Health Care after the Great Recession: Financing Options for Sustainable and High‐quality Health Systems
| Date | 01 March 2017 |
| Author | Olivier J. Wouters,Panos Kanavos |
| Published date | 01 March 2017 |
| DOI | http://doi.org/10.1111/1758-5899.12389 |
Health Care after the Great Recession:
Financing Options for Sustainable and
High-quality Health Systems
Panos Kanavos and Olivier J. Wouters
London School of Economics and Political Science
Abstract
Given the growing complexity of health care, current global demographic and epidemiologic trends, adverse economic condi-
tions in many parts of the world, and limited national budgets, it is increasingly difficult for policy makers and regulators to ensure
continued access to affordable and high-quality health care. Decision-makers must implement policies that support efficient,
equitable, and sustainable health systems. To that end, this special issue aims to foster dialogue on the current state of health-
care financing and some of the challenges that lie ahead for health systems. The objectives of this special issue are threefold: (1)
to analyse trends in health-care financing in a range of countries with varying degrees of economic development and political
organization; (2) to review the viability of different financing models based on international experiences; and (3) to examine how
efficiency in health care systems can be achieved without sacrificing quality. The issue consists of three sections and includes con-
tributions from academic experts, health-care practitioners, and members of the broader stakeholder community.
Background
In the wake of one of the most severe financial crises in
recent history, resources for health and social care services
are under threat as many member states of the Organisa-
tion for Economic Co-operation and Development (OECD)
are cutting back on public spending to reduce budget defi-
cits (Cylus et al., 2012; Reeves et al., 2014). At the same
time, a growing number of low and middle-income coun-
tries are investing heavily in health care, including statutory
health insurance, in an effort to promote human develop-
ment and economic growth (Gottret and Schieber, 2006). All
countries need to explore policy options to allocate
resources efficiently, safeguard the quality of health care,
promote prevention and lifestyle management, address the
rising burden of chronic disease, and ensure the financial
sustainability of health systems, among other priorities.
The objectives of this special issue in Global Policy are
threefold: (1) to analyse trends in health-care financing in a
range of countries with varying degrees of economic devel-
opment and political organization; (2) to review the viability
of different financing models based on international experi-
ences; and (3) to examine how efficiency in health care sys-
tems can be achieved without sacrificing quality. The issue
consists of three sections and includes contributions from
academic experts, health-care practitioners, and members of
the broader stakeholder community.
Section 1: public and private models of financing
health care
The first section of the special issue explores the strengths
and weaknesses of various public and private models of
financing health care in the context of economic recessions.
Angelis, Tordrup, and Kanavos open the section with a con-
ceptual and empirical analysis of the epidemiologic, demo-
graphic, fiscal, macroeconomic, and technological pressures
on public health insurance in selected OECD countries. They
analyse the financial sustainability of these health systems
over the next ten to 15 years. Wouters and McKee then
review the global evidence on whether private financing
options –private health insurance, medical savings accounts,
and out-of-pocket payments –are efficient and equitable,
especially in times of economic crisis; they also consider
whether these options offer patients adequate financial pro-
tection against unexpected health-care costs.
Holland approaches the issue of health improvement dur-
ing periods of austerity from a public health perspective. The
article reviews historical precedents to outline potential gov-
ernment strategies for enhancing individual and population
health. Costa Font et al. examine how selected European
countries are financing long-term care for elderly and dis-
abled patients –a major component of most health-care bud-
gets. Spending on such care is rising rapidly in many high-
income countries due to ageing populations and the growing
burden of chronic diseases, and the authors consider future
financing options for long-term care. Mills et al. develop a
taxonomy of health-care programmes, such as integrated care
and disease management programmes. They investigate the
role of these programmes in promoting sustainable financing
and equitable and high-quality care.
Section 2: efficiency in health care
The second section of the special issue examines aspects of
efficiency in health-care delivery and how the use of scarce
Global Policy (2017) 8:Suppl.2 doi: 10.1111/1758-5899.12389 ©2016 University of Durham and John Wiley & Sons, Ltd.
Global Policy Volume 8 . Supplement 2 . March 2017 5
Special Issue Article
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