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Solidarity and the distribution of Health Expenditures

Solidarity and the distribution of Health Expenditures. Johan Polder Tilec-Tranzo Annual Conference Tilburg, January 26th 2012. Succes comes at the price of public health expenditure (billion euros, share in total public spending; source: CPB). Competition in Dutch health care.

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Solidarity and the distribution of Health Expenditures

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  1. Solidarity and the distribution of Health Expenditures Johan Polder Tilec-Tranzo Annual Conference Tilburg, January 26th 2012

  2. Succes comes at the price of public health expenditure(billion euros, share in total public spending; source: CPB)

  3. Competition in Dutch health care • Harmful for solidarity? • no evidence • Harmful for tax payer? • Depends on the balance between costs and benefits

  4. Policy debate anno 2012 • Affordability of health care in the (near) future • Given ageing • Given trends in epidemiology and technology • Given economic outlook • Sustainability of solidarity • Given that babyboom cohort gets older • Given age specific trends in health expenditure

  5. This presentation • Macroeconomic perspective • The role of health as a determinant of health expenditure (HCE) • Especially • The distribution of HCE over the course of life regarding healthy ageing

  6. Tranzo Health Economists’ Group

  7. Absence of illness Self perceived health Physical and cognitive limitations What about health?

  8. Cost of illness 2010 Average HCE per inhabitant (euro) Females Males

  9. “Red herring” in Dutch hospital expenditureAverage expenditure for decedents and survivors Decedents Survivors age

  10. Latent health StatesBased on the Longitudinal Ageing Study Amsterdam (LASA) Bad health Moderate health Good health

  11. Life expectancy Health expenditure

  12. The 2 faces of healthy ageing Life expectancy at age 65 Cumulative HCE at age 65

  13. Lorenzcurve for Acute Care expenditureSingle year versus lifetime

  14. Conclusion • Despite / (due to?) competition • there’s a lot of solidarity in the Dutch health care system • (Between higher and lower incomes, not discussed) • Between healthy and unhealthy people • Between age cohorts • But also between people and their future selves

  15. Competition and solidarity • There’s a strong case for a longitudinal approach • Health Maintenance Organizations • Long term insurance contracts • Health Savings Accounts • Competition • fair balance between solidarity and a • Sustainable development of health care expenditure

  16. “The increasing share of global income spenton healthcare expenditures is not a calamity; itis a sign of the remarkable economic andsocial progress of our age” • (The Escape from Hunger and Premature Death, 1700–2100; 2004, p.107).

  17. Thank you…!

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