In Austria, health care is based on a social insurance system, which includes
health, accident,
pension as well as unemployment insurance. The underlying law is the Austrian
Social
Insurance Law (Allgemeines Sozialversicherungsgesetz, ASVG), effective since
1955. The
implementation of social insurance is ensured by the umbrella organisation the
Main Association
of Austrian Social Security Institutions (Hauptverband der österreichischen
Sozialversicherungsträger,
HVB) and its 19 sickness funds. Approximately 98% of the population is
covered by the social health insurance (SHI); health care contributions are
based on the income
of the insured person. Exemptions are made for socially disadvantaged persons
and
persons with communicable diseases.
Besides health insurance contributions, accounting for about 50%, health care in
Austria is
funded through a mix of personal contributions (30%; out-of pocket payment (OPP)
and private
health insurance) and general taxation (20%).
In the year 2006, total spending for health care was around 10.1% of gross
domestic product
(GDP). While public health expenditure accounts for two thirds of total health
expenditure
(THE), private expenditure (co-payments, private health insurance fees and other
out-of
pocket expenditure) amounts to one third of THE.
The Federal Ministry of Health, Family and Youth (Bundesministerium für
Gesundheit, Familie
und Jugend, BMGFJ) is the main policy-maker in health care at federal level.
Further key
actors in this field are the HVB and the Austrian Federal Agency for Safety in
Health Care
(Bundesamt für Sicherheit im Gesundheitswesen, BASG) acting as the Austrian
Medicines
Agency.
In 2007, a total of 40,798 medical doctors provided inpatient and outpatient
care for the Austrian
population. General practitioners (GPs) offer primary care and act as
gatekeepers. In
general they have contracts with one or more SHI plans and are remunerated by
flat-rate
fees and by fee-for-service payments. Specialist care is either administered in
hospitals or in
consultation offices. The basis for remuneration of public and non-profit-making
general hospitals
and public specialised hospitals is the diagnosis-related group (DRG)
(Leistungsorientierte
Krankenanstaltenfinanzierung, LKF / DRG) system...