Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-02-01T12:28:52Z No. of bitstreams: 1 alinedasilvagomes.pdf: 955855 bytes, checksum: 8185e6343f130f161ba5a2a5b828be42 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-03-21T19:18:04Z (GMT) No. of bitstreams: 1 alinedasilvagomes.pdf: 955855 bytes, checksum: 8185e6343f130f161ba5a2a5b828be42 (MD5) / Made available in DSpace on 2018-03-21T19:18:04Z (GMT). No. of bitstreams: 1 alinedasilvagomes.pdf: 955855 bytes, checksum: 8185e6343f130f161ba5a2a5b828be42 (MD5) Previous issue date: 2010 / O presente trabalho tem como objetivo compreender como o processo de estratificação e de desmercadorização interagiram na política de saúde brasileira no que tange a universalização do Sistema Único de Saúde diante do extenso mercado de planos e seguros privados. Para Esping-Andersen os conceitos de desemercadorização e estratificação são fundamentais para estabelecer sua tipologia de Welfare State. Este trabalho, utiliza-se destes conceitos através da perspectiva neoinstitucionalista histórica para compreender, ao longo da trajetória da política de saúde brasileira, como os sistemas público e privado conformaram a configuração atual caracterizada pela expansão dos dois sistemas. / The objective of this study is to understand how the stratification and de-commodification process interacted in the Brazilian health policy regarding the universalization of the Unified Health System in the face of the extensive market health insurance private. For Esping-Andersen the concepts of de-commodification and stratification are fundamental to establish their typology of Welfare State. This work uses these concepts through the neoinstitutionalist historical perspective to understand, along the trajectory of Brazilian health policy, how the public and private systems conformed the current configuration characterized by the expansion of the two systems.

South Africa possesses a highly fragmented health system with wide disparities in health spending and inequitable distribution of both health care professionals and resources. The national health system (NHI) of South Africa consists of a large public sector and small private sectors which are overused and under resourced and a smaller private sector which is underused and over resourced. In broad terms, the NHI promises a health care system in which everyone, regardless of income level, can access decent health services at a cost that is affordable to them and to the country as a whole. The relevance of this study is to contribute to the NHI debate while simultaneously providing insights from other countries which have implemented national health care systems. As such, the South African government can then appropriately implement as well as finance the new NHI system specific to South Africa’s current socio-economic status. The objective of this study was to examine health care financing models in different countries in order to draw lessons for South Africa when implementing the NHI. A case study was conducted by examining ten countries with a national health insurance system, in order to evaluate the health financing models in each country. The following specific objectives are pursued: firstly, to review the current health management system and the policy proposed for NHI; secondly, to examine health financing models in a selected number of countries around the world and lastly to draw lessons to inform the South African NHI policy debate. The main findings were firstly, wealthier nations tend to have a much healthier population; this is the result of these developed countries investing significantly in their public health sectors. Secondly, the governments in developing nations allocate a smaller percentage of their GDP and government expenditure on health care. Lastly, South Africa is classified as an upper middle income developing country; however, the health status of South Africans mirrors that of countries which perform worse than South Africa on health matters. In other words the health care in South Africa is not operating at the standard it should be given the resources South Africa possesses. The cause of this may be attributed to South Africa being stuck in what is referred to as the “middle income trap” amongst other reasons.

South Africa has a complex healthcare system. The provision and financing of health care in South Africa occur within two fundamentally different systems: the public healthcare sector and non-governmental not-for-profit organisations, on the one hand, and the private healthcare system, on the other hand. The socioeconomic status of an individual in South Africa is the primary determinant of the system through which he or she will receive access to healthcare. The healthcare services provided by the public and private sectors are perceived to be unequal. The introduction of healthcare reforms by the South African government through the National Health Insurance (NHI) aims to address these disparities. The primary objective of this study was to contribute to the successful implementation of the proposed South African NHI by identifying critical success factors that would impact such implementation. A sample of managerial representatives of the following healthcare institutions in the Nelson Mandela Bay Municipality (NMBM) was drawn: Large private hospitals groups; Eastern Cape Department of Health; Independent medical practitioners groups; South African Dental Association; Pharmacy Association of South Africa; Optometrist Association of South Africa. A total of 250 questionnaires were distributed among these institutions and approximately 233 usable questionnaires were returned (response rate 93.2 percent). A literature review was conducted to identify the various viewpoints (critical success factors, as well as positive and negative perceptions) on NHIs in other countries, as well as the proposed one in South Africa. About 43 of such viewpoints were identified. The 233 respondents were surveyed on these 43 viewpoints. The empirical results revealed the following three critical success factors for the successful implementation of the South African NHI: The projected benefits for stakeholders, with specific reference to medical aid schemes; the projected benefits to the private healthcare sector in servicing the public sector; and strategic leadership. The empirical results also showed that the healthcare managers, who serve the poor versus the affluent geographical areas of the NMBM, differ with regard to their projected success of the NHI. Finally, the study highlighted these health managers’ general perceptions about the envisaged benefits and shortcomings of the NHI.

This dissertation considers the issue of equivalence and the related matter of solidarity in the health insurance sector. The used methodology is an analysis on the basis of which the specific causes of the current state of the healthcare system are investigated. The initial chapters focus on the theoretical basis and insurance principles in general, and then health insurance in more detail. The individual systems (models) of healthcare, which are compared with the aim of finding the optimum method of financing the healthcare sector, are then described. The analytical section looks at the current state of healthcare in the Czech Republic and the main problems it faces: an ageing population and constantly rising healthcare costs, which are slowly becoming uncontrollable. Healthcare reform, which began on 1 January 2008 with the introduction of regulation fees, is also evaluated. A great deal of attention is paid to fees because the legality of their introduction is being settled by the Constitutional Court of the Czech Republic. In conclusion, the author outlines a healthcare system that would be, in his opinion, more financially manageable, and just more equitable and fair.

Comparison of level of taxation of tax non-residents' income and comparison of the level of the social security and health insurance contributions of tax non-residents in the selected EU countries and its impact on international labour migration.

The main theme of the thesis is managed care system description and definition. The first part is focused on managed care history, development in this system, and types of organizations providing this medical and hospital services. There is also chapter concerned with problems of resource management and managed care quality. The next chapter describes medical and health services and managed care in the USA, the only country offering these services in free mareket economy. For comparison in the next chapter there are presented someEuropean states, which try to introduce managed care as a tool for reduction of redundant and duplicate health services costs, include Czech Republic. At the conclusion, the comparison of some economic indicator of medical and health services among some European contries and the USA has been done.

The aim of my thesis is to review current and approchable types of insurance in Czech republic with an emphasis on the health insurance. The thesis should result in a summary of possible reform or stabilization arrangements that are solving unfavourable prognosis in Czech republic in the long term.

Simulation is an advanced tool to capture and simplify a complex system and it allows to track the effects of changes in it to function of the entire system. The aim of the thesis was to model the current function of the system and monitor the effects of changes by experiments with the model in order to find a new and better solution. In this thesis, the running of the client workplace of Všeobecná zdravotní pojišťovna ČR was monitored and the simulation was based on real data from May 2012. The simulation was performed using the software Simul8. The results of the base case show that the system leads to accumulation of entities and long time spent in the queue. Within experimenting with the model there were created 8 scenarios that modify some parts of the system. Firstly the results of the scenarios were compared to the base case and then they were compared with each other. The scenario that was chosen as the best, was better in most of parameters compared to the base case. The parameter with the worst value in the base case - time spent queuing for a normal counter - has improved by 62 % in the new scenario. This scenario was chosen as a new and better solution for the current system.

Method of defining the tax base is important for the correct determination of the amount of tax. With taxes on personal income is closely related to health insurance and social security burden on the same taxpayer income as the income tax. Relation between the income tax and health insurance and social security may be different. The work discusses how should be a tax base of personal income according to the theory and then defined three models of the income tax base with regard to (non) inclusion and (non) deductibility of insurance premiums from the tax base, which are used in subsequent analysis of labor income taxation in OECD. In the Czech Republic, the issue is very obsolete since the tax reform in 2008. From this year is the taxable income of individuals "super salary". The tax reform in 2015 will be again a change in the income tax base. The work is examined in detail legislative development of personal income tax between years 2008 and 2015. In the final part is analyzed creation of the tax base in individual OECD countries. Countries are classified according to the method of determining the tax base. The analysis showed that the most widely used model of tax base is a narrow tax base. Although broad tax base uses a 5 OECD members countries. In Hungary has broad tax base exactly the same form as in the Czech Republic. However, elements of a broad tax base can be found in other countries.

The aim of my thesis entitled "The impact of pension reform on public and commercial insurance" is primarily to assess the current state of public insurance, which includes social insurance, as the first pillar of the pension system, the evaluation of the other two pillars and reforms associated with it. I describe to you the functioning of the system of public health insurance and commercial insurance options. Also, as the reader will learn some background information functioning medical facility. As a result, I will summarize the effects of reform and attempt to assess.