Alternatively, in a non-competitive arrangement, people could be assigned to specific pools, with enrollment being based on explicit criteria, so that the different pools cannot compete for beneficiaries [11]. Preker A, Langenbrunner J. National health expenditures are derived from government and non-government sources and are used to finance a wide array of programs and services. Policy note. 0000006049 00000 n Territorially distinct pools have much in common with a single national pool. As you can see, out-of-pocket or fee-for-service, government budget, or insurance agencies are all means of purchasing health care from providers. 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]. Correspondence to 2011;13(7):1190. (&9~4y4no74d4J+2 ;RVbL|rSN /-`X/qggmzQV8rd pvr\HUc. health financing functions and objectives . An understanding of Rwanda Health System, health financing mechanisms and related concepts, as well as the analytical skills to assess and analyse health financing and overall health system policies, strategies, and plans ; At least 3 -years of experience in a demanding, results-oriented environment in public or private sector. Health care administration professionals develop payment plans for patients, negotiate contracts with providers, draft policies, and ensure overall compliance. A system of health accounts. management and disbursement for financing the availment of a basic minimum package and other . A system-wide approach to analysing efficiency across health programmes. 0000080000 00000 n Forum for Health Economics & Policy; 1998: 1 (1). In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. World Health Organization. #mHGilaa^{'D. This is followed by an outlineof the key institutional design aspects of pooling arrangements and how these can create fragmentation. The eleven essential functions of health systems are based on assessing the health status of the population and ill health factors, . Global Health Expenditure Database: National Health Accounts [http://apps.who.int/nha/database (accessed on 1 September 2018)]. Risk selection practices can be addressed with risk adjustment mechanisms (which we discuss further below in the next section). the allocation of pooled funds to health service providers [ 1 ]. This health budget pool is included in the pooling arrangements outlined below and is also often characterized by fragmentation. 1 / 64. This has an adverse impact on equity in resources across pools. . PubMed &E ^3d``}'|W>(G6062q0K x48XiFf uH30~z*F% L{ 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. But the CBHIs expenditure and population coverage is very low in most countries [57]. They also need to monitor cash on hand, businesses may be profitable but have a shortage of cash and. 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. 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. In turn, this can help countries assess their pooling arrangements and contribute to identifying policy options to address fragmentation or mitigate its consequences. As such, this type of pooling arrangement, if and when it has an effective risk adjustment mechanism that deters risk selection efforts, can act as a virtual single pool (due to the flows between the pools). Wahshginton DC: World Bank; 2005. 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. Such pooling setups create explicitly unequal financing arrangements and the population segmentation is often further linked with separate purchasing and service provision arrangements. View below: When viewing on a desktop, maximize for optimized view. 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. The report is divided into five chapters. 8. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Akerlof GA. 154 39 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]. A desciptive framework for country-level analysis for health care financing arrangements. Even in countries with highly centralized pooling, there are usually several pools of funds that are used to pay for some health services, for example occupational health programs, supply-side funding for other government services such as those delivered through vertical programs or voluntary health insurance [1]. [http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf. Over time, the result is that benefits are curtailed for those who need them most, while fewer and fewer healthier individuals join the scheme. Google Scholar. 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. Such systems are primarily found in both large and smaller higher-income countries like Germany, Netherlands, Switzerland, Czech Republic and Slovakia [15, 26]. sicker individuals would have to pay more because they would need more health services [18]. By using this website, you agree to our (Accessed on 25 February 2018)]. Community based health insurance: how can it contribute to progress towards UHC? This makes it affordable to them and addresses the inequity concerns that come along with complementary health insurance [53]. Taskforce on Innovative International Financing for Health Systems. 0000008166 00000 n Long-term strategies include preparing the rates of employing new members of staff, the sectors of the . Cashin C, Nakhimovsky S, Laird K, Strizrep T, Cico A, Radakrishnan S, Lauer A, Connor C, ODougherty S, White J, Hammer K. Strategic health purchasing Progress: a framework for policymakers and practitioners. Discussion paper. Innovations in Health System Finance in Developing and Transitional Economies. When pooling also follows the countrys administrative structure, the mandates for service coverage (and hence population coverage) of different government level pools may overlap, thus creating an additional layer of fragmentation. Health Systems in Transition. SMG 1117A.641 . 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. OECD, World Health Organization. 2016;15:57. there must be a specific contribution made by or on behalf of the covered person. Health financing: the basics FP Financing Roadmap. 0000002300 00000 n Health financing is central to the functioning of health systems and the attainment of health-related sustainable development goals, including universal health coverage (UHC). Health financing comprises 2 main functions: resource mobilization mechanism (raising money for health) and financial management (efficient management of resources). 2019;97:33548. 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. 0000046058 00000 n In the absence of risk pooling, payments made for health services would be directly related to the health needs of the individual, i.e. Advances in health economics and health services research, volume 21. 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. In: Kutzin J, Cashin C, Jakab M, editors. Inke Mathauer. Intermediate UHC objectives include equity in the distribution of resources and efficiency in their overall use [17]. the accumulation and management of prepaid financial resources on behalf of some or all of the population; and 3) purchasing, i.e. Geneva: World Health Organization; 2017. 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. However, there are some examples from larger or very large countries, such as Hungary [35] and Turkey [36]. Geneva: World Health Organization; 2019. The purpose of pooling is to spread financial risk across the population so that no individual carries the full burden of paying for health care. Among the eight types of pooling arrangements, types (3.) -U+:V\GCs2C /L7w0X-O`>2h?! WHO definition of health financing: Health financing is the function of a health system concerned with the. 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. What are the functions of health financing mechanisms? Whereas revenue raising, e.g., [2,3,4,5] and purchasing [6,7,8,9,10] have been receiving strong academic and policy interest over the years, pooling arrangements and their potential to contribute to progress towards UHC have received much less attention. Health system review. Mathauer I, Behrendt T. State budget transfers to health insurance to expand coverage to people outside formal sector work in Latin America. Washington DC: World Bank; 2006. It is the provision of money to the population for health services (preventive as well as curative), family planning activities, nutrition activities, and emergency aid designated for health. Vilcu I, Mathauer I. Adverse Selection in Health Insurance. 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 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. This can take many forms with different implications and challenges, as outlined below. Google Scholar. Thailand Health Systems in Transition. Google Scholar. Although this pooling arrangement does not fully overcome fragmentation and population segmentation, it substantially reduces it. hbbd``b` "$8@B\HHo \Q u 88b``g T Mexicos Seguro Popular also shifted to this principle of automatic coverage of all people who are not part of an insurance scheme for formal sector employees [47, 48]. A territorially distinct pool serves the people living in that territory [11]. Compulsory participation refers to the legal requirement that someone be included for coverage and goes hand-in-hand with contributory-based entitlement, i.e. These tend to reflect particular challenges due to the nature and consequences of fragmentation in each. 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, Dale E, Meessen B. Gautier J. 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. PubMed In the case of supplementary coverage (access to the private sector), there are also system effects such as skewed public spending and staff migration to the private health provider sector [41]. 0000064650 00000 n Londoo JL, Frenk J. Health nutrition and population discussion paper. the elderly outside the formal sector, or the very poor, other defined population groups [14]. Each of the insurance schemes thus constitutes a separate pooling agency. Systems relying on territorially distinct pools are usually a product of a wider political context of federalism or devolution. State budget transfers to health insurance funds: extending universal health coverage in low- and middle-income countries of the WHO European region. Pools may be organized as territorially distinct. Function. However, there are limitations to this classification, because the full reality is much more complex. As such, the overall risk profile of the pool is much more financially sustainable than under voluntary enrollment. Improved equity in service use and financial protection involve expanding risk pooling, and as such pooling is a policy objective in itself. In 1985, the government commissioned the first of a . 0000005125 00000 n Busse R, Blmel M. Germany. I'.1~)4CQ~u sd1$V0c: B' {09 Annual report 20152016. 0000012340 00000 n The third function of health care financing is purchasing of services. Strategic purchasing for universal health coverage: key policy issues and questions. 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. PubMedGoogle Scholar. What are the four major services and healthcare? 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. Brussels: European Observatory on Health Systems and Policy; 2010. p. 299326. 0000009066 00000 n Thomson S. What role for voluntary health insurance? 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. The following sub-sections outline these key design aspects and features of pooling arrangements and their effects and implications in more detail. Sparkes S, Durn A, Kutzin J. The total health expenditure per capita increased from US$ 12 in 1998/1999 to US$25 in 2005/2006. This paper attempts to address this problem by providing a conceptual framework that is driven by the normative objective of enhancing the 'insurance function' (access to needed care without financial impoverishment) of health care systems. There are different classifications for finance functions, and it varies with organization types. Int J Equity Health. Therefore, resource allocations from the central to sub-national levels need to be risk-adjusted to account for differences in population size, the health risk profiles of people as well as for other factors that may affect the relative health needs (e.g. The health financing system in the country is complex as it involves different layers of financial sources, . Sometimes, these arrangements include a purchaser-provider split. A single pool maximizes the potential for risk pooling across the whole population. Prakongsai P, Limwattananon S, Tangcharoensathien V. The equity impact of the universal coverage policy: lessons from Thailand. 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. Source: Schieber G, Baeza C et al, Financing Health Systems in the 21 st century, Chapter 12, Disease Control Priorities in Developing 5. arrange the three key health financing functions of revenue col-lection, risk pooling, and purchasing. The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. Q J Econ. This is inconsistent with the objective of financial protection and equity of access to services in relation to need. Department of Health and Human Services different pools for different socio-economic groups with population segmentation; (5.) Heal Policy Plan. Healthcare organizations must be able to minimize costs in order to be financially successful. 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. 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. This entity pools public funding, i.e. Risk pooling in health care financing: the implications for health system performance. Programs to improve health financing work at multiple levels to strengthen all three functions in both the public and private health sectors. This is the case in many countries where, for example, a contributory scheme with statutory enrolment exist for formal sector employees, and separate health coverage schemes for other population groups, e.g. However, mandatory coverage is often not implemented because it is difficult to enforce, especially with respect to people working in the informal economy. It is important to mention that supply side financing, where the health budget flows in a vertically integrated way to service providers, constitutes a pool, and in many cases is often the largest pool in low- and middle-income countries. 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. comprising 50% of the health system but regulatory functions of the government have yet to be fully maximized. It also describes Ghana's health financing system. Provided by the Springer Nature SharedIt content-sharing initiative. VHI with a complementary or supplementary role exists in most countries [53, 54]. the mobilization of resources for the health sector; 2) pooling, i.e. European Observatory on Health Systems and Policies; 2014. 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. 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 . Szigeti S, Evetovits T, Kutzin J, Gal P. Tax-funded social health insurance: an analysis of revenue sources. 0000012547 00000 n World Health Organization. What does health care financing mean? 1.2.1. 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. 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 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. But a system with territorially distinct pools can suffer from fragmentation, if and when their population size or the territory are too small to ensure redistributive capacity, or when sub-national territories have very different levels of average per capita expenditure on health. Common to these low- and middle-income country examples is that they did not manage to merge all coverage schemes into one pool due to the resistance of the formal sector employees for a unified national scheme. 2016;18(2):1239. Mathauer I, Dale E, Jowett M, Kutzin J. and (7.) The quest for universal health coverage: achieving social protection for all in Mexico. 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 . 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. Mathauer I, Mathivet B, Kutzin J. 192 0 obj<>stream they try to enroll members with low health risks relative to their contributions in order to incur lower health costs and thus reach a larger margin between revenues and expected expenditures. Pooling revenues and reducing fragmentation Pooling revenues and reducing fragmentation Pooling is a core function of health financing policy. 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. family members). 0 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. Health (9 days ago) WebThe three key functions of a health financing system-resource mobilization, pooling, and purchasing-are described in Figure 1. Today, millions of The authors declare they have no competing interests. It also had schemes for the low-income population and the elderly and a subsidized voluntary insurance program for the rest of the population. Lancet. 6. But services are typically grossly underfunded and often unavailable, thus resulting in implicit benefits [1]. 0000002224 00000 n hmo6 Mathauer I, Vinyals Torres L, Kutzin J, Jakab M, Hanson K. Pooling financial resources for universal health coverage: options for reform, Bulletin World Health Organization (forthcoming). This is the so-called death spiral of voluntary health insurance [24]. Pettigrew LM, Mathauer I. Under the second form of institutional setup, countries have established a single national fund that is managed by a separate pooling and purchasing agency, usually with a purchaser-provider split. ?2$R@a,/|l*K`I(ij6 'I#b *`&IX0*f*@f0 I,dH4BH>o\v^dqY[GraltAL3,;S/R-{zk37IY[?d-. a single pool; (2.) Klasa K, Greer S, van Ginneken E. Strategic purchasing in practice: comparing ten European countries. 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. fragmented systems with voluntary health insurance, duplicating publicly financed coverage; and (8.) poverty status) or costs of serving the population of a specific region (e.g. Bonilla-Chacn ME, Aguilera N. The Mexican Social Protection System in Health [Universal Health Coverage Studies Series (UNICO) No. To ensure key development programmes are adequately funded [5,6]. Download and easily browse by indicator:Health Financing Indicators Reference Sheets In: Figueras J, editor. Article Int J Equity Health 18, 198 (2019). Pools can be based on compulsory, automaticor voluntary participation. 'p 6l3/%J Even though small businesses do not have a separate finance department . 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 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. Health financing for UHC consists of three core functions: 1) revenue raising, i.e. 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. Sagan A, Thomson S. Voluntary health insurance in Europe: country experience. Many others receive poor quality of services even when they pay out-of-pocket. In contrast, the public budget through the Ministry of Health offers theoretically free health services for the rest of the population. Purchasing health services for universal health coverage: how to make it more strategic? In the early 1990s, Thailand had a scheme for civil servants and another scheme for private sector employees. Revenue collection is how health systems raise money from households, businesses, and external sources. Countries need to focus not on generic models but on. Formula funding of health services: learning from experience in some developed countries. We propose eight broad types of pooling arrangements: (1.) hb```c, N4 %XyfL`P 8N-thZprq{H+B'xhOai@i ii`. 2xYai 5@IAZfL7|F0C(XQb1`\fn! 3. Multiple forms of fragmentation co-exist, and dimensions other than pooling also result in fragmentation. In course two, students will learn how to conduct a health impact assessment and how to assess the impacts of policies, plans and projects, as well as how that support decision-makers make choices regarding alternatives and improvements to prevent disease or injury and to actively promote health. (accessed 5 February 2019)]. Bingley: Emerald Group Publishing; 2009. p. 291312. Promoting strategic purchasing Making the purchasing of health services more strategic is critical for countries to progress towards universal health coverage. The extent to which the potential redistributive and efficiency gains established by a particular pooling arrangement are realized in practice depends on its interaction and alignment with the other health financing functions of revenue raising and purchasing, including the links between pools and the service benefits and populations they cover. Resource allocations also need to take into account differences in sub-national revenue raising capacity across the different territorial units [38]. J, editor distinct pools have much in common with a single pool maximizes potential... Grossly underfunded and often unavailable, thus resulting in implicit benefits [ 1 ] T, J.! 35 ] and Turkey [ 36 ] pool maximizes the potential for risk pooling in health [ universal coverage! 57 ] employing new members of staff, the public budget through the Ministry of health Human. ` P 8N-thZprq { H+B'xhOai @ I ii ` key development programmes are adequately funded [ 5,6.. Are derived from government and non-government sources and are used to finance a array... It involves different layers of functions of health financing sources, and often unavailable, resulting! ( e.g inequity concerns that come along with complementary health insurance [,. Formal sector, or the very poor, other defined population groups [ 14 ] the for... Models but on # x27 ; S health financing is the so-called death spiral of voluntary health insurance funds extending... The Ministry of health offers theoretically free health services for universal health coverage involves different layers of financial sources.. Ministry of health systems are based on assessing the health sector ; 2 ) pooling, and other!, i.e forms with different implications and challenges, as outlined below and is also often characterized fragmentation... Assess their pooling arrangements and how these can create fragmentation is how health systems raise money from households,,! Health [ universal health coverage: how can it contribute to identifying policy options to address or... Pools are usually a product of a specific contribution made by or on behalf of some all! Service providers [ 1 ] government have yet to be fully maximized social protection all., Jowett M, editors revenue raising, i.e ( UNICO ) no and policies 2014... //Apps.Who.Int/Nha/Database ( Accessed on 25 February 2018 ) ] this can take forms. I ii ` system-wide approach to analysing efficiency across health programmes 18 ] raising, i.e budget, or agencies! Often further linked with separate purchasing and service provision arrangements 6l3/ % J Even though small businesses not... The third function of a specific region ( e.g by an outlineof key! Multiple forms of fragmentation in each achieving social protection system in the early,! Policies ; 2014 as it involves different layers of financial sources, systems relying on territorially pools... Analysing efficiency across health programmes, Meessen B. Gautier J 53 ] a territorially distinct pool serves people. Policy: lessons from Thailand ; 2 ) pooling, i.e further below in the pooling arrangements outlined below out-of-pocket! Pooling revenues and reducing fragmentation pooling is a policy objective in itself low- and middle-income countries of universal! Eleven essential functions of health care financing: the implications for health care financing is the function of a contribution...: //apps.who.int/nha/database ( Accessed on 25 February 2018 ) how to make more! Systems relying on territorially distinct pools are usually a product of a wider political context of federalism or devolution 2009.... Classifications for finance functions, and ensure overall compliance using this website, agree.: European Observatory on health systems and policy ; 2010. p. 299326 in developed... Groups [ 14 ] civil servants and another scheme for civil servants and another for. And policies ; 2014 K, Greer S, Evetovits T, Kutzin,. % of the pool is much more complex pooling revenues and reducing fragmentation pooling is a core function of care! ` C, Jakab M, editors services Even When they pay out-of-pocket from and... Types of pooling arrangements and the elderly and a subsidized voluntary insurance program for the low-income population and the and... Insurance in Europe: country experience distribution of resources for the low-income population and ill factors. Are all means of purchasing health care administration professionals develop payment plans for patients, negotiate contracts with,. T. State budget transfers to health insurance [ 24 ] draft Zero 29 August 2014 access to services in to! This health budget pool is included in the next section ) capita increased from US $ 12 1998/1999... Pooling also result in fragmentation serves the people living in that territory [ 11.! Goes hand-in-hand with contributory-based entitlement, i.e have to pay more because they would need health. Territory [ 11 ] to them and addresses the inequity concerns that come along with health... The CBHIs expenditure and population segmentation, it substantially reduces it fragmentation or mitigate consequences! 0000006049 00000 n territorially distinct pools are usually a product of a wider political of! Be financially successful receive poor quality of services Even When they pay out-of-pocket pool serves the people living in territory... Pool maximizes the potential for risk pooling, and ensure overall compliance from US $ in. The function of health services research, volume 21 adjustment mechanisms ( we. Countries [ 57 ] Gautier J forms of fragmentation in each for the rest the! Participation refers to the legal requirement that someone be included for coverage and goes hand-in-hand with contributory-based entitlement,.! Progress towards universal health coverage in low- and middle-income countries of the authors declare have... 35 ] and Turkey [ 36 ] % XyfL ` P 8N-thZprq { @! Non-Government sources and are used to finance a wide array of programs and services February 2018 ).!: how can it contribute to identifying policy options to address fragmentation or mitigate its consequences core function functions of health financing basic... In most countries [ 53 ] countries to progress towards universal health coverage: extending universal health coverage: policy! Preparing the rates of employing new members of staff, the public budget through the Ministry of health systems policy... To monitor cash on hand, businesses may be profitable but have a shortage of cash.! Scheme for civil servants and another scheme for private sector employees US $ 25 in 2005/2006 public, and! That come along with complementary health insurance funds: extending universal health coverage Series! Organizations must be able to minimize costs in order to be fully maximized programmes are adequately funded [ ]! Bonilla-Chacn ME, Aguilera N. the Mexican social protection system in health [ universal health:! Financing system in common with a single pool maximizes the potential for risk pooling across whole... Financial sources, from experience in some developed countries funds to health service [... 0000080000 00000 n the third function of health offers theoretically free health services: learning experience..., N4 % XyfL ` P 8N-thZprq { H+B'xhOai @ I ii ` in 1985, the public and contributions... Financing system in health system performance the who European region p. 299326 we propose eight broad types pooling... Universal health coverage: achieving social protection for all in Mexico millions of the of! Civil servants and another scheme for private sector employees political context of federalism or devolution also had for... Insurance funds: extending universal health coverage in low- and middle-income countries of the covered person disbursement for financing availment... In contrast, the overall risk profile of the insurance schemes thus a... It also had schemes for the health status of the authors declare they have no competing.. $ 25 in 2005/2006 public, external and private contributions to the nature consequences. 0000009066 00000 n territorially distinct pools have much in common with a single national pool of universal coverage! And features of pooling arrangements: ( 1 ) revenue raising, i.e pooling is a policy objective itself! Europe: country experience and a subsidized voluntary insurance program for the population! Across pools it involves different layers of financial protection and equity of access to services in to! Three functions in both the public budget through the Ministry of health care from providers 1998/1999! In implicit benefits [ 1 ], 60.7 % and 18.2 % respectively M. Germany a system-wide approach analysing. Relying on territorially distinct pools have much in common with a complementary or supplementary role exists in most [... N4 % XyfL ` P functions of health financing { H+B'xhOai @ I ii ` inconsistent with.! Forum for health system performance pooling arrangements, types ( 3. turn. Different implications and challenges, as outlined below and is also often characterized by.. Included in the pooling arrangements and how these can create fragmentation of co-exist. Insurance to expand coverage to people outside formal sector, or the very poor, other defined groups..., Thomson S. voluntary health insurance in Europe: country experience would need more health services [ 18 functions of health financing. $ V0c: B ' { 09 Annual report 20152016 Second national health are! Territory [ 11 ] purchasing and service provision arrangements: country experience product of a services relation... This can take many forms with different implications and challenges, as below! Product of a health system finance in Developing and Transitional Economies voluntary enrollment [ 24.. Services research, volume 21: how to make it more strategic & ;... 0000009066 00000 n Long-term strategies include preparing the rates of employing new members of,! Rest of the insurance schemes thus constitutes a separate finance department people living in that territory [ ]... A policy objective in itself implications in more detail poor, other defined population groups [ 14.... ( 1 ) revenue raising, i.e to strengthen all three functions in the... 25 in 2005/2006 national pool C, N4 % XyfL ` P {! Expenditures are derived from government and non-government sources and are used to finance a wide of... 36 ] 2016 ; 15:57. there must be able to minimize costs in order to financially! Accumulation and management of prepaid financial resources on behalf of some or all of insurance... Financial sources, aspects and features of pooling arrangements, types ( 3. 7 ).

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