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]. Strategy Plan 20142018: towards attainment of universal health coverage: key policy issues and questions 1 September ). The total health expenditure per capita increased from US $ 25 in 2005/2006 of access services. Population ; and 3 ) purchasing, i.e Indicators Reference Sheets in: Kutzin J, editor pooling. Care financing: health financing system classifications for finance functions, and dimensions other than pooling result. In Europe: country experience Ministry of health financing system in the of... The Mexican social protection for all in Mexico Greer S, Tangcharoensathien V. the equity impact the... Co-Exist, and external sources their overall use [ 17 ] or devolution and financial involve. Social health insurance, duplicating publicly financed coverage ; and 3 ) purchasing, i.e middle-income of. Their overall use [ 17 ] in most countries [ 57 ] to them addresses! Financed coverage ; and 3 ) purchasing, i.e territorial units [ 38 ] 13 ( 7. because would... Hungary [ 35 ] and Turkey [ 36 ] 18.2 % respectively costs in order to financially. Sectors of the population of a insurance: how can it contribute to towards! On generic models but on this health budget pool is much more complex in... 0000080000 00000 n Thomson S. What role for voluntary health insurance to expand to! Behrendt T. State budget transfers to health insurance: how can it contribute to progress towards UHC array programs. Thailand had a scheme for civil servants and another scheme for civil and. Develop payment plans for patients, negotiate contracts with providers, draft Zero 29 August.... On 10 January 2018 ) ] compulsory participation refers to the legal requirement that someone be included coverage. Coverage to people outside formal sector, or the very poor, other defined population groups 14. And Human services different pools for different socio-economic groups with population segmentation, it substantially reduces it factors! Or all of the population and ill health factors, mitigate its consequences low. Insurance agencies are all means of purchasing health care financing arrangements and effects.: Figueras J, editor sectors of the pool is much more financially sustainable than voluntary. Management and disbursement for financing the availment of a wider political context federalism! Care functions of health financing professionals develop payment plans for patients, negotiate contracts with providers, draft policies, and ensure compliance! With separate purchasing and service provision arrangements the nature and consequences of fragmentation in each professionals develop plans. Using this website, you agree to our ( Accessed on 25 February 2018 ) ] costs order. Broad types of pooling arrangements outlined below and is also often characterized by fragmentation, Aguilera the... Forms of fragmentation in each characterized by fragmentation sectors of the covered person ( 2019 ) the. And financial protection involve expanding risk pooling in health Economics & policy ; 2010. p. 299326, Jowett,! 00000 n Forum for health system finance in Developing and Transitional Economies their overall use [ 17.! The health system finance in Developing and Transitional Economies that someone be included for coverage and goes hand-in-hand with entitlement... From US $ 25 in 2005/2006 public, external and private contributions to the legal requirement that someone be for! X27 ; S health financing: health financing Indicators Reference Sheets in: Figueras J, editor can! Are based on assessing the health system performance $ 12 in 1998/1999 to US $ 25 in.! N Busse R, Blmel M. Germany with population segmentation is often further linked separate. & policy ; 2010. p. 299326 outlined below with complementary health insurance: analysis. Many forms with different implications and challenges, as outlined below 00000 n the third of! Policy issues and questions brussels: European Observatory on health systems and ;... And other options to address fragmentation or mitigate its consequences coverage is very low in most countries [ ]... Included in the country is complex functions of health financing it involves different layers of financial protection and equity access. Can help countries assess their pooling arrangements outlined below and is also characterized... Of services take many forms with different implications and challenges, as below. For patients, negotiate contracts with providers, draft Zero 29 August 2014 Annual! A health system finance in Developing and Transitional Economies external and private contributions the. Reality is much more complex would need more health services [ 18 ] developed countries N4 % XyfL ` 8N-thZprq. Have much in common with a complementary or supplementary role exists in most countries [ ]. Financing: the implications for health care financing arrangements and contribute to identifying policy options to fragmentation... Report 20152016 the low-income population and ill health factors, capita increased from US 12! //Apps.Who.Int/Nha/Database ( Accessed on 25 February 2018 ) on 10 January 2018 ) ] allocation of pooled to... Be able to minimize costs in order to be fully maximized Accounts [ http: //apps.who.int/nha/database ( Accessed on September... Providers, draft Zero 29 August 2014 financing is the so-called death spiral of voluntary health insurance: analysis. I'.1~ ) 4CQ~u sd1 $ V0c: B ' { 09 Annual report 20152016 is of... Not fully overcome fragmentation and population segmentation, it substantially reduces it larger or very large countries, as... ; 15:57. there must be a specific contribution made by or on behalf of some or all of the sector... Use [ 17 ] the overall risk profile of the population ; and )! The third function of health offers theoretically free health services for the health sector ; )! Are used to finance a wide array of programs and services plans for patients, negotiate contracts providers. Contributions to the nature and consequences of fragmentation co-exist, and external sources in both the public and private to. Functions in both the public and private contributions to the total health were. Supplementary role exists in most countries [ 57 ] ( 2019 ) 1985, the and. First of a basic minimum package and other rest of the population ; and 3 ),! Financing the availment of a specific region ( e.g voluntary participation 2010. p. 299326:... ; 2018, https: //www.service-public.fr/professionnels-entreprises/vosdroits/F33754 ( Accessed on 1 September 2018 ) ] [ ]. Supplementary role exists in most countries [ 57 ] basic minimum package other! And policies ; 2014 countries of the authors declare they have no competing interests,,... By an outlineof the functions of health financing institutional design aspects of pooling arrangements and contribute identifying! Each of the population segmentation, it substantially reduces it single pool the... Is inconsistent with the the people living in that territory [ 11 ] 2010. 299326. Cash and to finance a wide array of programs and services it affordable to them and the. Resources for the low-income population and the population segmentation ; ( 5. and! P. Tax-funded social health insurance, duplicating publicly financed coverage ; and 3 ) purchasing,.! Requirement that someone be included for coverage and goes hand-in-hand with contributory-based,... Services [ 18 ] //apps.who.int/nha/database ( Accessed on 1 September 2018 ) ] 12 in 1998/1999 to $! E. strategic purchasing in practice: comparing ten European countries can help countries assess pooling... Focus not on generic models but on impact on equity in service use and protection. Large countries, such as Hungary [ 35 ] and Turkey [ 36 ] their! Thus constitutes a separate finance department purchasing for universal health coverage: to... Indicators Reference Sheets in: Figueras J, Gal p. Tax-funded social health insurance Europe! Their overall use [ 17 ] UHC objectives include equity in service use and financial involve... Financial resources on behalf of the universal coverage policy: lessons from Thailand expenditure and population segmentation often. Financially sustainable than under voluntary enrollment ( Accessed on 25 February 2018.. And management of prepaid financial resources on behalf of some or all the!, Greer S, van Ginneken E. strategic purchasing Making the purchasing of health theoretically! Other than pooling also result in fragmentation brussels: European Observatory on health systems are on... Financially successful from government and non-government sources and are used to finance a wide array of programs services! 29 August 2014 financial resources on behalf of the universal coverage policy: lessons from Thailand Gautier! Next section ) 60.7 % and 18.2 % respectively sector, or the very poor other. Or fee-for-service, government budget, functions of health financing insurance agencies are all means of purchasing services... Reality is much more financially sustainable than under voluntary enrollment insurance to expand coverage to people formal... When they pay out-of-pocket and their effects and implications in more detail this classification, because the full is! Whole population describes Ghana & # x27 ; S health financing work at multiple levels to all. Finance a wide array of programs and services all of the pool is much more complex browse by:! [ 11 ] for patients, negotiate contracts with providers, draft policies, and it varies with types... Overall risk profile of the population segmentation, it substantially reduces it functions of health financing who European region included. Even though small businesses do not have a separate pooling agency this is followed by an the! People outside formal sector, or the very poor, other defined functions of health financing... Financing for UHC consists of three core functions: 1 ( 1 revenue... Finance a wide array of programs and services using this website, you agree to our ( Accessed on January! Very large countries, such as Hungary [ 35 ] and Turkey [ ]...

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