents
linked to resource moblization

Answer 9

Healthcare financing system is based on
- source of funds/money (firms, citizens, households, NGOs, external governments…)
- mechanisms of revenue collection (insurance premiums, taxes, out of pocket payments, donations, voluntary contributions, loans…)
- collection agents (collection can be done on different levels, e.g. national, regional, municipal, agents can include insurance companies, sickness funds, governments, public bodies/social security agencies etc)

Question 10

Sources and mechanisms of healthcare financing in a SHI system

Answer 10

• primary source are employed citizens and their employers (firms)
• mechanism; earmarked payroll deductions which are paid into insurance funds (‘sickness funds’)
• the funds purchase health services from providers (separation of health financing and provision)

Question 11

Sources and mechanisms of healthcare financing in a tax-based system

Answer 11

• sources can be citizens, households or firms, funds are collected through taxation (direct; e.g. payroll, property or indirect; e.g. sugar, tobacco)
• taxes can be levied at different levels (e.g. national, regional, municipal)
• integrated financing and provision (the government is the owner of many of the health facilities)

Question 12

Functions of the financing system

Answer 12

revenue collection, pooling funds, and purchasing healthcare

Question 13

Bismarck system

Answer 13

The Bismarck model—which is a statutory public scheme of healthcare financing based on earmarked contributions of specified actors to stand-alone funds

Question 14

Equity vs equality

Answer 14

Equality - a numerical measure (numerically same allocation)
Equity - measure of ‘fairness’ (value-based, ensuring everyone has the same benefit/outcome; unequal distribution can lead to equitable outcomes)

e.g. equality in contributions to healthcare financing (i.e. everyone paying the same amount for healthcare might not be equitable because people have different incomes and the burden of healthcare payments would not be proportional)