Designing a World-Class Health Care System

Abstract

Public health systems are finding it increasingly difficult to fund all the health care that their citizens want and need. Fiscal constraint is causing many nations to reconsider the respective roles of their public programs and private health insurance. The author examines the potential for and performance of health systems around the world and the advantages and disadvantages of public and private health financing. This analysis leads to the development of a framework for improvements in today's mix of health care financing and to high-level principles for a better-coordinated relationship between public and private programs. The role of health actuaries in moving toward more effective health systems is then explored.

Weekend versus Weekday Procedures for Total Hip Arthroplasties

“…16,18,19 This potentially highlights the discrepancy between the two health care structures, as there are clear differences in insurance, payment, and staffing that can all affect how much weekend workflow differs from that on weekdays. 35 This difference in day-of-surgery effects on LOS between U.S. and U.K. studies suggests that the cause may stem from a difference in hospital staffing and structure on weekends. Furthermore, differences in the patient characteristics and burden of disease in the U.S. versus the U.K. imply differences in postoperative management and discharge planning, which could affect how significantly day-of-surgery influences LOS and outcomes.…”

Perspectives Articles:Exploring Stakeholder Perspectives on What Is Affordable Health Care

“…An affordability crisis emerges when health care spending is compared with the sources of finance that are not growing as rapidly or in absolute dollars. Husein et al (1993) and Bolnick (2003) viewed health care from a national or state perspective as part of a three‐part framework and defined a health care system as affordable if the cost would not create a deficit in the budget.…”