TAILIEUCHUNG - Cost Sharing for Health Care: France, Germany, and Switzerland

The information has been organised thematically in possibly simple way. It concerns social nsurance benefi ts and some of non-insurance benefi ts that are, however, managed by ZUS, as a public institution servicing the social security system in Poland. The study also describes the general principles of operation of separate systems, which are not managed by ZUS: health insurance, family benefi ts, benefi ts in respect of unemployment as well as the scheme of social insurance of farmers. Information on the mentioned systems seems necessary to present a full picture of all benefi ts irrespective of their affi liation to. | THE HENRY J. KAISER FAMILY FOUNDATION Cost Sharing for Health Care France Germany and Switzerland Prepared by the Kaiser Family Foundation January 2009 Introduction Patients with health insurance are seeing their costs at the point of service escalate as insurers increase deductibles copayments and other cost-sharing features. Assuring that patients with health insurance are not burdened with excessive out-of-pocket costs is a key challenge for those interested in health care reform. This issue brief looks at how the health care systems in France Germany and Switzerland limit the cost-sharing requirements imposed on citizens using care. Cost sharing at the point of service is required in each of these countries but a number of different policies limit its impact on people and families with significant health care needs. The policies in these countries may provide lessons for . policymakers considering options for reform. Overview Countries typically have three long-term objectives for their health care systems Assure general access to health care services without regard to income Provide high quality and high value health care and Maintain long-term financial stability of the health care system. The challenge is to achieve all of these objectives at the same Issues of affordability and equity are key concerns as a country determines a health care system for its population. Most health care systems require participants to contribute some amount toward the cost of covered services or goods that they use. However deciding what those amounts known as cost sharing should be and whether and on what basis exemptions and limits to cost sharing should apply is a difficult and often political process. Cost sharing the unreimbursed amounts that health plan participants are required to pay when they use health care services has become an increasing feature of health plans. In the United States rising costs have led employers to increase the cost-sharing provisions of

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