Health policies and data

Measuring health coverage

 

 

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Health care coverage can be assessed by answering three basic questions: Who is covered? Which benefits are covered? What proportion of the costs is covered? Achieving universal health coverage and ensuring equity in access to health care to all citizens is one of the main goals of health systems. However, facing fiscal pressures, OECD governments have to decide whether they want to cover more services at a limited reimbursement rate, or whether they want to extend more the financial protection for a limited number of services.
The range of health care services covered by basic (primary) health care coverage (i.e. the first source of financial protection for health care users) and financing arrangements (e.g. user charges) for these services vary significantly across countries. The 2008 and 2012 HSC survey permitted to assess the dimensions of health coverage and those of cost-sharing arrangements, including whether medical care is free at the point of care, the level of coverage for different functions of care across OECD countries, policies to cover people from excessive co-payment and catastrophic expenditure on health (e.g. caps on cost-sharing), and specific cases and possible exemptions for different population sub-groups (e.g. children, disabled, people with chronic diseases, seniors, low-income). 

Provision of basic primary coverage (for the "typical" employed adult)

Provision-of-basic-primary-coverage

Source: OECD Health System Characteristics Survey 2012 and Secretariat’s estimates. Information as of April 2014.

 

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