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Israel has built a good healthcare system, combining universal coverage with a degree of competition and choice. However, some risks remain, at least in the medium term.
OECD countries are increasingly attempting to achieve savings through their public procurement systems, in particular in healthcare. In 2012, the State’s Employees’ Social Security and Social Services Institute in Mexico (ISSSTE) asked the OECD to review the effectiveness and integrity of its procurement system and to address bid-rigging. Many of the OECD’s recommendations led to enduring reforms at ISSSTE. In 2015 the OECD conducted a new review focusing on planning and coordination of procurement activities, market research and improvement of medical services. This report presents the findings of the review and notes the ISSSTE’s recent achievements. It also makes recommendations to support the alignment of the ISSSTE’s procurement practices with the 2015 OECD Recommendation of the Council on Public Procurement and includes action plans for priority activities.
Colombia has made major economic and social advances in recent years. The combination of strong economic growth and policies targeted at the most vulnerable groups improved considerably the living standards of the Colombian population. Today, the country enjoys higher employment and labour force participation rates than the average of OECD countries and unemployment is steadily declining. Nevertheless, despite these positive trends, deep structural problems remain. Labour informality is widespread, the rate of self-employment is high and many employees have non-regular contracts. Income inequality is higher than in any OECD country and redistribution through taxes and benefits is almost negligible. In addition, half a century of internal conflict and violence has displaced a significant part of the population, and many of them are living in extreme poverty. Despite considerable progress, violence continues to be a challenge and also affects trade union members and leaders. The Colombian Government has undertaken important reforms in recent years to address these labour market and social challenges, and the efforts are gradually paying off. However, further progress is needed to enhance the quality of jobs and well-being for all. The main trust of this report is to support the Colombian Government in tackling labour market duality, generate trust between the social partners, develop inclusive and active social policies, and get the most out of international migration.
A decade ago we published the first OECD Health System Review of Mexico. Since then, a great deal has changed, and for the better. Over the last 10 years, the publicly-subsidised health insurance plan (Seguro Popular) has extended coverage to more than 50 million people who were previously unprotected. Health service users today report a satisfaction rate of 97%.
Ten years after the introduction of publically-funded universal health insurance, the Mexican health system finds itself at a critical juncture. Unquestionably, some measures of health and health system performance have improved: those previously uninsured now use health services more often, whilst numbers reporting impoverishing health expenditure having fallen from 3.3% to 0.8%. Other indicators, however, remain worrying. Rates of survival after heart attack or stroke are markedly worse than in other OECD countries. Prevention is a particular concern: with 32% of the adult population obese, Mexico ranks as the second most obese nation in the OECD and almost 1 in 6 adults are diabetic. Other key metrics imply deep-rooted inefficiencies in the system: administrative costs, at 8.9% of total health spending, are the highest in the OECD and have not reduced over the past decade. Likewise, out-of-pocket spending has stuck at nearly 50% of total health spending - the highest in the OECD - and implies that individuals feel the need to visit private clinic despite having health insurance. In short, Mexico’s massive public investment in its health system has failed to translate into better health and health system performance to the extent wished and a programme of continued, extensive reform is needed. This report sets out the OECD’s recommendations on the steps Mexico should take to achieve this.
In the ten years since the introduction of Seguro Popular, some 50 million Mexicans previously at risk of unaffordable health care bills now have access to health insurance. The OECD Review of Health Systems: Mexico 2016 finds that the share of the population exposed to unaffordable or impoverishing health care costs has fallen from 3.3% to 0.8% of the population in the past decade.
Ageing has a wide range of impacts on individuals and society as a whole. But the consequences for health care, working life, income and well-being in general are not always what many people imagine. OECD Insights: Ageing: Debate the Issues discusses the problems, challenges, and opportunities that ageing brings to citizens and governments in developed and developing countries. Experts on demography, medical research, pensions, employment and other domains from inside and outside the OECD present their latest analyses and views on one of the most important trends shaping our societies.
La Colombie a considérablement amélioré son système de santé ces 20 dernières années avec, à la clé, un allongement de l’espérance de vie et une baisse de la mortalité infantile. Cette dernière a diminué, passant de 40 décès pour 1 000 naissances vivantes en 1970 à 12.8 ces dernières années et l’espérance de vie à la naissance a atteint 75.2 ans sur la même période.
Colombia’s record in extending health insurance and health services to its population is impressive. In 1990, around 1 in 6 of the population had health insurance. Now, nearly 97% do, with greatest expansion occurring amongst poorer households. Likewise, in 1993 out-of-pocket spending made up 52% of total national expenditure on health. By 2006, this had fallen to less than 15%. Although Colombia has high rates of income inequality (with a Gini coefficient of 53.5 in 2012, compared to the OECD average of 32.2), access to health care services is much more equal. In urban populations, for example, 1.8% of children aged less than two years of age are recorded as having received no routine vaccinations, compared to 1.0% of rural children. Colombia nevertheless faces important challenges to maintain and improve the performance of its health system. This report looks at Colombia’s health care system in detail and offers recommendations on what Colombia can do to ensure accessibility, quality, efficiency and sustainability.
Tackling mental ill-health of the working-age population is a key issue for labour market and social policies in OECD countries. OECD governments increasingly recognise that policy has a major role to play in keeping people with mental ill-health in employment or bringing those outside of the labour market back to it, and in preventing mental illness. This report on Australia is the ninth and last in a series of reports looking at how the broader education, health, social and labour market policy challenges identified in Sick on the Job? Myths and Realities about Mental Health and Work (OECD, 2012) are being tackled in a number of OECD countries. It concludes that policy thinking in Australia shows well-advanced awareness both of the costs of mental illness for society as a whole and of the health benefits of employment. However, challenges remain in: making employment issues a concern of the health care services; helping young people succees in their future working lives; making the workplace a safe, supportive psychosocial environment; and better designing and targeting employment services for jobseekers with mental ill-health.