The health systems we enjoy today, and expected medical advances in the future, will
be difficult to finance from public resources without major reforms. Public health
spending in OECD countries has grown rapidly over most of the last half century. These
spending increases have contributed to important progress in population health: for
example, life expectancy at birth has increased, rising on average by ten years since
1970. The challenge now is to sustain and enhance these achievements in a context
of tight fiscal constraints in many countries combined with upward pressure on health
spending from factors such as new technological advances and demographic changes.
Finding policies that can make health spending more sustainable without compromising
important achievements in access and quality requires effective co-operation between
health and finance ministries. Sound governance and co-ordination mechanisms are therefore
essential to ensure effective policy choices. Prepared by both public finance and
health experts, this report provides a unique detailed overview of institutional frameworks
for financing health care in OECD countries. One of the main features of this book
is a comprehensive mapping of budgeting practices and governance structure in health
across OECD countries.