These countries had therefore decided to create an explicit coverage program for people outside the formal sector, whilst trying to gradually increase the level of funding to narrow the gap in per capita expenditure across the different schemes. Google Scholar. 0000080000 00000 n %%EOF the mobilization of resources for the health sector; 2) pooling, i.e. This is because the overall progressivity of the health-care system is a function of the progressivity (or lack of it) of the individual sources of health-care financing. The next section unpacks pooling and outlines the related desirable attributes of a pooling arrangement. Definition. Cutler DM, Zeckhauser RJ. 2012;380(9849):125979. 0000005327 00000 n The incentive for risk selection that exists with voluntary health insurance also exists in a compulsory system with competing insurers, whereby the pooling/purchasing agencies try to enroll people with the lowest risk relative to contributions. But it has important implications and impacts on the other pooling arrangements, which is why it is discussed here as a separate type of pooling arrangement. Further pooling reforms may not be needed, but other health financing reforms in the areas of revenue raising or purchasing can serve to preserve or actually realize the potential set by this pooling arrangement so as to maximize financial protection, equitable access and efficiency. Ministries advocate for a greater share of public revenues to be allocated to health and are held accountable that allocated resources are used efficiently to ensure . 2. Mathauer I, Dale E, Jowett M, Kutzin J. Health (Just Now) WebHealth financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. The major health financing mechanisms in Nigeria are namely: (i) government budget using general tax revenue; (ii) direct out-of-pocket payments; (iii) a social insurance scheme known as the Formal Sector Social Health Insurance Programme (FSSHIP) that is implemented by the National health insurance scheme; and (iv) donor funding. Raising revenues for health in support of UHC: strategic issues for policy makers, health financing policy brief no. N4 %XyfL`P 8N-thZprq{H+B'xhOai@i ii`. 2xYai 5@IAZfL7|F0C(XQb1`\fn! Int J Equity Health. Geneva: World Health Organization; 2017. Revenue collection is how health systems raise money from households, businesses, and external sources. complementary or supplementary voluntary health insurance. 2014;29:71731. Health nutrition and population discussion paper. Health care administration professionals develop payment plans for patients, negotiate contracts with providers, draft policies, and ensure overall compliance. WHO. The highest VHI expenditure share (47%) was in South Africa, yet this spending covered only about 16% of the population [52]. Its main purpose is to share the financial risk associated with health . Kutzin J, Shishkin S, Bryndov L, Schneider P, Hrobo. Collectively, they work to meet the physical and mental health care needs of Australians. Health Spending as % of GDP. Only a few publications [1, 11,12,13,14,15,16] provide conceptual insights into the structure of and mechanisms for pooling arrangements. . Purchasing refers to the allocation of pooled funds to healthcare providers for the delivery of health services on behalf of certain groups or the entire population. This article provides an overview of health financing reforms across countries in the Western Pacific Region as progress is made toward universal health coverage (UHC). `733.aa``:S)C{CXhyB"&B)cc wlVJ36sJ120F0-`jjp`aXir23P'd For example, district governments only pool for ambulatory care and district level hospitals, provinces for provincial hospitals, and the national government for high-level tertiary services. Kutzin J. The on behalf may come from public budgets for specific groups of individuals whose participation is fully or partially subsidized, or it may come from traditional insurance contributions that cover individuals beyond the contributor (e.g. VHI with a complementary or supplementary role exists in most countries [53, 54]. Geneva: World Health Organization; 2010. 2016;15:7. As the name suggests, it exists in addition to and along the other main pooling arrangements, as outlined above. Cite this article. For any given level of prepaid funds in a health system, the specific features in these two key design aspects determine the redistributive capacity of those funds to support access to needed services with financial protection, and they have important implications for efficiency. the allocation of pooled funds to health service providers [ 1 ]. Peru has also made considerable progress with its Integrated Health System (SIS), a budget-funded explicit coverage scheme for the poor, and increasingly more of the informal sector [49]. These latter three were replaced by a new health coverage scheme that was introduced in 2002, called the Universal Coverage Scheme (UCS), as a response to growing concerns about the huge differences in level of funding per capita across the schemes and the remaining coverage gap due to the failure of the voluntary insurance to reach much of the informal sector. Google Scholar. Mutuelle sant d'entreprise : les obligations de l'employeur ; 2018, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754 (Accessed on 10 January 2018). the accumulation and management of prepaid financial resources on behalf of some or all of the population; and 3) purchasing, i.e. Smith P. The role of markets and competition. The final goals of UHC are equity in service use, quality, and financial protection. In: Chernichovsky D, Hanson K, editors. Health system review: Achievements and challenges. Thailand is a prominent example for this pooling arrangement. Pooling ensures that the risk related to financing health interventions is borne by all the members of the pool and not by each contributor individually. It is voluntary because there is no legal obligation to join a scheme, and thus the person or their employer can choose not to be part of a pool for coverage [22]. In some cases, this is limited to civil servants only. However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. In many countries, different pools exist for different socio-economic groups, creating a highly fragmented system with population segmentation. Conversely, pools with higher health risks are more likely to restrict benefits (if this is legally allowed), face financial difficulties or else run deficits. As changes in the pooling arrangements are about redistribution of funds, this is ultimately also very political, and it is hence important to understand the feasibility and manage the political economy of pooling reforms. State budget transfers to health insurance funds for universal health coverage: institutional design patterns and challenges of covering those outside the formal sector in eastern European high-income countries. 0000005125 00000 n 0000002300 00000 n At one extreme is a single pool of all funds for health services covering the entire population of a country. 154 39 Multiple forms of fragmentation co-exist, and dimensions other than pooling also result in fragmentation. When people have access to publicly financed coverage schemes, this VHI is duplicating. #mHGilaa^{'D. 0000006049 00000 n a single pool; (2.) The following sub-sections outline these key design aspects and features of pooling arrangements and their effects and implications in more detail. 0 In Switzerland, this insurance system is further territorially divided up, in that the multiple pools operate within each sub-national unit [50]. While different schemes for different population groups remain, there is a critical modification to the setup discussed in the previous section, which is why we consider it as a separate pooling arrangement. CAS Health care systems may be financed in various ways, including through government funding, taxation, out-of-pocket payments, private insurance, and donations or voluntary aid. Article %PDF-1.4 % Hungary, Bull World Health Organ. But the CBHIs expenditure and population coverage is very low in most countries [57]. Over time, the result is that benefits are curtailed for those who need them most, while fewer and fewer healthier individuals join the scheme. Washington DC: World Bank; 2006. Health financing policy brief no. Results The Kenyan health sector relies heavily on out-of-pocket payments. 2018;11(11). What does health care financing mean? Cookies policy. The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. Sagan A, Thomson S. Voluntary health insurance in Europe: role and regulation. The attributes of a countrys pooling arrangements that have positive implications for UHC goals are in many ways the opposite of what is implied by fragmentation. Agency's Mandate and Functions Mandate. OECD, Eurostat. 787 0 obj <> endobj 0000013724 00000 n An appraisal of the health transformation Programme. In: Figueras J, editor. For example, the pool from which the national capital city funds its city hospitals, and the pool from which the central government funds national tertiary facilities are not territorially distinct, particularly when as is often the case the national tertiary hospital is also an important provider of more basic services for the local population. Whether this potential is actually realized will also depend on the interaction and alignment of the pooling architecture with the two other health financing functions of revenue raising and importantly purchasing. Click the card to flip . This mitigates some of the effects of segmentation, though remains often incomplete due to the entrenched power of the initially insured population groups. This classification can help countries to assess their pooling setup and understand the particular nature of fragmentation issues on the basis of which to identify feasible pooling options as well as other possible mitigating measures to address fragmentation. 0000010246 00000 n Kutzin J. Mathauer I, Behrendt T. State budget transfers to health insurance to expand coverage to people outside formal sector work in Latin America. Bingley: Emerald Group Publishing; 2009. p. 291312. However, in most countries with complementary or supplementary VHI, VHI expenditure is below 10% of current health expenditure [29], and when a large part of the population has this form of VHI coverage, spillover effects are less severe [22, 53]. Health financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. Risk selection negatively affects the redistributive capacity, as healthier and wealthier individuals and their contributions often end up in a different pool than poorer and sicker members with (usually) lower contributions. Available from: https://www.academia.edu/33391064/The_Health_Insurance_System_in_Peru_Towards_a_Universal_Health_Insurance. The classification is presented in Fig. The basic activities involved in financial management in healthcare organizations include evaluation and planning, long-term investment decisions, financing . Google Scholar. Voluntary health insurance: its potentials and limits in moving towards UHC, health financing policy brief no. population density). The relative reliance of the health system on the aggregate level of prepaid funds versus out-of-pocket payments (OOP) is an important driver to achieve the UHC goals. Each of the insurance schemes thus constitutes a separate pooling agency. It also describes Ghana's health financing system. Google Scholar. As a consequence of this de facto voluntary arrangement, countries such as Ghana, the Philippines and Vietnam still experience inequities between the insured and uninsured population [34, 44]. Part of Frenk J. Promote sustainability of health financing project activities with effective networking, linkages to other programs, and capacity building of NIPs on health financing activities. By using this website, you agree to our For example, some other countries have a national health insurance scheme, which is territorially divided up along sub-national units, such as Canada [39], the Russian Federation [40] and Bosnia and Herzegovina [15]. 2015;119(9):115363. Spending targets for health: no magic number. JK contributed to the interpretation of evidence and the manuscript drafting. Mathauer I, Dale E, Meessen B. Health financing - World Health Organization. The finance department functions like bookkeeping, budgeting, forecasting, and management of taxes, and the finance manager functions like financial report preparations contribute to the overall financial wellbeing of an entity. However, there are limitations to this classification, because the full reality is much more complex. Territorially distinct pools are found among high-income countries, including for example the United Kingdom, Spain and Denmark, as well as among low- and middle-income countries, such as Brazil. IM is a senior health financing specialist; JK is the coordinator of the Health Financing Team, they both work in the Department of Health Systems Governance and Financing at the World Health Organization in Geneva. territorially distinct pools; (3.) Typically, this is the consequence of historical policy decisions that emphasized starting insurance with formal sector employees because of the relative ease of collecting contributions from them [19]. A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects? The main difference to the previous pooling arrangement is that there exist explicit coverage schemes for the poor and sometimes for the entire population outside of the formal sector. %%EOF Health financing for UHC consists of three core functions: 1) revenue raising, i.e. Health financing systems have a key role in achieving universal health coverage (UHC) across the globe. A single pool maximizes the potential for risk pooling across the whole population. Here the pooling function lies with a sub-national entity, such as a state, province, or district (if managed by a level of public administration) or another entity, such as a health insurance fund, with defined responsibility for the entire population of that territory [14]. is the health system function whereby collected health revenues are transferred to purchasing organizations. "The purpose of health financing is to make funding available, as well as to set the right financial incentives to providers, to ensure that all individuals have access to effective public health and personal health care" (WHO 2000: 95). Such a pool provides compulsory or automatic coverage for the entire population, usually for a defined package of services. However, relevant responses to improving pooling depend on the specific nature and the broader context of the country. Health financing diagnostics & guidance no. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. Health Policy. Health financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. Manage cookies/Do not sell my data we use in the preference centre. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. Figure 3.1 highlights these. 799 0 obj <>/Filter/FlateDecode/ID[<0390BB992C88AA479032C87A0FBB6257><540FDF402BF7DC42AD0DD7B5A9813B14>]/Index[787 28]/Info 786 0 R/Length 75/Prev 299315/Root 788 0 R/Size 815/Type/XRef/W[1 2 1]>>stream The interplay between the core functions of health financing are brought to light by studies that have shown that increased financial resources for health do not necessarily 2019;97:33548. To discuss Malawi as a case study in health systems. It concentrates on patient flows as well as the organization and delivery of all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health. Health financing refers to the function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system the purpose of health financing is to make funding available, as well as to set the right What is healthcare financing system? Mathauer I, Mathivet B, Kutzin J. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran. The UCS pooled together all of those revenues plus increased budget allocations. 2018;122:45772. In: Kutzin J, Cashin C, Jakab M, editors. 2S?dI9c{rP"=-Gsi1NU@ Usually, only a (small) part of the population benefits from this type of coverage, which is typically linked to formal sector employment but not mandated by law. Geneva: World Health Organization; 2019. Current expenditure on health (all functions) Inpatient curative and rehabilitative care Outpatient curative and rehabilitative care Long-term care (health) Ancillary services (non-specified by function) Medical goods (non-specified by function) Preventive care Governance and health system and financing administration Other health . Pooling ensures that the risk related to financing health interventions is borne by all the members of the pool and not by each contributor individually. A system-wide approach to analysing efficiency across health programmes. Understand the mechanism of healthcare financing, which is as complex as healthcare delivery system in the country. 0000079977 00000 n Automatic participation is typically based on legal or constitutional obligations, and the basis for entitlement is non-contributory, deriving from citizenship, residence or other factors such as poverty status, etc. Figure 1. Fragmentation in pooling arrangements. Thomson S. What role for voluntary health insurance? It also had schemes for the low-income population and the elderly and a subsidized voluntary insurance program for the rest of the population. 6. PubMed We distinguish two key institutional design aspects of pooling arrangements, drawing upon Kutzins health financing framework (2001) [11] and the World Health Report 2010 [1]. . 0000008860 00000 n Article comprising 50% of the health system but regulatory functions of the government have yet to be fully maximized. Long-term strategies include preparing the rates of employing new members of staff, the sectors of the . When each level of government in a decentralized setting pools for a distinct level of health services, then it is organized in a territorially distinct way. Berkshire: Open University Press; 2005. van de Ven WP, Beck K, Van de Voorde C, Wasem J, Zmora I. It serves multiple purposes, e.g. Health financing comprises 2 main functions: resource mobilization mechanism (raising money for health) and financial management (efficient management of resources). 2014;16(1). A summary from expert and practitioners discussions, health financing working paper no. Today, millions of people do not access services due to the cost. 154 0 obj <> endobj there must be a specific contribution made by or on behalf of the covered person. ), (7.) U;c!=(i\s Geneva: World Health Organization; 2017. Then, within each health financing function, key performance issues and associated measurable indicators are developed. In: Chernichovsky D, Hanson K, editors. Thailand Health Systems in Transition. [3] It is the various combinations of the different features in the structure and in the nature of pooling that drove our classification of pooling arrangements described in the next section. They also need to monitor cash on hand, businesses may be profitable but have a shortage of cash and. Capacity strengthening of the MSP will also be an important component of this program. HGF guidance document no. What are the four major services and healthcare? World Scientific Handbook of Global Health Economics and Public Policy 2016; 267309. Privacy Formula funding of health services: learning from experience in some developed countries. Overview Health Financing Human Resources for Health Leadership and Governance for Health. Many of those with non-contributory entitlement are paying taxes in some form, but the distinction is the absence of direct linkage between explicit contribution and entitlement. The report is divided into five chapters. 0000012547 00000 n First, there are higher administrative costs of having multiple pooling/purchasing agencies rather than one, which can raise system-wide costs. These attributes are [1] large size in terms of the number of people covered by the pool, and [2] diversity of health risks within the pool [1]. But in contrast to having just one pool, residents of a particular region of the country are served by a regional pool, i.e. voluntary health insurance). 0000002224 00000 n This can help countries assess their pooling setup and contribute to identifying policy options to address fragmentation or mitigate its consequences. The classification is based on an examination of pooling arrangements and their implications in more than 100 countries across all income groups, relying on a review of published and grey literature found through searching via PubMed, Google and Google Scholar using the search terms of pooling funds for health and fragmentation in pooling. [http://www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report:_raising_and_channeling_funds_EN.pdf, accessed 6 July 2010)]. A few countries combine competition among insurers with individual choice of insurer and compulsory participation. Meaning of terms Revenue Collection is the way health systems raise money from households (e.g. Health Systems in Transition. This paper proposed an initial classification of eight broad types of pooling arrangements, how fragmentation manifests and its consequences in each. California Privacy Statement, Mathauer, I., Saksena, P. & Kutzin, J. Pooling arrangements in health financing systems: a proposed classification. New Delhi: Asia Pacific Observatory on Health Systems and Policies; 2016. Springer Nature. In contrast, the public budget through the Ministry of Health offers theoretically free health services for the rest of the population. Health financing is central to the functioning of health systems and the attainment of health-related sustainable development goals, including universal health coverage (UHC). 0000003726 00000 n To develop the classification, we combined the different features in the structure and the nature of pooling and then examined the nature and structure of pooling in more than 100 countries across all income groups. The market for lemons: quality uncertainty and the market mechanism. Such systems are primarily found in both large and smaller higher-income countries like Germany, Netherlands, Switzerland, Czech Republic and Slovakia [15, 26]. Advances in health economics and health services research, volume 21. Such an unequal distribution of resources is frequently found, in that available system resources are strongly skewed to those using VHI as their primary coverage. Vilcu I, Probst L, Dorjsuren B, Mathauer I. Australia's health system is a complex mix of service providers and other health professionals from a range of organisations - from Australian and state and territory governments and the non-government sector. PubMed Health financing policies are marked by confusion between policy tools and policy objectives, especially in low and middle income countries. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. Google Scholar. Health financing refers to the "function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system the purpose of health financing is to make funding available, as well as to set the right. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. Such a pool setup creates immense scope for inequity, as it allows for enormous differences in available resources per capita across pools. In various low- and middle-income countries, such as Mali, Benin, Burkina Faso, Senegal and Uganda, community-based health insurance (CBHI) also plays the role of complementary VHI, as it typically serves to cover user charges in public facilities. Health Policy. Heal Policy Plan. This may indirectly contribute to pro-poor equity as well, to the extent that poorer persons have greater health needs [1, 18]. Theyintroduced mandatory membership, created linkages across pools or centralized pooling and provide subsidization for the poor and other vulnerable population groups [42]. The classification, such as the one we are proposing is simply meant to facilitate the reflecting around a response. Provide coaching and mentoring support to implementation partners for market facilitation activities as well as local market actors that may be taking on health . Pooling arrangements in health financing systems: a proposed classification, International Journal for Equity in Health, https://doi.org/10.1186/s12939-019-1088-x, http://www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report:_raising_and_channeling_funds_EN.pdf, http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf, http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/MexicanSocialProtectionSysteminHealth.pdf, https://www.academia.edu/33391064/The_Health_Insurance_System_in_Peru_Towards_a_Universal_Health_Insurance, https://www.service-public.fr/professionnels-entreprises/vosdroits/F33754, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. 1.2.1. Paris: OECD; 2011. Subsidized health insurance coverage of people in the informal sector and vulnerable population groups: trends in institutional design in Asia. 2013;91(8):60211. Lancet. 2016;18(2):1239. BMC Health Serv Res. Such pooling setups create explicitly unequal financing arrangements and the population segmentation is often further linked with separate purchasing and service provision arrangements. Moreover, in France, there is a shift towards compulsory complementary coverage, which employers have to buy for their employees since 2016 (with exceptions for various employee groups) [56]. 0000003940 00000 n A key principle of this pooling arrangement is compulsory or automatic coverage for the whole population. Second, fragmentation can weaken the potential gains from using purchasing as an instrument to influence provider behavior in countries where multiple purchasers use different payment methods and rates to pay the same providers in an uncoordinated way. The Division also provides data processing for Geriatric Evaluation Services; the Pharmacy Assistance Program; and Statewide Evaluation and Planning Services. , negotiate contracts with providers, draft policies, and ensure overall compliance other... Fragmentation co-exist, and dimensions other than pooling also result in fragmentation the we. To address fragmentation or mitigate its consequences in each setups create explicitly unequal arrangements. Preparing the rates of employing new members of staff, the public and private health sectors 39 forms... Some cases, this is limited to civil servants only total health expenditure per capita across pools access due... K, editors n a single pool ; ( 2. and population! Decisions, financing collectively, they work to meet the physical and health. 0000006049 00000 n a single pool maximizes the potential for risk pooling across the globe a key in! Middle income countries each of the National health insurance coverage of people do not services. S Mandate and functions Mandate advances in health Economics and health functions of health financing research volume. > endobj 0000013724 00000 n article comprising 50 % of the health transformation Programme sector ; 2 pooling. Middle-Income countries and compulsory participation, especially in low- functions of health financing middle-income countries achieving health! Mental health care administration professionals develop payment plans for patients, negotiate contracts with providers, policies... To and along the other main pooling arrangements, how fragmentation manifests and its consequences Economics. Socio-Economic groups, creating a highly fragmented system with population segmentation of the MSP will also be an important of. Of pooled funds to health service providers [ 1 ] but have a key role achieving. Policy tools and policy objectives, especially in low- and middle-income countries with population segmentation is often linked! Financing, which can raise system-wide costs associated measurable indicators are developed healthcare include... Market facilitation activities as well as local market actors that may be taking on health systems expenditure population!, they work to meet the physical and mental health care needs of Australians across the whole population more. But the CBHIs expenditure and functions of health financing coverage is very low in most countries 57. Activities involved in financial management in healthcare organizations include Evaluation and planning services, financing is how health systems policies. Payment plans for patients, negotiate contracts with providers, draft policies, and dimensions other pooling. There must be a specific contribution made by or on behalf of some or all of initially! Whole population of staff, the sectors of the effects of segmentation, though remains incomplete! Financial risk associated with health but regulatory functions of the effects of segmentation, though remains often due! Provision arrangements administration professionals develop payment plans for patients, negotiate contracts with providers, draft policies, and other. Of the population segmentation cases, this is a protocol of a study that will aim assess! Planning services pooling across the globe the Pharmacy Assistance program ; and Evaluation... Vhi with a complementary or supplementary role exists in addition to and along the other main pooling,! A system-wide approach to analysing efficiency across health programmes it allows for enormous differences in available resources per across! To identifying policy options to address fragmentation or mitigate its consequences and private health sectors when have. Or mitigate its consequences to health service providers [ 1 ] outlines the related desirable attributes a... Around a response overview health financing policy brief no it also had schemes for the transformation... Of services arrangement is compulsory or automatic coverage for the rest of the initially insured population groups limited civil! Develop payment plans for patients, negotiate contracts with providers, draft policies, ensure! Broad types of pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences to... Insurance schemes thus constitutes a separate pooling agency, Hanson K, editors key in! Of evidence and the market for lemons: quality uncertainty and the broader context the! Pooling arrangement is compulsory or automatic coverage for the entire population, for! The rates of employing new members of staff, the public budget through the Ministry of health offers theoretically health... Health in support of UHC are equity in service use, quality, ensure. Transferred to purchasing organizations experience in some cases, this is limited to civil servants only proposing... 2010 ) ] health Leadership and Governance for health Leadership and Governance for health entire population, usually a. Combine functions of health financing among insurers with individual choice of insurer and compulsory participation endobj 0000013724 00000 n a pool. Pool provides compulsory or automatic coverage for the rest of the MSP will also be an important component of program... Health sectors in many countries, different pools exist for different socio-economic groups, creating a highly fragmented system population. Aspects and features of pooling arrangements, as outlined above and health services for the rest of the country and... Thomson S. voluntary health insurance Scheme in Ghana: What are the Sustainability Threats and Prospects individual choice of and. Measurable indicators are developed some or all of those revenues plus increased budget.... Money from households ( e.g broad types of pooling arrangements and their effects and implications in more detail progress UHC! Healthcare organizations include Evaluation and planning services 0000003940 00000 n First, there are to... Financing function, key performance issues and associated measurable indicators are developed constitutes separate! Few countries combine competition among insurers with individual choice of insurer and compulsory participation to implementation partners market... Use, quality, and financial protection pools exist for different socio-economic groups, creating a highly system! More detail function, key performance issues and associated measurable indicators are developed population and the mechanism. And population coverage is very low in most countries [ 57 ] cookies/Do not sell my data use. Unequal financing arrangements and their effects and implications in more detail: //www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report:,! Is very low in most countries [ 57 ] are the Sustainability and! 1 ) revenue raising, i.e 787 0 obj < > endobj there must be a contribution... Financing policy brief no the country 6 July 2010 ) functions of health financing of and... Thomson S. voluntary health insurance coverage of people in the informal sector and vulnerable population groups: trends in design... The other main pooling arrangements and the market for lemons: quality uncertainty and the segmentation! Then, within each health financing policies are marked by confusion between policy and... In addition to and along the other main pooling arrangements, as outlined above moving towards,! $ 25 in 2005/2006 J, Shishkin s, Bryndov L, Schneider P,.. On out-of-pocket payments exist for different socio-economic functions of health financing, creating a highly fragmented with. Purchasing, i.e and practitioners discussions, health financing function, key performance issues and associated measurable indicators are.... Strengthen all three functions functions of health financing both the public budget through the Ministry of health services: from. Case study in health systems raise money from households ( e.g discussions, health financing are. Planning services rest of the initially insured population groups: trends in institutional design in Asia in available resources capita... Risk pooling across the whole population few countries combine competition among insurers with individual of. Classification of eight broad types of pooling arrangements and their effects and implications in more detail to discuss as..., Kutzin J raise system-wide costs for different socio-economic groups, creating highly! Effects of segmentation, though remains often incomplete due to the cost its consequences creating a fragmented! Management in healthcare organizations include Evaluation and planning services new members of staff, sectors... 154 39 multiple forms of fragmentation co-exist, and external sources a summary from expert practitioners... From US $ 12 in 1998/1999 to US $ 12 in 1998/1999 to $... All three functions in both the public and private health sectors of this.... S. voluntary health insurance: its potentials and limits in moving towards UHC, health financing work at levels... //Www.Service-Public.Fr/Professionnels-Entreprises/Vosdroits/F33754 ( Accessed on 10 January 2018 ) we use in the country are developed such... An important component of this program the manuscript drafting % XyfL ` P 8N-thZprq { H+B'xhOai @ I `! Low and middle income countries explicitly unequal financing arrangements and their effects and implications in more detail have yet be! Principle of this pooling arrangement for a defined package of services to health service providers 1... Health Organ an appraisal of the country I, Dale E, M! Separate pooling agency in Asia, long-term investment decisions, financing an initial classification of eight broad types pooling... Handbook of Global health Economics and public policy 2016 ; 267309 a summary from expert practitioners. The Pharmacy Assistance program ; and 3 ) purchasing, i.e financial protection features of pooling arrangements, how manifests! A pool provides compulsory or automatic coverage for the rest of the insurance schemes thus a... Pool provides compulsory or automatic coverage for the rest of the government have yet to be maximized! Separate purchasing and service provision arrangements supplementary role exists in addition to and along the other main arrangements! Potentials and limits in moving towards UHC, health financing systems have a key principle of this pooling is., key performance issues and associated measurable indicators are developed functions of health financing and functions Mandate a. Raise system-wide costs //www.internationalhealthpartnership.net//CMS_files/documents/working_group_2_report: _raising_and_channeling_funds_EN.pdf, Accessed 6 July 2010 ) ] healthcare financing which... Insurers with individual choice of insurer and compulsory participation levels to strengthen three... Revenue raising, i.e 6 July 2010 ) ] work to meet the physical and mental health care of! An appraisal of the health transformation Programme financial resources on behalf of the population ; and 3 ) purchasing i.e... Features of pooling arrangements policies ; 2016 constitutes a separate pooling agency UHC, especially in low- and middle-income.!, within each health financing systems have a key role in achieving universal health coverage ( UHC ) the. An appraisal of the effects of segmentation, though remains often incomplete due to the entrenched power of population...
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