Christoph Napierala

Finance Equity Comparison of Health Systems: Discussion of the current overall ranking of health systems by clustering these in their way of financing and equity Christoph Napierala

Master's Thesis from the year 2008 in the subject Health Science, grade: MPH, University of Zurich (Swiss School of Public Health), course: Master of Public Health, language: English, abstract: In numerous political and theoretical discussions the restrictions in performance and service of health care systems are a constant argument. The debate on limited health resource availability and fairness of distribution leads to economic arguments on scarcity of funds, and efficiency of financing. This paper focuses on the explanation of equity of resource distribution by focussing especially on financing health systems and how it affects equity in itself. It concentrates on an inter-country comparison emphasizing performance indicators, based on the WHR2000, and connecting them to health finance relevant numbers. Progressivity figures are used to highlight cross country equity differences. The analysis will provide evidence about the financing method mix' clusters and progressivity factor (Kakwani Index) influencing WHO DALE ranking. Regional and wealth perspectives are also looked at. Conclusively simple correlations can be observed for example between the Kakwani Index and the DALE ranks i.e. the more progressive a health care system is financed the better it is ranked. But also regarding financing mix' basic relationships can be found like social insurances leading to a better position contrary to the privately financed system mixes. Overall the protection of the poor is obtained by designing progressive financing systems which are predominantly public financed. But it has also become obvious that the performance of health systems do not solely depend on their way of finance even though it can partly be explained by indicators used in this paper. The cross-country finance comparison provides the basis for further investigations by solidifying results expanding the model's integration for example to educational levels. The use of a comparative scale or benchmarks like t