
6033SSL – Deferral Assignment
April 26, 2023
HSN301 DIET AND DISEASE
April 26, 2023Question 1: Carefully describe two ways of paying healthcare providers. Discuss the advantages and disadvantages of each. (800 words)
Proposed answer structure:
- Choose between capitation, activity based payments (DRGs based), fee for service, salaries, budgets, P4P etc.
- Define payment method and explain how it works
- payment is prospective or retrospective?
- impact on quantity and quality of care provided
- incentives for efficiency
Question 2: Carefully discuss the weighted capitation as a tool for allocating resources within the healthcare system. (800 words)
Proposed answer structure:
- Contextualize the weighed capitation as a resource allocation mechanism and define that it is a capitation adjusted for need.
- Discuss the importance of weighed capitation for the reduction of health inequalities.
- Discuss the type of individual and area level data used to adjust capitation and discuss.
- Discuss the index and matrix approach as two methods of establishing the weighed capitation.
- The best answers will illustrate the different ways by illustrating how this is done in two countries (e.g. Sweden and the Netherlands).
Question 3: The Mirandan Republic is a small country in South America, endowed with large oil reserves: 80% of the country’s GDP consists of oil exports and related activities. Political instability has been persistent in Miranda since the country’s independence: elected governments often last only a few months and are replaced by others with very different political priorities.
The health system in this country relies heavily on out-of-pocket payments. A newly appointed minister of health, who holds and MSc from a UK university, proposes to introduce a tax funded NHS system in the country. Do you agree with this? Justify your answer (800 words)
Proposed answer structure:
- Explain why OOPs is not a good source of funding and why a risk pooling scheme, such as tax finance, is preferable.
- Explain that the viability of this depends on a stable share of the fiscal budget being allocated to
healthcare - Show how this can be undermined by political instability and also by volatility in the price of oil.
- The best answers would add that one of the advantages of of tax finance could be equity but only if the a tax system is progressive and tax evasion does not undermine that
- Weigh the arguments pro and against the policy reform and make a recommendation