HLTHAGE 2F03 Lecture Notes - Lecture 3: National Health Insurance, Public Finance, Social Insurance
19 Jan 2018
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Document Summary
Social health insurance: social insurance organization are legally private, non-profit organizations to which individuals make contributions which are often mandatory and deducted from earnings. (e. g. , france and. Private insurance covers selected services not included in the public insurance plan such as prescription drugs, dental care, physiotherapy. Private insurance can influence use of public services. In the latter case, called payment scheme (and funding mechanism in the former). Paying doctors: fee for service (ffs, case-based funding. Providers receive a fixed, specified payment for each case they treat. Payment varies according to the diagnosis (e. g. , pneumonia, myocardial infarction, etc. : capitation, salary, global budget a payment mechanism whereby a provider receives a total budget for a defined period of time. The size of the total budget can be based on a number of factors: historical costs, the number of services provided last period, and so forth.
