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Finland appears to have a high performing health system, with remarkable good quality in both primary and hospital care. The country also achieves good health status at relatively low level of health spending. Despite these advances, there are specific areas where improvements can be made such as preventing the spread of obesity and addressing gaps in mental health.
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The growth rate in health spending per capita in Canada has slowed down markedly in recent years, being close to zero in real terms since 2011. Life expectancy in Canada is one year higher than the OECD average, but rising alcohol consumption and obesity rates are growing risk factors to health. Canada could further improve the quality of care in order to cope better with rising prevalence of chronic diseases.
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The Australian health system is a complex mix of federal and state government funding and responsibility, making it difficult for patients to navigate. Despite its complexity, Australia’s universal health system achieves good results relatively efficiently.
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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.
The OECD Development Assistance Committee (DAC) collects aid flows at activity level based on a standard methodology and agreed definitions. Aid to Health is covered by two main sectors; 1.Aid to Health - General and Basic Health, and, 2. Population Policies/Programmes and Reproductive Health - includes HIV/AIDS.
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.