PHC & Business:
at whose Cost?
Koustuv Dalal, PhD
Director, Centre for Injury Prevention and Safety Pomotion,A WHO CCCSP Strategic Centre
Örebro University, SWEDEN
Koustuv.dalal@oru.se
Health as economic goods
Demand for health consists of two simultaneous choices:
(1) Consumption:
health yields direct utility (satisfaction) i.e. you feel better
when you are healthier
(2) Investment:
health increases the number of days available to participate in
market and non-market activities – the novel bit of the model
Total Time = 365 days = T H (Improving Health)
+ TB (Producing Home goods)
+ TL (Loss for illness)
Leisure
+ TW (Work)
koustuv.dalal@oru.se
Investing in health
INPUTS
Health Care
Diet
Exercise
Environment
Income
Time
P
R
O
D
U
C
T
I
O
N
OUTPUT
P
R
O
C
E
S
S
HEALTH
STOCK
koustuv.dalal@oru.se
HEALTHY DAYS
Physical
Mental
Limited activity
Children
40-45
Older Peoples
Life
years
20
Productive age
> 20
Society
Economic
Burden
koustuv.dalal@oru.se
Unhealthy
Peoples
Elderly
Major Healthcare Financing Models
Model
National Health
Service
Revenue
Source
Groups
Covered
Care
Provision
Finance
General
revenues
Every one
Public providers Central
government
Social Health
Insurance
Taxes from
payroll
Specific
groups
Own, public, or
private facilities
Semiautonomous
organizations
Communitybased Health
Insurance
Private,
voluntary
contributions
Contributing
members
NGOs or
private facilities
Non-profit plans
Voluntary Health Private
Insurance
voluntary
contributions
Contributing
members
Private and
public facilities
For- profit and
non-profit
insurance
organizations
Out-of-Pocket
Payments
Individual
payments to
Public and
private facilities
Experience from SWEDEN after privatization of
management (service paid by public money)
• Shortage of physicians
• High mobility of physicians
• Over phone screening by nurses
• Delay-dealing
• Long waiting time
=> Most importantly over-use of over-the-counter
drugs (paracetamol, pain-killers, vitamins etc)
Kazakhstan economy is in transition
Population health is very important for steady
economic growth.
Business in healthcare has detrimental effects of
population health (inequality)
Do you think my Kazakh sisters and brothers are
ready to accept such healthcare challenges?
Спасибо