LESSONS US TAKES FROM A SINGLE PAYER SYSTEM IN MANAGING HEALTCARE COST: FRENCH HEALTHCARE SYSTEM

Yıl 2014, Sayı: 6, 28 - 52, 01.12.2014

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Öz

Healthcare spending in the US is characterized as being the most costly per person while health system is not delivering superior results on health outcomes. There have been many explanations that the US having the highest healthcare spending, such as prices, high prevalence of new-technology, chronic diseases and administrative cost. This study focuses on the structure of the US healthcare system and discusses the results for replacing the present public-private system with a single payer public system to restrain or reduce healthcare spending. In this context, the paper analyzes the US and France healthcare systems and then compares both systems in terms of costs. Finally the paper concludes the US payer system has not been exercising the same monopsony power that has enabled the French healthcare system keeping costs considerably lower, while proving equal, if not better care

Anahtar Kelimeler

US healthcare system, French healthcare system, single payer, health spending

AMERİKA’NIN SAĞLIK HARCAMALARINI KONTROL ALTINA ALMAK İÇİN TEK GERİ ÖDEYİCİLİ SİSTEMLERDEN ÇIKARACAĞI DERSLER: FRANSIZ SAĞLIK SİSTEMİ

Öz

Amerikan sağlık sistemi, sağlık çıktılarında iyi sonuçlar alamamakla birlikte, ülkedeki kişi başına düşen sağlık harcamaları çok yüksektir. Amerika’nın en yüksek sağlık harcamalarına sahip olmasının en önemli nedenleri sırasıyla, yüksek fiyatlar, ileri teknolojinin sık kullanımı, kronik hastalıklar ve yönetim giderleridir. Bu çalışmada, Amerikan sağlık sisteminin yapısına odaklanılıp,
sağlık harcamalarının azaltılması ya da kısıtlanması için mevcut kamuözel çok yapılı karmaşık sistemin tek ödeyicili (monopson) kamu sistemi ile değiştirilmesi durumu tartışılmıştır. Bu çerçevede her iki ülkenin de sağlık sistemlerini incelenmiş, sonrasında sağlık harcamaları ve maliyetler açısından karşılaştırılmıştır. Amerikan ve Fransız sağlık sistemleri birbirine yakın sağlık çıktıları üretirken, Amerikan’ın sağlık harcamalarını önemli ölçüde düşük tutmaya katkı sağlayan monopson güce sahip olmadığı sonucuna ulaşılmıştır.

Anahtar Kelimeler

ABD sağlık sistemi, Fransa sağlık sistemi, tek ödeyici, sağlık harcamaları

Kaynakça

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