Health affairs
-
Australia is similar to the United States in that it is a federation of states, its medical profession is well organized and politically powerful, and it has a substantial private sector. Unlike the United States, Australia provides universal access to health care and has controlled its total health care spending to around 8.5 percent of gross domestic product (GDP). This paper reviews the role of private health insurance and recent initiatives to support this; the strategies used to control costs in the fee-for-service sector; and the capacity for experimentation in health care financing within a national system that guarantees universal access.
-
Comparative Study
Health care financing and delivery in developing countries.
Developing countries account for 84 percent of world population and 93 percent of the worldwide burden of disease; however, they account for only 18 percent of global income and 11 percent of global health spending. Limited resources and administrative capacity coupled with strong underlying needs for services pose serious challenges to governments in the developing world. This paper analyzes health spending, health outcomes, and health delivery system characteristics for the six developing regions of the world as well as for low-, medium-, and high-income country groupings.
-
Driven by fiscal pressures in the 1990s, Canada's provincial Medicare systems cut inpatient care, expanded community services, and consolidated hospitals under regional authorities in nine of ten provinces. Public confidence has been badly shaken by the transition. ⋯ Efforts to reform physician payment have stalled, and capacity to measure and manage the quality of care is generally underdeveloped. Thus, for the next few years, policymakers must stabilize the acute care sector, while cautiously pursuing an agenda of piece-meal reforms.