As a contribution to the search for suitable and sustainable solutions to finance rising medical care expenditures, the book proposes a typology of healthcare financing and insurance schemes, based on the dimensions of basic vs. supplementary services and mandatory vs. voluntary coverage, to analyse the design and the complex interactions between various financing and insurance arrangements in several OECD countries. This study provides a better understanding of the strengths and weaknesses of the financial and organisational structures of different countries’ healthcare financing and insurance schemes. Its main contributions are the development of a novel and rigorous theoretical framework analysing the economic rationales for the optimal design of healthcare financing and insurance schemes, and an empirical and institutional analysis investigating the consequences for efficiency and affordability of the complex interactions between basic and supplementary sources of financing.

This book is a thorough, balanced, and insightful study of what is happening and what should be happening in health care financing. Americans want unlimited access to the best care at affordable prices. Fiscal pressures in American health care point in all different directions, like a pile of jackstraws. This important book analyzes how new payment incentives stimulate planned competition or reregulation; and the far-reaching impact these changes have on hospitals, physicians, long-term care facilities, HMOs, public health clinics, and multihospital systems. Tools for survival include better financial planning, productivity improvement, better scheduling systems, and total quality management. Steven R. Eastaugh begins his book with a general overview of cost management, accounting, product-line selection, and new payment incentives. Part II provides an in-depth survey of fiscal trends in long-term care, managed care, HMOs, and PPOs. Part III analyzes five basic strategies that a provider may consider; with special focus on market analysis, diversification, and pricing. The next part reviews physician payment options, the new Medicare 1992 payment systems for hospitals and physicians, and cost analysis of hospital patient care, research, and education. Part V considers productivity enhancement methods, incentives to assist productivity programs, and the Deming method of total quality management. Part VI focuses on investment, financing, and capital structure decisions in health care institutions and also in large multifacility systems. The last part summarizes major strategies for success in the 1990s, future policy alternatives, and suggests a number of alternative roads to universal entitlement and national health care reform. As Eastaugh suggests in this book, Our health system faces . . . immense opportunity and danger in a reformation on four fronts: access, efficiency, effectiveness, and quality of life. The challenge for providers and managers during this period of unparalleled opportunity is to win a clear victory on all four fronts, and not erode either access or quality in the name of efficiency. The range of coverage in Health Care Finance is extremely wide and detailed--making it essential and useful reading for health care professionals and students alike.

In November 1997 the World Bank and Singapore's Institute of Policy Studies sponsored a conference, "Financing Health Care and Old Age Security", to assess and identify potential solutions to these concerns. It addressed a topic of concern to nearly every country, developing and industrial, that is, how to deal with the implications of financing medical care and income security for rapidly aging populations. The issues identified and the solutions proposed can provide insight and guidance for policymakers, researchers, and others interested in addressing these challenges now. Of special interest are the contributors' analyses of Singapore's unique, integrated approach to managing social risk, which is based on mandatory individual savings accounts.

Who pays for long-term care? Discover the unique approaches of seven countries around the Pacific Rim! Long-Term Care in the Twenty-First Century discusses policies and programs for long-term care in seven countries around the Asia-Pacific Rim: the United States, Canada, Japan, Australia, Singapore, Hong Kong, and Taiwan. Each country is covered in two chapters, one to examine the philosophy and values that underlie its approaches to long-term care, the second to discuss its systems of service delivery. These thoughtful analyses, backed up with facts and figures, explain program successes and failures in the context of demographic and social trends and with reference to the differing political systems across the region. Its breadth of perspective and insightful examination of cultural differences make Long-Term Care in the Twenty-First Century an important contribution to the international comparative study of aging. The programs in the United States, Australia, and Canada offer a fascinating contrast with the longer-established and very different programs in the Asian countries, including Japan, the world’s oldest country. Long-Term Care in the Twenty-First Century provides practical information on essential gerontological issues for each country, including: financing arrangements development of client classification systems case management in both residential and community-based systems key source documents, references, and Web sites political and cultural influences home-based and family caregiving This valuable book provides a critical record of developments in the current transition period. This multicultural perspective contributes a chance for all countries to learn from the experience of others in dealing with a problem that is increasingly important as the world population ages. Long-Term Care in the Twenty-First Century is an essential resource for scholars, service providers, policymakers, and anyone concerned with care of the aged, not only in Pacific Rim countries but around the world.