Financing health care: False profits and the public good

机译：卫生保健筹资：虚假利润和公益

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Fiscal consolidation, escalating health care costs and demographic changes are placing universal public health care under increasing pressure. In this environment the idea that the private sector is more efficient, effective and better able to fund health care than the public sector has been promoted. After almost thirty years of privatisation in the health care sector the evidence shows that these claims do not reflect the evidence. Comparisons of total health spending at national level show that countries with higher private spending on health spend more on health care and achieve worse results in key indicators of national health. Countries such as the UK and Sweden spend less than 10% of GDP on health care, of which over 80% is public expenditure. By comparison the USA spends almost 18% of GDP on health care, of which less than 50% is public, but has lower life expectancy and higher infant mortality rates. France which has very high life expectancy and low infant mortality rates spends 11.4% of GDP on health of which 76.7% is public. The reasons for the efficiency and effectiveness of the public provision of health are not complex. Administrative costs of public insurers are routinely and dramatically lower than private insurers. Public systems, with a single payer system in the form of a government or state run agency, produce efficiencies of scale and are better able to control costs.

机译：财政合并，医疗保健费用不断上涨和人口变化正在使全民公共医疗保健面临越来越大的压力。在这种环境下，人们提出了一种想法，即私营部门比公共部门更有效率，更有效并且能够更好地为医疗保健提供资金。经过近30年的医疗保健部门私有化，证据表明这些说法并不反映证据。国家一级卫生总支出的比较表明，私人卫生支出较高的国家在卫生保健上的支出更多，而在国民卫生关键指标上却取得了较差的结果。英国和瑞典等国家在医疗保健上的支出不到GDP的10％，其中80％以上是公共支出。相比之下，美国在医疗保健上的支出几乎占GDP的18％，其中公共支出不到50％，但预期寿命较低，婴儿死亡率较高。法国的预期寿命很高，婴儿死亡率很低，在卫生方面的支出占GDP的11.4％，其中76.7％为公共卫生支出。公共卫生提供效率和效力的原因并不复杂。公营保险公司的行政费用通常比私人保险公司低很多。具有政府或国营机构形式的单一付款者系统的公共系统可以产生规模效益，并且能够更好地控制成本。

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Lethbridge Jane;
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年度 2014
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2. Determining what should be included in a publicly funded health care system: reflecting on 'Individual responsibility for what? A conceptual framework for exploring the suitability of private financing in a publicly funded health-care system' [J] . Stabile Mark Health economics, policy, and law. . 2015,第4期

机译：确定公共资助的医疗体系应包括什么：反思“对什么负有个人责任？探索私人融资在公共资助的卫生保健系统中的适用性的概念框架”
3. Institutional effects on nurses’ working conditions: a multi-group comparison of public and private non-profit and for-profit healthcare employers in Switzerland [J] . Remo Aeschbacher, Véronique Addor Human Resources for Health . 2018,第1期

机译：制度对护士工作条件的影响：瑞士公共和私营非营利和营利性医疗保健雇主的多组比较
4. Healthcare Public Key Infrastructure (HPKI) and Non-profit Organization (NPO): Essentials for Healthcare Data Exchange [C] . Hiroshi Takeda, Yasushi Matsumura, Katsuhiko Nakagawa, MEDINFO . 2004

机译：医疗保健公钥基础设施（HPKI）和非营利组织（NPO）：医疗保健数据交换的必需品
5. THE ECONOMICS OF NOT-FOR-PROFIT TAX STATUS FOR HOSPITALS: CALIFORNIA, 1984 TO 1994 (HEALTH CARE, PUBLIC FINANCE). [D] . MARTIN, BRIAN BO. 1997

机译：医院非营利税收状况的经济学：加利福尼亚州，1984年至1994年（医疗保健，公共财政）。
6. Institutional effects on nurses’ working conditions: a multi-group comparison of public and private non-profit and for-profit healthcare employers in Switzerland [O] . Remo Aeschbacher, Véronique Addor 2018

机译：制度对护士工作条件的影响：瑞士公共和私营非营利和营利性医疗保健雇主的多组比较
7. Trends in the Quality of Care for Medicare Beneficiaries Admitted to the Hospital With Unstable Angina 11This study was supported in part by the Patrick and Catherine Weldon Donaghue Medical Research Foundation Hartford. Dr. Krumholz is a Paul Beeson Faculty Scholar. The analyses on which this publication is based were performed under Contract Number 500-96-P549, entitled “Utilization and Quality Control Peer Review Organization for the State of Connecticut,” sponsored by the Health Care Financing Administration, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Health Care Financing Administration, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this Contractor. Ideas and contributions to the authors concerning experience in engaging with the issues presented are welcomed. [O] . Krumholz Harlan M., Philbin Daniel M., Wang Yun, 1998

机译：不稳定型心绞痛住院的医疗保险受益人的护理质量趋势11该研究部分得到了帕特里克和凯瑟琳·韦尔顿·多纳休医疗研究基金会的支持。 Krumholz博士是Paul Beeson系的学者。本出版物所依据的分析是在合同号500-96-P549下进行的，该合同的名称为“康涅狄格州使用和质量控制同行评审组织”，由卫生与公共服务部卫生保健融资管理局赞助。本出版物的内容不一定反映卫生和公共服务部的观点或政策，提及商品名称，商业产品或组织也不一定表示得到美国政府的认可。作者对所提出想法的准确性和完整性承担全部责任。本文是卫生保健筹资管理局发起的“卫生保健质量改善计划”的直接结果，该计划鼓励确定通过对护理模式进行分析而得出的质量改善项目，因此该承包商不需要任何特殊资金。欢迎作者就涉及所提出问题的经验提出想法和贡献。
8. Medicare Managed Care: Better Risk Adjustment Expected to Reduce Excess Payments211 Overall While Making Them Fairer to Individual Plans. Statement of William J. 211 Scanlon, Director Health Financing and Public Health Issues, Health, Education 211 and Hu [R] . 1999

机译：医疗保险管理护理：更好的风险调整预计会减少超额支付211整体，同时使他们更加公平对待个人计划。 William J. 211 scanlon的声明，健康，教育和健康，健康，教育211和胡锦涛主任

Financing health care: False profits and the public good

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