A fuzzy logic approach toward solving the analytic enigma of health system financing

Dov Chernichovsky, Arkady Bolotin, David De Leeuw

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Improved health, equity, macroeconomic efficiency, efficient provision of care, and client satisfaction are the common goals of any health system. The relative significance of these goals varies, however, across nations, communities and with time. As for health care finance, the attainment of these goals under varying circumstances involves alternative policy options for each of the following elements: sources of finance, allocation of finance, payment to providers, and public-private mix. The intricate set of multiple goals, elements and policy options defies human reasoning, and, hence, hinders effective policymaking. Indeed "health system finance" is not amenable to a clear set of structural relationships. Neither is there a universe that can be subject to statistical scrutiny: each health system is unique. "Fuzzy logic" models human reasoning by managing expert knowledge" close to the way it is handled by human language. It is used here for guiding policy making by a systematic analysis of health system finance. Assuming equal welfare weights for alternative goals and mutually exclusive policy options under each health-financing element, the exploratory model we present here suggests that a German-type health system is best. Other solutions depend on the welfare weights for system goals and mixes of policy options.

Original languageEnglish
Pages (from-to)158-175
Number of pages18
JournalEuropean Journal of Health Economics
Issue number3
StatePublished - 22 Oct 2003


  • Expert knowledge
  • Fuzzy logic
  • Health system finance
  • Macroeconomic efficiency
  • Public-private mix

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy


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