Fiscal Sustainability Of Health Systems Bridging Health And Finance Perspectives

The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to ...

The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to important progress in population health: for example, life expectancy at birth has increased, rising on average by ten years since 1970. The challenge now is to sustain and enhance these achievements in a context of tight fiscal constraints in many countries combined with upward pressure on health spending from factors such as new technological advances and demographic changes. Finding policies that can make health spending more sustainable without compromising important achievements in access and quality requires effective co-operation between health and finance ministries. Sound governance and co-ordination mechanisms are therefore essential to ensure effective policy choices. Prepared by both public finance and health experts, this report provides a unique detailed overview of institutional frameworks for financing health care in OECD countries. One of the main features of this book is a comprehensive mapping of budgeting practices and governance structure in health across OECD countries.

This publication explores the policy options to finance more resilient health systems whilst maintaining fiscal sustainability. It finds that the scale of the additional health financing needs requires ambitious and transformative policy changes.

The global movement toward universal health coverage (UHC) is accompanied by requests for large increases in government health spending in some countries. This combined with the global economic situation and stagnant economic growth across many low- and middle-income countries make it more critical than ever to place health financing discussions firmly in the context of macroeconomic and fiscal realities. Unfortunately, there is often a disconnect in decision making, with key fiscal decisions made in the absence of a clear understanding on the one hand of the potential consequences for the health sector, and on the other, the consequences for the country’s macroeconomic and fiscal position of increasing or reallocating government spending. Constructive health financing policy dialogue aims to reach a common understanding between health sector leaders and central budget authorities about policy objectives for the health sector and the resources needed to achieve those objectives, how much priority will be given to health in the government budget, and how the health sector will be held accountable for using funds effectively. This common understanding should be built on a realistic picture of the country’s macroeconomic and fiscal context, the constraints and competing priorities in the budget-setting process. When ministries of health and ministries of finance have a common understanding of macroeconomic and fiscal constraints, discussions can focus productively on using funds within the potential health resource envelope in the most effective way to achieve health system objectives. This guidance note outlines the key components of the macroeconomic, fiscal, and public financial management context that need to be considered for an informed health financing discussion at the country level. The guidance note is organized around four sets of questions that are key to placing the health financing dialogue in the context of a country’s macroeconomic and fiscal context. Each section points to measures, resources, and analytical tools that are available to assist in answering these questions for a specific country. The guidance note draws on case studies from 11 countries moving toward or sustaining universal health coverage conducted as part of the Japan†“World Bank Partnership Program on UHC as well as from other country examples.

How can we improve health, wealth and societal well-being by investing in health systems? How can we ensure that health systems are sustained in the future? How can we monitor, manage and improve performance so that health systems are as effective and efficient as possible? This book looks at health systems from a new perspective. By reviewing the complex relationship between health systems, health and wealth, it argues that health systems need not be, as is often believed, simply a drag on resources but rather can be part and parcel of improving health and achieving better economic growth. Aiming to assist policy-makers as they assess the case for investing in health systems, Health Systems,Health, Wealth and Societal Well-being reviews the evidence on: The contribution of health systems to better health and to economic growth The ways that investment in better health can save future health costs as well as boosting economic growth How we can create equitable, sustainable health systems fit for the 21st century

This volume contains an Open Access Chapter - This book provides a comprehensive understanding of the sustainability of health systems in Europe. Furthermore, it includes an introduction on how EU action in supporting health- care policies in the EU Member States, both looking at implemented actions and describing current priorities for the future.