1. Introduction The increasing longevity of life poses inevitable challenge on care systems. At the same time we have to note, that this is just one of the challenges the care system is facing and it has been under such a challenges since medical profession (we can say even art) has appeared in ancient times. Since the 1960's, when John Kenneth Arrow (Arrow, 1963) and others introduced to general economists the economics of health, this discipline has become inevitable tool for everyone who wants to talk about the effectiveness of care systems in a way that tries to achieve this effectiveness under the condition of various economic environments. This has always made the economics difficult to implement, because the tools used in one country were not working well in another one, where the conditions and especially the philosophical backgrounds were different. As stated in literature, health systems differ in their design, in the amounts and types of resources they use, and in the outcomes and other results they attain. But policy makers share common goals and can learn from each other's experiences as to what works--and what does not--when making changes to systems intended to improve performance. (OECD, 2004). In this paper, I will try to emphasize and briefly go through things which are--in my point of view--the key elements of thinking about the care systems and their effectiveness in the context of longevity. First, we have to define, what the effectiveness of care systems is about. There are a lot of criteria, which could be used on this purpose. Then, the discussion of longevity impact on current social systems takes place, followed by brief assessment of Czech care system issues and implications for financing schemes settings. Given the limited scope and purpose of the paper, the issues will be presented as the general level, showing the key concepts and trends that are currently seen as important. 2. Factors and Logic of Health Care Financing Schemes The separate criteria of effectiveness could be grouped into three main categories. In this sense, we can define social, economic and medical criteria. These are the main indicators which all form the general aim--the status of particular population. This general aim is, however, one of the hardest and most key elements of care systems. Where is the problem with this aim? The problem is very much connected with the nature of society's criteria. There are basically two groups of them--the market criteria and the organizational-command criteria. None of them is perfect by itself, however, they are suitable for different situations and different purposes. The connection with status of the populations is as follows. The market criterion assumes, that demonstrating its own individual responsibility of one's health, when performed properly and by the majority of citizens, will lead to achievement of this aim, because if everybody has the care on the top of his priorities' list, the he will demonstrate this priority and thus the resource allocation to this area and market-effective behavior will prevail. The organizational-command criterion assumes, that the interest of status of the citizens is, in addition to their own due, also the thing which should be organized on the basis of solidarity and cost-effectiveness in the whole society. Moreover, this criterion emphasizes that the market alone is unable to make effective allocation because of the market failures. In this short overview, it is not possible to mention them here in detail. (2) It however means that the pure market solutions based on demand and supply simply do not work. There are various evidence of this, for example the following table, which shows expenditure characteristics of the care systems in the USA with the projection into year 2020 (and more data could be viewed at the cited source, not transferred here because of the limited scope of this paper). …
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Open Access
Sep 1, 2018
Jan Mertl 
