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  • 1
    Language: English
    Pages: 64 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.350
    Keywords: Economics ; United States
    Abstract: This paper assesses the performance of the United States health system in an international context and discusses potential directions for reform. The US health system is unique among OECD countries in its heavy reliance on the private sector for both financing and delivery of health care. The public sector plays a not-insignificant role, providing coverage for the elderly, disabled and poor, and spending as much on health as a share of GDP as is spent in total by many OECD countries. The system is considered highly flexible, capable of evolving quickly to address the changing preferences of consumers and the incentives put in place by the requirements of payers and government regulation. It is also characterised by excellent access by the insured population to the latest advances in medical technology. However, 14 per cent of Americans lack insurance coverage, and the decentralised, multi-payer approach to financing and regulation provides relatively few levers to control ...
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  • 2
    Language: English
    Pages: 51 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.398
    Keywords: Economics ; United States
    Abstract: Regulatory reform efforts in a broad range of industries have resulted in increased importance of competitive forces as a means to allocate resources and improve economic efficiency. A number of indicators suggest that such forces have been stronger in the United States than in most other OECD countries for some time. This has contributed to sizeable productivity gains and good economic performance over the past decade or so. Nonetheless, despite the generally pro-competitive thrust of policies, a number of challenges remain. Although there are few sectors of the economy from which competition policy and law are completely excluded, given the high risk of sanctions and damages for violation, many anomalous exemptions and special regimes have found their way into US legislation. Contrary to other OECD countries, government related firms are exempted from competition enforcement. Intellectual property rights create special challenges for competition policy and some problems have followed their strengthening over the past two decades, such as the soaring cost of patent litigation. The generally favourable experience with deregulation created pressures for liberalisation in network industries, where the United States has rather been a laggard, at least in the electricity sector. Reforms in the 1990s have entailed some positive results but also some setbacks, reflecting both the difficulties in ensuring competition in such industries and policy mistakes.
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  • 3
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 27 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.645
    Keywords: Economics ; Iceland
    Abstract: Health outcomes and the quality of health care in Iceland are very good by international comparison, while income-related health inequality appears to be smaller than in most other countries. However, the health-care system is costly and, according to OECD estimates, public expenditure on health and long-term care could reach 15% of GDP by 2050 if no restraining measures are taken. This highlights the importance of raising cost-effectiveness and spending efficiency more generally. To this end, it would seem advisable to remove impediments to private provision and open up the health sector to competition. At the same time, the introduction of cost-sharing should be considered where it does not exist (as in hospitals), although concerns about equity need to be taken into account. This would relieve the burden on public finances, as would the introduction of spending ceilings, cost-efficiency analysis and activity-based funding arrangements. The high cost of pharmaceuticals should be reduced by promoting competition and the use of inexpensive generic drugs.
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  • 4
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 29 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.360
    Keywords: Economics ; Iceland
    Abstract: This paper analyses the main features of Iceland’s public expenditure and addresses some key policy issues. While overall public spending is not high compared with Iceland’s Nordic neighbours, other OECD countries have made more progress in reining it in. Budget consolidation efforts and public-sector reforms temporarily reversed the upward trend in the government expenditure-to-GDP in the 1990s, but since then the ratio has edged up again. This highlights the need for enhancing spending control through further reforms. Indeed, although the expenditure management system has undergone significant changes over the past ten years or so, much remains to be done to increase budgetary discipline and improve the system’s ability to contain social-spending pressures, which will intensify as the population ages. In particular, weaknesses that need to be addressed would seem to relate to the budget process and the lack of a medium-term expenditure policy, along with insufficient performance ...
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  • 5
    Online Resource
    Online Resource
    Paris : OECD Publishing
    Language: English
    Pages: 30 p. , 21 x 29.7cm
    Series Statement: OECD Economics Department Working Papers no.516
    Keywords: Economics ; Iceland
    Abstract: This paper reviews Iceland’s performance in skills accumulation against the backdrop of a rapidly changing economic environment and discusses directions for further improvements. Since the late 1990s, the government has considerably raised expenditure on education, which is now among the highest in the OECD relative to GDP. Nonetheless, Iceland continues to have one of the largest shares of those in the working age population who have not attained upper secondary or higher qualifications, and educational achievements of 15- year olds are not outstanding relative to the country’s advanced state of economic development. This is all the more unsatisfactory because spending per student in the compulsory education sector exceeds the OECD mean considerably, even after controlling for differences in per capita GDP. Measures to improve outcomes include curriculum adjustments and an enhancement of teaching evaluation and quality. While ensuring that students acquire a satisfactory basic set of competencies, there is room for reducing the average duration of primary and secondary education, which is quite long by international comparison. In contrast to upper secondary attainment, that for the tertiary sector is above the OECD average, and higher education has to cope with an enormous rise in participation. With a view to maintaining quality in the face of these developments, the government has introduced legislation that is welcome. However, it does not address the issue of tuition fees, which are authorised in the private but not in the public sector. This Working Paper relates to the 2006 OECD Economic Survey of Iceland (www.oecd.org/eco/surveys/iceland).
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