We study the effects of "balance billing", i.e., allowing physicians to charge a fee from patients in addition to the fee paid by Medicare. First, we show that on pure efficiency grounds the optimal Medicare fee under balance billing is zero. An active Medicare policy thus can only be justified...

Belgium has a good record in delivering accessible care, but adaptation to population ageing will be complicated by the fragmentation of responsibilities in the healthcare system and a strong reliance on government regulations. The organisation of the system could be rationalised by giving...

The Netherlands, as other OECD countries, faces the challenge of providing high quality health and long-term care services to an ageing population in a cost-efficient manner. In the health care sector, reforms have aimed at introducing more competition. Despite major changes and some positive...

This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of...

There are no ready-made data on hospital outputs and inputs which would allow comprehensive international comparisons of hospital efficiency to be carried out. This paper, therefore, relies on selected evidence to compare hospital efficiency in a subset of OECD countries, based on three...

Health services are largely tax-financed in the United Kingdom and account for 14 per cent of general government spending. This paper analyses how the National Health Service (NHS) has been dealing with the associated expenditure pressures in the pre-1990 set-up and during the “quasi-market”...

This article looks at the application of performance measurement systems in the health sector across OECD countries. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that the...

In this article we give a presentation of the Norwegian quality based financing (QBF) mechanism and our experiences with this financing mechanism. The article outlines the main features of the Norwegian health care system, and its financing mechanisms. We then focus in on the QBF with a...

Measuring health care productivity is important as health is a large sector of the economy and with the majority of funding coming from public sources, the outlook for productivity growth is a critical factor in the debate about fiscal sustainability. The UK has over 20 years’ experience of...

In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more "sustainable"...