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Different categories of services present different policy issues for financing health care. This conceptual paper suggests four categories: (1) public health services for the entire population; (2) basic health care to individuals, where anticipated costs are small and relatively homogeneous; (3) potentially catastrophically expensive services to individuals, where costs are skewed but not predictable; and (4) potentially catastrophically expensive services to individuals, where anticipated costs are both skewed and predictable. Using Canadian and Manitoba data to illustrate some implications of the distribution of health expenditures, we suggest policies suitable for one category of services may not necessarily work for others. The small proportion responsible for incurring high health expenditures are not attractive candidates for voluntary risk pools, particularly in competitive markets. [ABSTRACT FROM AUTHOR]

This paper examines health-care spending projections when the interaction between end-of-life care expenditures and declining mortality is taken explicitly into account. Based on Quebec's historical public health-care spending data and mortality rates for 20 age groups over the period 1998 to 2009, an econometric model is developed with the aim of differentiating 'ordinary' health-care spending from end-of-life care expenditures. Numerical simulations reveal that the average annual growth rate of future health-care spending projected over the period 2009-2056 diminishes by about 0.19 to 0.23 percentage points. This implies a cumulative health-care savings of about 8.4 to 10.3 percent in 2056, independent of other health-related factors. [ABSTRACT FROM AUTHOR]