German health care financing is now at the crossroads of fundamental reform. The two main proposals that the new “grand” coalition government must take as its starting point for compromise could hardly be more polarized. The proposal favored by the left, the Bürgerversicherung, a Citizens’ Health Insurance that is compulsory for all, would introduce a new system of proportional taxation, based ...

Although Canada and the United States have fundamentally different systems for financing health care, there are many similarities between the two countries in their approaches to physician payment. The similarities have increased recently with the adoption of the Medicare fee schedule. Canadian provinces have been using fee schedules for more than 20 years. This article provides an overview of ...

10.1056/nejmp1114236 nejm.org 1 Medicare’s investment in graduate medical education (GME), which currently totals $9.5 billion annually. They offer various prescriptions, including reducing federal support, developing new achievement measures for which GME programs should be held accountable, and seeking independent assessment of the governance and financing of training programs. The recommenda...

In this article, we highlight key considerations for better addressing sexual and reproductive health and rights issues within universal health coverage (UHC), particularly in the context of the post-2015 sustainable development agenda. We look at UHC as a health, development and health care financing issue, and its history. We discuss its limitations as currently understood from a human rights...

Numerous reports have documented the problems of adequate insurance coverage. Among them, a 2004 report of the Center for Rural Affairs entitled Health Care in Rural America outlines the parameters of the problem for rural citizens. This report continues the discussion by examining some recent research that delves into the causes and consequences of inadequate health care financing in rural areas.

The ongoing effort of the U.S. Department of Health and Human Services to identify private financing mechanisms that can effectively assist the rapidly growing population of older persons in paying for long-term care expenses is discussed in this article. The focus on private strategies stems from the recognition that Federal and State sectors already pay almost one-half of all long-term care e...

BACKGROUND In the transition from a planned economy to a market-oriented economy, China's state funding for health care declined and traditional coverage plans collapsed, leaving China's poor exposed to potentially ruinous health care costs. In reforming health care for the 21st century, equity in health care financing has become a major policy goal. To assess progress towards this goal, this p...

One of the many important ethical issues raised by health care systems is how best to sustain equity. As conflicting individual interests are inevitable within a health care system, issues of fairness are bound to arise. Changes in the structure of a health care system are thus key events that can affect equity in important ways. Using the "Benchmarks of Fairness" approach, we assessed the poss...

T U.S. health care system has a lot going for it – tremendous resources, a talented workforce and cutting-edge science and technology – yet by many accounts, it is a mess. In 2004, medical spending in this country reached a staggering $1.9 trillion and grew 7.9 percent over the previous year. Although this was the slowest growth rate since 2000, health care spending still rose faster than wages...