BACKGROUND: Both rising healthcare costs and the global financial crisis have fueled a search for policy tools in order to avoid unsustainable future financing of essential health benefits. The scope of essential health benefits (the range of services covered) and depth of coverage (the proportion of costs of the covered benefits that is covered publicly) are corresponding variables in determining the benefits package. We hypothesized that a more comprehensive health benefit package may increase user cost-sharing charges. METHODS: We conducted a desktop research study to assess the interrelationship between the scope of covered health benefits and the height of statutory spending in a sample of 8 European countries: Belgium, England, France, Germany, the Netherlands, Scotland, Sweden, and Switzerland. We conducted a targeted literature search to identify characteristics of the healthcare systems in our sample of countries. We analyzed similarities and differences based on the dimensions of publicly financed healthcare as published by the European Observatory on Health Care Systems. RESULTS: We found that the scope of services is comparable and comprehensive across our sample, with only marginal differences. Cost-sharing arrangements show the most variation. In general, we found no direct interrelationship in this sample between the ranges of services covered in the health benefits package and the height of public spending on healthcare. With regard to specific services (dental care, physical therapy), we found indications of an association between coverage of services and cost-sharing arrangements. Strong variations in the volume and price of healthcare services between the 8 countries were found for services with large practice variations. CONCLUSION: Although reducing the scope of the benefit package as well as increasing user charges may contribute to the financial sustainability of healthcare, variations in the volume and price of care seem to have a much larger impact on financial sustainability. Policy-makers should focus on a variety of measures within an integrated approach. There is no silver bullet for addressing the sustainability of healthcare.
BACKGROUND: Both rising healthcare costs and the global financial crisis have fueled a search for policy tools in order to avoid unsustainable future financing of essential health benefits. The scope of essential health benefits (the range of services covered) and depth of coverage (the proportion of costs of the covered benefits that is covered publicly) are corresponding variables in determining the benefits package. We hypothesized that a more comprehensive health benefit package may increase user cost-sharing charges. METHODS: We conducted a desktop research study to assess the interrelationship between the scope of covered health benefits and the height of statutory spending in a sample of 8 European countries: Belgium, England, France, Germany, the Netherlands, Scotland, Sweden, and Switzerland. We conducted a targeted literature search to identify characteristics of the healthcare systems in our sample of countries. We analyzed similarities and differences based on the dimensions of publicly financed healthcare as published by the European Observatory on Health Care Systems. RESULTS: We found that the scope of services is comparable and comprehensive across our sample, with only marginal differences. Cost-sharing arrangements show the most variation. In general, we found no direct interrelationship in this sample between the ranges of services covered in the health benefits package and the height of public spending on healthcare. With regard to specific services (dental care, physical therapy), we found indications of an association between coverage of services and cost-sharing arrangements. Strong variations in the volume and price of healthcare services between the 8 countries were found for services with large practice variations. CONCLUSION: Although reducing the scope of the benefit package as well as increasing user charges may contribute to the financial sustainability of healthcare, variations in the volume and price of care seem to have a much larger impact on financial sustainability. Policy-makers should focus on a variety of measures within an integrated approach. There is no silver bullet for addressing the sustainability of healthcare.
Authors: Ashley N Corallo; Ruth Croxford; David C Goodman; Elisabeth L Bryan; Divya Srivastava; Therese A Stukel Journal: Health Policy Date: 2013-08-23 Impact factor: 2.980
Authors: Daniel Strech; Markus Follmann; David Klemperer; Monika Lelgemann; Günter Ollenschläger; Heiner Raspe; Monika Nothacker Journal: Z Evid Fortbild Qual Gesundhwes Date: 2014-11-07
Authors: Wendy Levinson; Marjon Kallewaard; R Sacha Bhatia; Daniel Wolfson; Sam Shortt; Eve A Kerr Journal: BMJ Qual Saf Date: 2014-12-31 Impact factor: 7.035
Authors: Wynand P M M van de Ven; Konstantin Beck; Florian Buchner; Erik Schokkaert; F T Erik Schut; Amir Shmueli; Juergen Wasem Journal: Health Policy Date: 2013-02-08 Impact factor: 2.980
Authors: Jennifer Apolinário-Hagen; Severin Hennemann; Christina Kück; Alexandra Wodner; Dorota Geibel; Marlies Riebschläger; Martin Zeißler; Bernhard Breil Journal: Health Serv Insights Date: 2020-03-13