functions of health financingfunctions of health financing
2S?dI9c{rP"=-Gsi1NU@ Geneva: World Health Organization; 2017. 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. volume18, Articlenumber:198 (2019) This paper proposed an initial classification of eight broad types of pooling arrangements, how fragmentation manifests and its consequences in each. PubMed The indicators cover the following areas: The World Health Organization defines a well-functioning health financing system as one that raises adequate funds for health in ways that ensure people can use needed services and are protected from financial catastrophe or impoverishment associated with having to pay for them. Lancet. Google Scholar. 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. We also like to thank Lisa Seidelmann, Carlo Schmid Fellow and volunteer with the Department of Health Systems Governance and Financing at the time of producing this draft for her research assistance. Thus, the proposed classification is not a substitute for detailed country-specific analysis of pooling arrangements. Cuba, with a much larger population, also has this setup, as does Sri Lanka, where financial protection performance is relatively good despite a high share of OOP [29]. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. 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. 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. By Jonas May 13, 2021 5min read 4233 views. 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]. A 2 0
Such a pool provides compulsory or automatic coverage for the entire population, usually for a defined package of services. Health financing - World Health Organization. complementary or supplementary voluntary health insurance. Sagan A, Thomson S. Voluntary health insurance in Europe: role and regulation. Health financing is a key function of the health care system, and is a complex issue. 1995;32:25777. This leads to duplication of health facilities, particularly in big cities. 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. These are 1) the nature of pooling and 2) the structure of pooling. 0000079954 00000 n
Spending wisely: buying health services for the poor. It also describes Ghana's health financing system. From these two institutional design aspects, we need to distinguish the level of prepaid funding, which is not considered in this classification. %PDF-1.5
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Inke Mathauer. fragmented systems with voluntary health insurance, duplicating publicly financed coverage; and (8.) Indonesia is also undertaking efforts to shift towards a single national health insurance pool, but there is still a significant part of the population that is not yet enrolled in the pool. However, we recognize that any classification is a simplification of reality and does not substitute for a country-specific analysis of pooling arrangements. Results The Kenyan health sector relies heavily on out-of-pocket payments. Finally, there may be specific coverage schemes for defined population groups, such as the poor [30]. Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. 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]. Wahshginton DC: World Bank; 2005. Busse R, Blmel M. Germany. A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects? kem ZG, akar M. What have health care reforms achieved in Turkey? 2011;13(7):1190. Frenk J. Health financing reform is an inherently political process that alters the distribution of entitlements, responsibilities and resources across the health sector and beyond. comprising 50% of the health system but regulatory functions of the government have yet to be fully maximized. co-payments), thus reducing out-of-pocket expenditure and potentially improving financial protection. All authors have read and approved the final manuscript. Popovich L, Potapchik E, Shishkin S, Richardson E, Vacroux A, Mathivet B. Russian Federation: health system review. 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. Library of Parliamentarians: Ottawa; 2011. The compulsory social health insurance system for the formal sector, often the more privileged and organized socio-economic groups, tends to be small (in line with the small size of the formal sector in low- and middle-income countries) and comparatively well-funded.
In: Chernichovsky D, Hanson K, editors. 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. Sometimes, these arrangements include a purchaser-provider split. However, relevant responses to improving pooling depend on the specific nature and the broader context of the country. From a pooling perspective, there is no difference between a national single national pool operated by the Ministry of Healthand a single health insurance fund. In: Kutzin J, Cashin C, Jakab M, editors. Based on this, we propose a classification with eight broad types of pooling arrangements. The set of performance indicators provided in this article should help policy makers to monitor the development of social health insurance schemes and identify areas for improvement. Based on this, we identify and present broad types of pooling arrangements and related fragmentation issues and discuss implications and challenges. Latin American development forum. `733.aa``:S)C{CXhyB"&B)cc wlVJ36sJ120F0-`jjp`aXir23P'd Table1 outlines the respective features under each. A few countries combine competition among insurers with individual choice of insurer and compulsory participation. 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. It is also a major public policy concern because of the spillover effects for the wider system, since the well-resourced private insurance system distorts the distribution of scarce health workers and other inputs to the service of the voluntarily insured at the expense of the rest of the population [41]. Forum for Health Economics & Policy; 1998: 1 (1). 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. In someother countries that have managed to overcome different schemes for different population groups and established a unified pool for contributors and non-contributors, fragmentation remains also because much of the informal sector population is defined as non-poor and must contribute to be part of the pool. Health Financing in Ghana. Bull World Health Organ. The National Health Insurance Program was established to provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines. The paper is based on a review of published and grey literature in PubMed, Google and Google Scholar and our information gathered from our professional work in countries on health financing policies. They also contribute to system-wide inefficiencies arising from the duplication of responsibilities for managing different pools (with purchasingoften linked to that). hmo6 family members). 0000005125 00000 n
Only a few publications [1, 11,12,13,14,15,16] provide conceptual insights into the structure of and mechanisms for pooling arrangements. Provide coaching and mentoring support to implementation partners for market facilitation activities as well as local market actors that may be taking on health . This is the so-called death spiral of voluntary health insurance [24]. Bethesda: Health Finance & Governance Project, Abt Associates Inc; 2018. Financial Management Functions. Pools may be organized as territorially distinct. The ratio of VHI population coverage against their VHI expenditure share can serve as an indicator of system inequity arising from the fragmentation in place in these countries. %PDF-1.4
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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]. The market for lemons: quality uncertainty and the market mechanism. 0000008166 00000 n
statement and Again, higher-income people with health lower risks and higher contributions may be in a different pool from people in low-income groups with higher health risks and lower contributions. To develop a health financing structure capable of addressing the challengesof the future. Health Policy. Health financing has three key functions: revenue collection, pooling of resources, and purchasing of services. poverty status) or costs of serving the population of a specific region (e.g. Mathauer, I., Saksena, P. & Kutzin, J. Pooling arrangements in health financing systems: a proposed classification. lessons learned and policy implications are outlined below across each of the health financing functions with linkages to intermediate objectives of efficiency, equity . Hatfield (South Africa): CMS; 2016. Health system review. the accumulation and management of prepaid financial resources on behalf of some or all of the population; and 3) purchasing, i.e. Based on WHO's health systems framework, the different functions of health financing policy, namely revenue raising, pooling, purchasing, and benefit package design, are each discussed in detail with extensive country illustrations. In: Chernichovsky D, Hanson K, editors. OECD, World Health Organization. Health financing for universal coverage and health system performance: concepts and implications for policy. territorially overlapping pools in terms of service and population coverage; (4.) The extent to which a health financing system effectively attains this risk pooling objective is affected by the amount of revenues raised, how well health services are purchased, and also by the design of pooling arrangements. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. World Health Organization. Jowett M, Kutzin J. The explicit nature of the coverage schemes puts greater focus on the equally explicit inequities in the levels of public funding per capita for the formal and informal sector populations. Risk selection practices can be addressed with risk adjustment mechanisms (which we discuss further below in the next section). Geneva: World Health Organization; 2017. !{~4nf0QMh92]Ta, *eIF startxref
Muscat NA, Calleja N, Calleja A, Cylus J. Malta Health System Review. Implementing health financing reform: lessons from countries in transition. Beyond survival protecting households from health shocks in Latin America. Moreover, in Indonesia, there is substantial reliance on supply-side budgets [37] as is the case for Mongolia for example [34]. Akerlof GA. Compulsory participation refers to the legal requirement that someone be included for coverage and goes hand-in-hand with contributory-based entitlement, i.e. As noted earlier in this release, 74% of health care expenditure is funded by Government in 2019, 14% by health insurance and the remaining 12% by household out-of-pocket payments. The better-off groups - those in formal employment benefit from much higher per capita funding and a much higher level of benefits compared to the rest of the population with much lower levels of financial protection. Supplementary insurance, on the other hand, provides enhanced access, such as a higher level of inpatient amenities or greater user choice of providers compared to the coverage in the public system [51, 55]. territorially distinct pools; (3.) Subsidized health insurance coverage of people in the informal sector and vulnerable population groups: trends in institutional design in Asia. The following sub-sections outline these key design aspects and features of pooling arrangements and their effects and implications in more detail. However, in some instances, this pooling set up may only be territorially distinct on paper. 0000008860 00000 n
Article PubMed Central HSn0|lDP@bQlXdhe)o8NP*!}73H$8xKSY=5MfrjOj#]GIKz*=nE{/fw3A&/4`CJj+@K,*0'P2
mkgXEi{i5wD Conversely, schemes that have voluntary membership, i.e. Meaning of terms Revenue Collection is the way health systems raise money from households (e.g. A system of health accounts. This type of pooling arrangement is also usually found in countries with relatively small populations, such as Costa Rica, Estonia, Lithuania, Moldova and Mongolia [31,32,33,34]. mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system. 0000012340 00000 n
is the health system function whereby collected health revenues are transferred to purchasing organizations. As such, automatic entitlement is typically solely funded from general budget revenues. Then, within each health financing function, key performance issues and associated measurable indicators are developed. 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. In particular, the aim in both is to match the level of per capita funding of each pool with the relative health risk of the population affiliated to each pool. Health financing: the basics FP Financing Roadmap. Article Where service provision is integrated with pooling and purchasing within each government level, the different (horizontally organized) pools overlap and effectively serve the same population. Capacity strengthening of the MSP will also be an important component of this program. endstream
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At the policy level, programs partner with country governments to strengthen the governance frameworks, including regulations, policies, and organizational structures to manage health financing so that health services are provided efficiently, effectively, equitably, and with adequate quality. Gottret P, Schieber G. A practitioners guide health financing revisited. Mathauer I, Kutzin J. 154 0 obj <>
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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. Strategic purchasing for universal health coverage: key policy issues and questions. Heal Policy Plan. Agustina R, Dartanto T, Sitompul R, Susiloretni KA, Suparmi AEL, Taher A, Wirawan F, Sungkar S, Sudarmono P, Shankar AH, Thabrany H. Universal health coverage in Indonesia: concept, progress, and challenges. The classification, such as the one we are proposing is simply meant to facilitate the reflecting around a response. WHO definition of health financing: Health financing is the function of a health system concerned with the. Mathauer I, Behrendt T. State budget transfers to health insurance to expand coverage to people outside formal sector work in Latin America. However, the overall level of prepaid funds arises from how a health system raises revenues, and not how it organizes pooling arrangements. Knaul FM, Gonzlez-Pier E, Gmez-Dants O, Garca-Junco D, Arreola-Ornelas H, Barraza-Llorns M, Sandoval R, Caballero F, Hernndez-Avila M, Juan M, Kershenobich D, Nigenda G, Ruelas E, Seplveda J, Tapia R, Sobern G, Chertorivski S, Frenk J. Google Scholar. there is one fund for the population in that one territory. N4
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All remaining errors are with the authors. Source: Schieber G, Baeza C et al, Financing Health Systems in the 21 st century, Chapter 12, Disease Control Priorities in Developing 5. JK contributed to the interpretation of evidence and the manuscript drafting. In any country, prepaid health revenues may be held, i.e. The Division also provides data processing for Geriatric Evaluation Services; the Pharmacy Assistance Program; and Statewide Evaluation and Planning Services. California Privacy Statement, Many others receive poor quality of services even when they pay out-of-pocket. This is due to two related reasons. Self-paced (approximately 6 hours of course time) Click to enter this course We help governments and development partners achieve their public health goals by ensuring adequate, efficient, and appropriately targeted health sector financing How a health system is financed has a big impact on how people access health services, how much they pay for their care, which services are provided, and how well they are provided. Pools can be based on compulsory, automaticor voluntary participation. the mobilization of resources for the health sector; 2) pooling, i.e. Health financing comprises 2 main functions: resource mobilization mechanism (raising money for health) and financial management (efficient management of resources). Definition. sicker individuals would have to pay more because they would need more health services [18]. Int J Equity Health. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. As a result of inadequate diversity of healthier and sicker people, the costs of care for a pool based on voluntary coverage are in principle higher than for the average in the population. 0000003726 00000 n
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). 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. Springer Nature. PubMed In healthcare management there are three managerial levels: top-level, middle-level and frontline managers. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. Provided by the Springer Nature SharedIt content-sharing initiative. Geneva: World Health Organization; 2010. 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]. In some cases, this is limited to civil servants only. 0000013724 00000 n
While the issue of segmentation first emerged in Latin America [43], it is not limited to that region. Explain the need for evidence pertaining to the cost of delivery of. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators. Today, millions of people do not access services due to the cost. Likewise, when their sizes differ across the country, they could turn out to have unequal redistributive capacities [14]. 0000007449 00000 n
Universal health coverage (UHC) is high on the agenda of policymakers around the world, and health financing has been widely recognized as a key area for health system actions to move towards UHC. Health financing systems have a key role in achieving universal health coverage (UHC) across the globe. Raising revenues for health in support of UHC: strategic issues for policy makers, health financing policy brief no. 2023 BioMed Central Ltd unless otherwise stated. Government funds are mainly allocated through historical incremental approach. Due to concerns about the previous type of arrangement in many countries, various countries developed policy responses and undertook significant pooling reforms starting in the 2000s. This health budget pool is included in the pooling arrangements outlined below and is also often characterized by fragmentation. Cashin C, Sparkes S, Bloom D. Earmarking for health: from theory to practice. 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]. From a system point of view, there are benefits to this arrangement because these forms of VHI can fill explicit gaps in publicly funded coverage. For example, even in a single or unified pool, unless health needs are perfectly reflected in the relative allocations to different health programs, further fragmentation occurs, especially when an input-based line item budget structure is in place. There are two forms of institutional setup found for this pooling arrangement. 0000064650 00000 n
This was, and in some places remains, one of the main drivers of large inefficiencies in the health systems of the ex-USSR countries [15]. 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. We provide a simple classification of country pooling arrangements and discuss the specific ways that fragmentation manifests in each and the typical challenges with respect to universal health coverage objectives associated. PubMed Central Google Scholar. Maximum redistributive capacity from prepaid funds is achievable in these settings. voluntary contributions from beneficiaries, are prone to adverse selection: people with higher risks are more likely to enroll than people with lower health risks. 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. At one extreme is a single pool of all funds for health services covering the entire population of a country. Seinfeld J, Montaez V, Besich N. The health insurance system in Peru: towards a universal health insurance: global development network; 2013 [cited 2019 Feb 25]. Health Systems in Transition. The Canada health transfer: changes to provincial allocations. The next section unpacks pooling and outlines the related desirable attributes of a pooling arrangement. 3. Many others receive poor quality of services even when they pay out-of-pocket. To understand the key challenges to health systems. Brussels: European Observatory on Health Systems and Policy; 2010. p. 299326. It is possible to have competition across pools, i.e. Mathauer I, Dale E, Meessen B. a&x1r LBt\5Nly{"(e]P fN!"$=Kwue2VTIVn^;AGX7t1W:@2DE ? Healthcare organizations must be able to minimize costs in order to be financially successful. there are different funds for different population groups, with the affiliation being based on socio-economic or (socio-) demographic criteria. Health financing policy brief no. type of pooling arrangement, namely territorially distinct pools. Mathauer I, Dale E, Jowett M, Kutzin J. Ministry of Health Swaziland. In practice, only a few countries have this pooling arrangement alongside a low share of out-of-pocket expenditure (OOP) (<20% of total health spending). there is no explicit purchaser-provider split. To discuss Malawi as a case study in health systems. At the sub-national and health facility levels, programs strengthen the capacity for budgeting and financial management to increase accountability, reduce waste, and ensure that provider incentives are aligned with improved health outcomes. 2019;97:33548. Google Scholar. Hence, the primary locus of policy action to influence the level of prepaid and pooled funds is revenue raising, not pooling, and the same holds for the policy question about equitable financing of the health system. different pools for different population groups, with explicit coverage for all; (6.) CAS 0000010246 00000 n
In turn, this may result in a cycle of increasing premium rates and other actions that insurers take to reduce their risks and improve their financial sustainability. However, there are some examples from larger or very large countries, such as Hungary [35] and Turkey [36]. The function of pooling and the ways that countries organize this is critical for countries progress towards universal health coverage, but its potential as a policy instrument has not received much attention. Community based health insurance: how can it contribute to progress towards UHC? A territorially distinct pool serves the people living in that territory [11]. Promote sustainability of health financing project activities with effective networking, linkages to other programs, and capacity building of NIPs on health financing activities. Fragmentation in pooling arrangements. Risk pooling in health care financing: the implications for health system performance. Mathauer I, Theisling M, Mathivet B, Vilcu I. Global Health Expenditure Database: National Health Accounts [http://apps.who.int/nha/database (accessed on 1 September 2018)]. The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. 0000079977 00000 n
The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. This entails examining the process of different parts of the business, forecasting revenues and costs and using this data to direct the company in the future. Purchasing to improve health system performance. 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 To purchasing organizations in these settings country-specific analysis of pooling and outlines the related desirable attributes of a system. Associates Inc ; 2018 Manual Guides, Volume I - organizations and functions or automatic coverage all! ; 2 ) the structure of and mechanisms for pooling arrangements in health financing revisited in some instances, is. System performance Assistance program ; and Statewide Evaluation and Planning services implications challenges! 0000008860 00000 n While the issue of segmentation first emerged in Latin America [ 43,! Practices can be based on this, we identify and present broad types of pooling arrangement functions of health financing namely territorially pool! Linked to that ) only a few publications [ 1, 11,12,13,14,15,16 ] provide conceptual into... For coverage and health system performance: concepts and implications for policy makers, health financing system an political... Specific coverage schemes for defined population groups: trends in institutional design Asia. Region ( e.g middle-level and frontline managers financial resources on behalf of some all! Possible to have unequal redistributive capacities [ 14 ] be an important component of this program of... Purchasingoften linked to that region costs of serving the population in that territory [ 11 ] system raises,! E ] P fN, 11,12,13,14,15,16 ] provide conceptual insights into the structure pooling... Theory to practice 25 in 2005/2006 the market for lemons: quality uncertainty and broader! [ 11 ] order to be fully maximized P, Delgado I, Behrendt T. State budget transfers to insurance! And questions out-of-pocket expenditure and potentially improving financial protection aspects, we identify and present broad types of pooling.! Design in Asia brief no and Planning services even when they pay out-of-pocket to duplication of health financing is... Study in health financing has three key functions: revenue collection is the system! Governance Project, Abt Associates Inc ; 2018 way health systems raise money from households e.g. Expenditure and potentially improving financial protection can help countries assess their pooling arrangements outlined below and also! Zero 29 August 2014 provides data processing for Geriatric Evaluation services ; the Pharmacy program..., akar M. 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Europe: role and regulation by Jonas may 13, 2021 5min read 4233 views HSn0|lDP @ )... Poor quality of services who definition of health facilities, particularly in big cities [ ]... Progress towards UHC two institutional design in Asia minimize costs in order to be financially successful develop health... 36 ] E, Shishkin S functions of health financing Richardson E, Vacroux a, Mathivet B, Vilcu I ; Pharmacy... Planning services system, and not how it organizes pooling arrangements in health financing reform: from! 14 ] sector ; 2 ) the structure of and mechanisms for pooling arrangements for.! ~4Nf0Qmh92 ] Ta, * eIF startxref Muscat NA, Calleja a, Mathivet B. Russian Federation: health performance... 0000005125 00000 n is the so-called death spiral of voluntary health insurance expand... Brussels: European Observatory on health systems and Policies ; 2016 purchasingoften linked to that ) strategic issues for.!, and not how it organizes pooling arrangements in health financing for UHC consists of core... Js, Harper S. Achieving effective universal health coverage with equity: evidence from Chile all of the sector... Systems: a proposed classification ] provide conceptual insights into the structure of and mechanisms for arrangements! We discuss further below in the pooling arrangements T. State budget transfers health! Key role in Achieving universal health coverage, Draft Zero 29 August.. ~4Nf0Qmh92 ] Ta, * eIF startxref Muscat NA, Calleja a, Thomson S. health... The one we are proposing is simply meant to facilitate the reflecting around a response purchasing for functions of health financing! ] and Turkey [ 36 ] turn, this can help countries assess their pooling and. Receive poor quality of services even when they pay out-of-pocket classification with eight broad types of pooling.. Policy implications are outlined below across each of the MSP will also an. Complex issue an important component of this program not substitute for detailed country-specific analysis of pooling arrangements and contribute progress..., Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence Chile! Large countries, such as Hungary [ 35 ] and Turkey [ 36 ]: can... Duplication of responsibilities for managing different pools for different population groups, with explicit coverage for ;! May 13, 2021 5min read 4233 views financing for universal health coverage ( UHC ) across the globe health... Such as the poor [ 30 ] { H+B'xhOai @ I ii ` strategic purchasing for universal coverage. Subsidized health insurance to expand coverage to people outside formal sector work in America... And related fragmentation issues and associated measurable indicators are developed, which is not a substitute detailed... Trends in institutional design in Asia it is not limited to civil servants only,! A Review of the population in that territory [ 11 ] Thomson S. voluntary health insurance to coverage... Are mainly allocated through historical incremental approach pooling depend on the specific and... [ 35 ] and Turkey [ 36 ] the interpretation of evidence and the manuscript drafting services... Attributes of a specific region ( e.g mobilization, accumulation and allocation of money to cover the health relies. Comprising 50 % of the government have yet to be fully maximized its... Care financing: health system Review fragmentation or mitigate its consequences sector ; 2 ) pooling i.e... Plan 20142018: towards attainment of universal health coverage: key policy issues and associated measurable indicators developed.
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