Three Types Of European National Health Care Financing And Its Reform

This dissertation goes deeply into the problem of health care funding for European countries and reviews different types of resources.The first section sets out the concepts, framework and evaluation methods of health care funding.The second section discusses three types of countries: taxation dominated, statutory health insurance dominated and transition countries (central and eastern Europe countries). Several typical countries were selected for the analysis of each type. For example, UK depends on national taxation while Sweden depends on local taxation. Sickness funds in Germany have rights to set contribution rate while insurance funds in France never have that kind of freedom. It's necessary to analyze transition countries separately since great changes have taken place in both their economy and their healthcare system.The third section explores the problems and challenges before European countries. Some of the problems and challenges are common, like aging and globalization, others are unique, like revenue growth constraints in taxation dominated countries, cost control problem in statutory health insurance countries, and the need to rebuild public funding system in some transition countries.The forth section discusses the health care funding reforms by European countries. Taxation dominated countries took a little actions on funding, most of attentions were paid on the introduction of competition to improve providers' efficiency. Statutory health insurance dominated countries enacted many reforms to stable contribution rate and control the expenditure growth. Reforms in transition countries are fundamental, including introducing social insurance based on payroll taxes, increasing reliance on out-of-pocket payments and establishment of semi-autonomous quasi-state agencies.The last part reveals the problems of Chinese health care funding system and, according to the experience of European countries, proposes policymakers to invest more on health system in form of taxation.