IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/8470.html
   My bibliography  Save this paper

A Fuzzy Logic Approach Toward Solving the Analytic Maze of Health System Financing

Author

Listed:
  • Dov Chernichovsky

Abstract

Improved health, equity, macro-economic efficiency, efficient provision of care, and client satisfaction are the common goals of the health system. The relative significance of these goals varies, however, across nations, communities, and with time. As for health care finance, the attainment of these goals under varying circumstances involves alternative policy options for each of the following elements: sources of finance, allocation of finance, pay to providers, and public-private mix. The intricate set of multiple goals, elements, and policy options defies human reasoning, and, hence, hinders effective policymaking. Indeed, health system finance' is not amenable to a clear set of structural relationships. Neither is there a universe that can be subject to statistical scrutiny: each health system is unique. 'Fuzzy logic' and its underlying 'Expert System' that model human reasoning by managing knowledge' close to the way it is handled by human language, provides a powerful tool for systematic analysis of health system finance, and for guiding policy making. Assuming equal welfare weights for alternative goals, and mutually exclusive policy options under each health-financing element, the exploratory model we present here suggests that a German type health system is best. Other solutions depend on the welfare weights and mixes of policy options.

Suggested Citation

  • Dov Chernichovsky, 2001. "A Fuzzy Logic Approach Toward Solving the Analytic Maze of Health System Financing," NBER Working Papers 8470, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:8470
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w8470.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Kim, Kwangkee & Moody, Philip M., 1992. "More resources better health? A cross-national perspective," Social Science & Medicine, Elsevier, vol. 34(8), pages 837-842, April.
    2. Dov Chernichovsky, 2000. "The Public-Private Mix in the Modern Health Care System - Concepts, Issues, and Policy Options Revisited," NBER Working Papers 7881, National Bureau of Economic Research, Inc.
    3. Beck, Konstantin & Spycher, Stefan & Holly, Alberto & Gardiol, Lucien, 2003. "Risk adjustment in Switzerland," Health Policy, Elsevier, vol. 65(1), pages 63-74, July.
    4. D. Chernichovsky & H. Barnum & E. Potapchik, 1996. "Health system reform in Russia: the finance and organization perspectives," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 4(1), pages 113-134, May.
    5. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
    6. János Kornai & John McHale, 2000. "Is Post‐Communist Health Spending Unusual?," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 8(2), pages 369-399, July.
    7. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dov Chernichovsky & Arkady Bolotin & David Leeuw, 2003. "A fuzzy logic approach toward solving the analytic enigma of health system financing," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 158-175, September.
    2. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    3. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    4. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    5. Gao, Qiuming & Wang, Derek, 2021. "Hospital efficiency and equity in health care delivery: A study based in China," Socio-Economic Planning Sciences, Elsevier, vol. 76(C).
    6. Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2011. "Horizontal Inequity in Access to Health Care in Four South American Cities," Revista de Economía del Rosario, Universidad del Rosario, June.
    7. Fourie, Johan & Jayes, Jonathan, 2021. "Health inequality and the 1918 influenza in South Africa," World Development, Elsevier, vol. 141(C).
    8. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    9. Kim, Tae Jun & Vonneilich, Nico & Lüdecke, Daniel & von dem Knesebeck, Olaf, 2017. "Income, financial barriers to health care and public health expenditure: A multilevel analysis of 28 countries," Social Science & Medicine, Elsevier, vol. 176(C), pages 158-165.
    10. Robert Kolesar & Sambo Pheakdey & Bart Jacobs & Narith Chan & Samedy Yok & Martine Audibert, 2019. "Expanding Social Health Protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations," Working Papers halshs-02018867, HAL.
    11. Bond, Derek & Conniffe, Denis, 2003. "Allocating Funding across Health Boards - Is Equity Easy?," Papers HRBWP05, Economic and Social Research Institute (ESRI).
    12. Jones, Andrew M. & Rice, Nigel & Robone, Silvana & Dias, Pedro Rosa, 2011. "Inequality and polarisation in health systems' responsiveness: A cross-country analysis," Journal of Health Economics, Elsevier, vol. 30(4), pages 616-625, July.
    13. Magnus Lindelow, 2002. "Sometimes more equal than others: How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," CSAE Working Paper Series 2002-15, Centre for the Study of African Economies, University of Oxford.
    14. Bond. D. & Conniffe.D., 2002. "Cross-Regional Equality in Health Care Funding," Economics Department Working Paper Series n1120102.pdf, Department of Economics, National University of Ireland - Maynooth.
    15. Schulz, Erika & Coda Moscarola, Flavia & Golinowska, Stanisława & Radvansky, Marek & Geyer, Johannes, 2013. "Impact of Ageing on Curative Health Care Workforce in Selected EU Countries," EconStor Preprints 128601, ZBW - Leibniz Information Centre for Economics.
    16. Alan Maynard, 1999. "Inequalities in health: an introductory editorial," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 281-282, June.
    17. Tamara Tonoyan, 2005. "Poverty, Inequality and Health: А case study of Armenia," Departmental Discussion Papers 124, University of Goettingen, Department of Economics.
    18. Fiorillo, Damiano & Sabatini, Fabio, 2011. "Quality and quantity: the role of social interactions in individual health," AICCON Working Papers 84-2011, Associazione Italiana per la Cultura della Cooperazione e del Non Profit.
    19. Wagstaff, Adam & Doorslaer, Eddy van, 2001. "Paying for health care : quantifying fairness, catastrophe, and impoverishment, with applications to Vietnam, 1993-98," Policy Research Working Paper Series 2715, The World Bank.
    20. Yasushi Ohkusa & Chika Honda, 2003. "Updated Horizontal Inequity in Health Care Utilization in Japan: Comparisons with OECD Countries Using an Original Survey," ISER Discussion Paper 0585, Institute of Social and Economic Research, Osaka University.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:8470. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.