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Global Health Care Systems
A perspective on issues, practices and trends among OECD nations

Khemani, Ashim; Carlyle, Robert
Publisher:  Aon Consulting
Year Published:  2009  
Price:  $85.00   ISBN:  978-0-9808980-0-2

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  Aon Consulting

Provides a comprehensive look at the issues, practices and trends that make up the health care systems among the highly developed, industrialized countries of the Organisation of Economic Co-operation and Development (OECD).

While working with Alberta Health and Wellness on projecting the impact of different health care funding arrangements on health care demand and costs, the client asked us to examine the health care models in other countries. This exercise proved to be the impetus for the book. The investigation provided a much needed basis for a deeper comparison of the models available. This comparison begins to form a clearer picture of the possibilities and may provide some answers to the question foremost on many people's minds, "Where is health care going?"

Ultimately, Global Health Care Systems will help Aon Consulting build an awareness of the importance of plan design going forward, assist our practice areas in delivering long-term value to clients and enhance our credibility as an innovative thought leader in the global health care community.

Written from the perspective of both the practitioner and the consumer, the book investigates the health care system as a collective with all of its emerging practices, trends and interrelated drivers, and explores the variety of options available.


Key Messages

* There are many different types of health care systems. Most countries in the Organization for Economic Co-operation and Development (OECD) have universal health care, but there is tremendous variety in how this is accomplished. Unfortunately the debate in Canada is about the differences between our system and that in the U.S. Rather than looking to Europe, Japan and Australia for ideas, any change elicits the knee jerk reaction that it is an un-Canadian move to "U.S.-style" health care, We need to look at best practice from around the world and adapt it for our unique Canadian circumstances.

* Roughly 30% of Canada's health care spending comes from the private sector. Unlike many European countries, there is little integration of public and private health care, leading to a situation where there is no overall coherent strategy for meeting all the health care needs of Canadians.

* The fundamental difference between Canadian and U.S. health care is not public and private sector service delivery. The difference is philosophic. In Canada free access to all medically necessary treatment is often viewed as a basic right; in the U.S. access to health care is tempered by the belief that citizens should take responsibility for their health. Almost all differences in the two systems come from this difference in the government's role in health care.

* Canada has not been able to train sufficient physicians and other health care workers; there are chronic shortages across the country. In recent years this gap has been partially filled with foreign recruitment. However, the World Health Organization estimates that there is a global shortage of 4,250,000 health care workers, so Canada's approach is not sustainable. Furthermore, much of Canada's recruitment is from developing countries that cannot afford to lose the health care workers that we are taking, after they are trained.

* Chapter Two: Health Care Objectives, page 19-20

"However, according to the OECD, national health care systems continue to direct the majority of their budgets to 'sick care' and only spend on average about 3 per cent of current health expenditure on prevention and public health programs." (reference: OECD, 2005. Health Care at a Glance: OECD Indicators)

"At the micro level, many private health insurance plan sponsors providing primary and ancillary health care coverage insist on lifestyle changes for the people whose health care services they pay for."

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