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Prepared by Iryna Ivaschenko
The purpose and scope of private health insurance varies significantly in other OECD countries (Docteur and Oxley, 2003). In particular, it is largely used to supplement publicly provided care in Belgium, Canada, Denmark, France, Germany, the Netherlands, and New Zealand, while in Australia, Ireland, Spain, and the United Kingdom it is largely used to widen the choice of providers or the speed of the delivery of care. Private health insurance is uncommon in Hungary, Japan, Korea, Mexico and most Nordic countries.
While empirical evidence is limited, managed care appears to have yielded one-time cost savings distributed over a several years, but to have had limited effects on the long-term growth health spending (see, for example, Aaron and Schwartz, 1993).
The average costs of a hospital stay is three times the OECD median, while a recent study found U.S. consumers paid 40 percent more per capita but received 15 percent fewer real health care resources compared to their German peers, with any gains in the efficiency of delivery more than offset by higher administrative costs. Compared to the United Kingdom, the U.S. system used about 30 percent more inputs per capita (see Anderson and others, 2004).
Insurance inequality also has been argued to be associated with unequal access to non-hospital health care (van Doorslaer and others, 2004).
While some of the uninsured may be eligible for government programs, few doubt that the uninsured reflect a significant share of the U.S. population.