OECD Economics Department Working Papers

Working papers from the Economics Department of the OECD that cover the full range of the Department’s work including the economic situation, policy analysis and projections; fiscal policy, public expenditure and taxation; and structural issues including ageing, growth and productivity, migration, environment, human capital, housing, trade and investment, labour markets, regulatory reform, competition, health, and other issues.

The views expressed in these papers are those of the author(s) and do not necessarily reflect those of the OECD or of the governments of its member countries.

English, French

Health Care Reform Controlling Spending and Increasing Efficiency

The paper reviews trends in health-care expenditure and assesses the main forces underlying the increase since 1960. It then describes and evaluates various health-care reforms. The report argues that top-down budget controls appear to have had some success in reducing the growth in health-care spending but, to be sustainable, they need to be supported by microeconomic reforms. Significant improvements in micro-efficiency and effectiveness can be obtained by improving incentives facing health-care providers. Policy developments in a few leading countries suggest that a system where funders/insurers act as purchasers, contracting with competing health-care providers, is a promising model for reform. A statistical annex assesses whether differences in institutional arrangements for funding and providing health care explain international differences in health expenditure ...


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