PHM-Exch> Addressing financial sustainability in health systems

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crosposted from: EQUIDAD at listserv.paho.org


 *Addressing financial sustainability in health systems

*

Sarah Thomson, Research Fellow, European Observatory on Health Systems and
Policies, and LSE Health, London

Tom Foubister, Research Officer, LSE Health, London

Josep Figueras, Director, European Observatory on Health Systems and
Policies, Brussels

Joseph Kutzin, Regional Adviser, Health Systems Financing, and Head of the
WHO Office, Barcelona

Govin Permanand, Programme Manager/Technical Officer, Health Evidence
Network, WHO Regional Office for Europe, Copenhagen

Lucie Bryndová, Adviser to the Minister of Health, Cabinet of the Minister,
Prague

*World Health Organization 2009 on behalf of the European Observatory on
Health Systems and Policies 2009

*

Available online PDF [49p.] at: http://www.euro.who.int/Document/E93058.pdf

“………The question as to whether health systems will be financially
sustainable in the future is frequently raised in health policy debate. The
problem is often phrased in terms of the ability of governments and others
adequately to finance health care in the face of growing cost pressures,
with population ageing, new technologies and consumer expectations around
health care coverage and quality being the three most commonly cited
challenges.



Although the notion of ‘financial sustainability’ appears to be central to
health policy debate, it does not form part of most health system
objectives, including those of the World Health Organization’s health system
performance framework (1). Moreover, there is little clarity or consensus
about the term's meaning, beyond it having something to do with ‘ability to
pay’ or ‘affordability’. Nevertheless, the underlying ‘sustainability’ issue
– balancing rising cost pressures against limited resources – is a concern
across countries, all the more so in the context of the current financial
crisis. Inevitably, this means addressing trade-offs, both within the health
sector itself and more broadly between the health sector and the rest of the
economy.



This policy summary aims to shed light on the notion of financial
sustainability and to examine its policy relevance in practical terms.
Without a better understanding of what is meant by financial sustainability
and, importantly, without explicitly linking the issue to questions such as
willingness to pay for health care, the value of the benefits gained from
health spending and how to improve the performance of the health system,
policy responses to sustainability concerns may be misdirected and yield
unintended consequences.



This policy summary shows the limitations of adopting financial
sustainability as a ‘policy goal’, arguing instead that it should be
understood as a 'policy constraint', and translating this notion into three
key policy-relevant questions……….”



*Contents *

Preface

1 Introduction

2 Understanding the challenge of financial sustainability in health

3 How much should we spend on health care?

4 What level of health care coverage should we provide?

5 How can we enhance value in the health system?

6 Conclusion

References
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