2017 Ekokes Sesi 11 DAP Health Care and health system Comparison
Health care and health
system comparison
Diah Ayu Puspandari
Mengapa perlu perbandingan?
Mengapa perlu perbandingan?
Informasi untuk
kebijakan publik
Perbaikan
Benchmarks high
performance
• OECD project initiated in 2002
that aims to measure and
compare the quality of health
service provision across
countries. Data on drug
utilization and prices, as well as
magnetic resonance imaging
(MRI) prices, from other sources
were also included.
Fungsi Pemerintah
Sumber Pembiayaan
Fungsi sektor swasta
Australia
Regionally administered, joint
(national & state) public hospital
funding; universal public medical
insurance program (Medicare)
General tax revenue; earmarked
income tax
~47.3% buy complementary (e.g.,
private hospital and dental care,
optometry) and supplementary
coverage (increased choice, faster
access for nonemergency
services, rebates for selected
services)
Canada
Regionally administered universal
public insurance program that
plans and funds (mainly private)
provision
Provincial/federal general tax revenue
~67% buy complementary
coverage for noncovered benefits
(e.g., private rooms in hospitals,
drugs, dental care, optometr
China
Supervision by health authorities
(Health and Family Planning
Commissions) at the national,
provincial and local levels; some
direct provision through public
ownership of hospitals
There are three main publicly financed
health insurance types with local-area
risk-pooling: urban employer-based
(mainly payroll taxes, for formally
employed urban residents), urban
resident basic (mainly government
funded, for urban nonemployed
residents), and rural cooperative
medical scheme (government-funded,
for rural residents)
Complementary to cover costsharing and gaps, as well as
better health care quality and/or
higher reimbursements. No data
on coverage, but growth has
been rapid.
Eduardo Banzon presentation, InaHEA 2016
US
Fungsi Pemerintah
Sumber Pembiayaan
Fungsi sektor swasta
Medicare: age 65 and older, some disabled;
Medicaid: some low-income; for those without
employer coverage, state-level insurance
exchanges with income-based subsidies;
insurance coverage mandated, with some
exemptions (10.4% of adults uninsured)
Medicare: payroll tax,
premiums, federal tax
revenue; Medicaid:
federal, state tax revenue
Primary private voluntary
insurance covers ~66% of
population (employerbased and individual);
supplementary for
Medicare
What is UHC ?
Effektif?
Akses : US? 10,4 % tanpa asuransi
Biaya : US tertinggi?
Kualitas : mis medical error
Biaya tinggi
• Kuantitas layanan?
• Harga?
• Biaya administrasi?
Iron triangle
• In United States politics, the iron
triangle comprises the policymaking relationship among the
congressional committees, the
bureaucracy, and interest
groups.
system comparison
Diah Ayu Puspandari
Mengapa perlu perbandingan?
Mengapa perlu perbandingan?
Informasi untuk
kebijakan publik
Perbaikan
Benchmarks high
performance
• OECD project initiated in 2002
that aims to measure and
compare the quality of health
service provision across
countries. Data on drug
utilization and prices, as well as
magnetic resonance imaging
(MRI) prices, from other sources
were also included.
Fungsi Pemerintah
Sumber Pembiayaan
Fungsi sektor swasta
Australia
Regionally administered, joint
(national & state) public hospital
funding; universal public medical
insurance program (Medicare)
General tax revenue; earmarked
income tax
~47.3% buy complementary (e.g.,
private hospital and dental care,
optometry) and supplementary
coverage (increased choice, faster
access for nonemergency
services, rebates for selected
services)
Canada
Regionally administered universal
public insurance program that
plans and funds (mainly private)
provision
Provincial/federal general tax revenue
~67% buy complementary
coverage for noncovered benefits
(e.g., private rooms in hospitals,
drugs, dental care, optometr
China
Supervision by health authorities
(Health and Family Planning
Commissions) at the national,
provincial and local levels; some
direct provision through public
ownership of hospitals
There are three main publicly financed
health insurance types with local-area
risk-pooling: urban employer-based
(mainly payroll taxes, for formally
employed urban residents), urban
resident basic (mainly government
funded, for urban nonemployed
residents), and rural cooperative
medical scheme (government-funded,
for rural residents)
Complementary to cover costsharing and gaps, as well as
better health care quality and/or
higher reimbursements. No data
on coverage, but growth has
been rapid.
Eduardo Banzon presentation, InaHEA 2016
US
Fungsi Pemerintah
Sumber Pembiayaan
Fungsi sektor swasta
Medicare: age 65 and older, some disabled;
Medicaid: some low-income; for those without
employer coverage, state-level insurance
exchanges with income-based subsidies;
insurance coverage mandated, with some
exemptions (10.4% of adults uninsured)
Medicare: payroll tax,
premiums, federal tax
revenue; Medicaid:
federal, state tax revenue
Primary private voluntary
insurance covers ~66% of
population (employerbased and individual);
supplementary for
Medicare
What is UHC ?
Effektif?
Akses : US? 10,4 % tanpa asuransi
Biaya : US tertinggi?
Kualitas : mis medical error
Biaya tinggi
• Kuantitas layanan?
• Harga?
• Biaya administrasi?
Iron triangle
• In United States politics, the iron
triangle comprises the policymaking relationship among the
congressional committees, the
bureaucracy, and interest
groups.