12/05/2004 - A new OECD report, Towards High-Performing Health Systems, gives concrete examples of the changes needed to improve health and health care while ensuring the financial sustainability of health systems. OECD countries must strive to get better value for money if they are to reconcile rising demands for health care with public financing constraints.
Policy makers in OECD countries are under pressure to improve their health systems. Patients are demanding health care that responds to their needs and preferences, as illustrated by the fact that waiting lists for surgery are a pressing public policy issue in nearly half of OECD countries. Shortfalls in health-care quality - such as provision of services to patients who are not appropriate candidates, failures to furnish needed services and errors in health-care delivery - result in unnecessary deaths, disability, poor health, and add to costs. Disparities in health and access to care across income or other population groups persist within many countries.
Responding to demands for better healthcare can increase cost pressure at a time when health spending is already climbing - to more than 8% of GDP, on average, across the OECD and exceeding 10% in Germany, Switzerland and the United States. In 1990 OECD countries spent about 7% of GDP on health. By contrast, in 1970, health spending represented an average of just 5% of GDP.
Even so, spending more is not necessarily a problem, particularly if the added benefits exceed the extra costs. The new drugs, devices and procedures that are responsible for much of the cost growth have also been responsible for better health and reduced disability. But since three-quarters of OECD health spending is publicly financed, rising costs increase the pressure on governments to contain costs or force them to divert resources from other priorities.
Modest co-payments can relieve public financing systems, but are no magic bullet, partly because vulnerable populations must be protected to avoid restrictions on access that could be costly in the long run. Private health insurance can increase consumer choice and the responsiveness of health systems, but has not provided much help in reducing public spending, due to complex interactions between the public and private sectors. And well-designed government interventions, such as subsidies or regulation, are critical if equity of access and financing is to be assured. Ultimately, increasing the efficiency of health systems is the most promising response to pressures to contain costs while improving performance.
The report, which synthesises findings from the OECD's 3-year project on health and highlights useful practices that can be employed in efforts to improve health-system performance, will be discussed in Paris on 13-14 May at the first OECD meeting dedicated to Health Ministers.
Based on assessment of countries' experiences, analysis of the underlying issues, and review of evidence, Towards High-Performing Health Systems identifies practices that improve performance. For instance:
Towards High-Performing Health Systems stresses that there is no one-size-fits-all approach to performance improvement. Countries' unique circumstances need to be taken into account when determining appropriate policy. But since countries share common goals - health care that is accessible and of high quality, and health systems that are responsive, affordable and good value for money - there is much to be learned from each other's experiences, as is demonstrated in the report.
Journalists may obtain a copy of the publication from the OECD Media Relations Division
(tel: 33 1 45 24 97 00). For further information about the publication, journalists are invited to contact Elizabeth Docteur (tel. (33) 1 45 24 76 03) or Martine Durand (tel. (33) 1 45 24 87 07), Directorate for Employment, Labour and Social Affairs.
Non-journalists can purchase copies of the publication from our Online Bookshop.
Note: a summary of the report and a list of the main outcomes of the Health Project are attached below. For more information on the OECD Health Project and Meeting of OECD Health Ministers, consult www.oecd.org/healthmin2004.