Scaling Up Affordable Health Insurance

Staying the Course

Author: Alexander S. Preker,Marianne E. Lindner,Dov Chernichovsky,Onno P. Schellekens

Publisher: World Bank Publications

ISBN: 0821385798

Category: Business & Economics

Page: 778

View: 9361

This book presents an in-depth review on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Global Marketplace for Private Health Insurance

Strength in Numbers

Author: Alexander S. Preker,Peter Zweifel,Onno P. Schellekens

Publisher: World Bank Publications

ISBN: 9780821376775

Category: Business & Economics

Page: 528

View: 3580

Financial protection against the cost of illness and inclusion of vulnerable groups will require better mobilization and use of private means. Private voluntary health insurance already plays an important role in mobilizing additional resources to the health sector and protecting against the catastrophic cost of illness in some countries. This review explores the context under which private voluntary health insurance could contribute to an improvement in the sustainability of the health sector and financial protection in other countries.

Public Ends, Private Means

Strategic Purchasing of Health Services

Author: Alexander S. Preker

Publisher: World Bank Publications

ISBN: 0821365487

Category: Medical

Page: 414

View: 3443

Great progress has been made in recent years in securing better access and financial protection against the cost of illness through collective financing of health care. Managing scarce resources effectively and efficiently is an important part of this story. Experience has shown that, without strategic policies and focused spending, the poor are likely to get left out. The use of purchasing to enhance public sector performance is well-documented in other sectors. Extension to the health sector of lessons from this experience is now successfully implemented in many developing countries. Public.

Social Health Insurance for Developing Nations

Author: R. Paul Shaw

Publisher: World Bank Publications

ISBN: 0821369504

Category: Business & Economics

Page: 172

View: 673

Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.

The Impact of Health Insurance in Low- and Middle-Income Countries

Author: Maria-Luisa Escobar,Charles C. Griffin,R. Paul Shaw

Publisher: Brookings Institution Press

ISBN: 9780815705611

Category: Social Science

Page: 232

View: 1004

Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Colombia embarked in 1993 on a fifteen-year effort to cover its entire population with insurance, in combination with greater freedom to choose among providers. A decade later Mexico followed suit with a program tailored to its federal system. Several African nations have introduced new programs in the past decade, and many are testing options for reform. For the past twenty years, Eastern Europe has been shifting from government-run care to insurance-based competitive systems, and both China and India have experimental programs to expand coverage. These nations are betting that insurance-based health care financing can increase the accessibility of services, increase providers' productivity, and change the population's health care use patterns, mirroring the development of health systems in most OECD countries. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance–based care is key to the public policy debate of whether to extend insurance to low-income populations—and if so, how to do it—or to serve them through other means. Using recent household data, this book presents evidence of the impact of insurance programs in China, Colombia, Costa Rica, Ghana, Indonesia, Namibia, and Peru. The contributors also discuss potential design improvements that could increase impact. They provide innovative insights on improving the evaluation of health insurance reforms and on building a robust knowledge base to guide policy as other countries tackle the health insurance challenge.

Disease Control Priorities, Third Edition (Volume 2)

Reproductive, Maternal, Newborn, and Child Health

Author: Robert Black,Ramanan Laxminarayan,Marleen Temmerman,Neff Walker

Publisher: World Bank Publications

ISBN: 1464803684

Category: Medical

Page: 416

View: 932

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

Health Insurance Handbook

How to Make It Work

Author: Hong Wang,Kimberly Switlick,Christine Ortiz,Beatriz Zurita,Catherine Connor

Publisher: World Bank Publications

ISBN: 082138953X

Category: Business & Economics

Page: 136

View: 1784

Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.

Private Voluntary Health Insurance in Development

Friend Or Foe?

Author: Alexander S. Preker,Richard M. Scheffler,Mark C. Bassett

Publisher: World Bank Publications

ISBN: 0821366203

Category: Business & Economics

Page: 424

View: 5101

Private voluntary health insurance already plays an important role in the health sector of many low and middle income countries. The book reviews the context under which private insurance could contribute to an improvement in the financial sustainability of the health sector, financial protection against the costs of illness, household income smoothing, access to care, and market productivity. This volume is the third in aseries of in-depth reviews of the role of health care financing in providing access for low-income populations to needed healthcare, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Scaling Up Health Service Delivery

From Pilot Innovations to Policies and Programmes

Author: Ruth Simmons,Peter Fajans,Laura Ghiron

Publisher: World Health Organization

ISBN: 9241563516

Category: Medical

Page: 183

View: 4075

"The focus here is on ways to increase impact of health service innovations that have been tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting, sustainable basis." -- p.i Preface.

Universal Health Coverage for Inclusive and Sustainable Development

A Synthesis of 11 Country Case Studies

Author: Akiko Maeda,Edson Araujo,Cheryl Cashin,Joseph Harris,Naoki Ikegami,Michael R. Reich

Publisher: World Bank Publications

ISBN: 146480298X

Category: Medical

Page: 72

View: 8653

The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries (LMICs), where most of the world's poor live. The book synthesizes the experiences from 11 countries – Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam – in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The study examined the UHC policies for each country around three common themes: (i) the political economy and policy process for adopting, achieving, and sustaining UHC; (ii) health financing policies to enhance health coverage; and (iii) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.

Disease Control Priorities, Third Edition (Volume 4)

Mental, Neurological, and Substance Use Disorders

Author: Vikram Patel,Dan Chisholm,Tarun Dua,Ramanan Laxminarayan,Mari'a Lena Medina-Mora,Theo Vos

Publisher: World Bank Publications

ISBN: 1464804281

Category: Medical

Page: 304

View: 5655

Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.

Public-private Partnerships for Public Health

Author: Michael Reich

Publisher: Harvard University Press

ISBN: 9780674008656

Category: Health & Fitness

Page: 205

View: 7383

Global health problems require global solutions, and public-private partnerships are increasingly called upon to provide these solutions. Such partnerships involve private corporations in collaboration with governments, international agencies, and nongovernmental organizations. They can be very productive, but they also bring their own problems. This volume examines the organizational and ethical challenges of partnerships and suggests ways to address them. How do organizations with different values, interests, and world-views come together to resolve critical public health issues? How are shared objectives and shared values created within a partnership? How are relationships of trust fostered and sustained in the face of the inevitable conflicts, uncertainties, and risks of partnership? This book focuses on public-private partnerships that seek to expand the use of specific products to improve health conditions in poor countries. The volume includes case studies of partnerships involving specific diseases such as trachoma and river blindness, international organizations such as the World Health Organization, multinational pharmaceutical companies, and products such as medicines and vaccines. Individual chapters draw lessons from successful partnerships as well as troubled ones in order to help guide efforts to reduce global health disparities.

What's In, What's Out

Designing Benefits for Universal Health Coverage

Author: Amanda Glassman,Ursula Giedion,Peter C. Smith

Publisher: Brookings Institution Press

ISBN: 1944691057

Category: Medical

Page: 400

View: 5323

Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.

Global Marketplace for Private Health Insurance

Strength in Numbers

Author: Alexander S. Preker,Peter Zweifel,Onno P. Schellekens

Publisher: World Bank Publications

ISBN: 9780821376775

Category: Business & Economics

Page: 528

View: 2852

Financial protection against the cost of illness and inclusion of vulnerable groups will require better mobilization and use of private means. Private voluntary health insurance already plays an important role in mobilizing additional resources to the health sector and protecting against the catastrophic cost of illness in some countries. This review explores the context under which private voluntary health insurance could contribute to an improvement in the sustainability of the health sector and financial protection in other countries.

Implementation Research in Health

A Practical Guide

Author: David H. Peters,Nhan T. Tran,Taghreed Adam

Publisher: World Health Organization

ISBN: 9241506210

Category: Medical

Page: 67

View: 787

Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.

Private Voluntary Health Insurance

Consumer Protection and Prudential Regulation

Author: Greg Brunner,Pablo Gottret,Birgit Hansl,Vijayasekar Kalavakonda,Somil Nagpal,Nicole Tapay

Publisher: World Bank Publications

ISBN: 082138757X

Category: Business & Economics

Page: 130

View: 4963

This book aims to help countries design and implement a legal framework for a viable private health insurance market, with rationale for insurance regulation, institutions involved, and standards and protections used in regulating private health insurance.

Scaling Up Multiple Use Water Services

Accountability in Public Water Sector Performance for Health and Wealth

Author: Barbara Van Koppen,Stef Smits,Cristina Rumbaitis Del Rio

Publisher: N.A

ISBN: 9781853398292

Category: Business & Economics

Page: 104

View: 741

Poor people in developing countries need water for many purposes: for drinking, bathing, irrigating vegetable gardens, and watering livestock. However, responsibility for water services is divided between different government agencies, the WASH (Water, Sanitation and Hygiene) and irrigation sub-sectors, with the result that people’s holistic needs are not met. Multiple use water services (MUS) is a participatory water services approach that takes account of poor people’s multiple water needs as a starting point of planning, and the approach has been implemented in at least 22 countries in Africa, Asia and Latin America. Scaling up Multiple Use Water Services argues that by designing cost-effective multi-purpose infrastructure MUS can have a positive impact on people’s health and livelihoods. It analyses and explains the success factors of MUS, using a framework of accountability for public service delivery, and it also examines why there has been resistance against scaling up MUS. A stronger service delivery approach can overcome this resistance, by rewarding more livelihood outcomes, by fostering discretionary decision-making power of local-level staff and by allowing horizontal coordination.This book should be read by government and aid agency policy makers in the WASH and agriculture sectors, by development field workers, and by academics, researchers and students of international development.

The American Health Care Paradox

Why Spending More is Getting Us Less

Author: Elizabeth H. Bradley,Lauren A. Taylor

Publisher: PublicAffairs

ISBN: 1610392108

Category: Political Science

Page: 272

View: 5927

Foreword by Harvey V. Fineberg, President of the Institute of Medicine For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We've left out of our tally the most impactful expenditures countries make to improve the health of their populations-investments in social services. In The American Health Care Paradox, Bradley and Taylor illuminate how narrow definitions of "health care," archaic divisions in the distribution of health and social services, and our allergy to government programs combine to create needless suffering in individual lives, even as health care spending continues to soar. They show us how and why the US health care "system" developed as it did; examine the constraints on, and possibilities for, reform; and profile inspiring new initiatives from around the world. Offering a unique and clarifying perspective on the problems the Affordable Care Act won't solve, this book also points a new way forward.

Reforming China's Rural Health System

Author: N.A

Publisher: World Bank Publications

ISBN: 0821379836

Category: Medical

Page: 248

View: 3618

Since 1978 when it embarked on sweeping agricultural and industrial reforms, China's economic growth has been remarkable. Its success in transforming itself within just three decades from a very poor low-income country to a successful middle-income country is unparalleled. During this period, however, and in contrast to the first 30 years of the People's Republic, progress in the health sector has been disappointing. For example, during the period 1980-2007, China increased its income per head as a percentage of the OECD average from 3 percent to 15 per cent, but infant mortality fell no faste.

World Scientific Handbook Of Global Health Economics And Public Policy (A 3-volume Set)

Author: Scheffler Richard M

Publisher: World Scientific

ISBN: 9814612332

Category: Health & Fitness

Page: 1628

View: 7625

This Handbook covers major topics in global health economics and public policy and provides a timely, systematic review of the field. Edited by Richard M Scheffler, Distinguished Professor of Health Economics and Public Policy and Director of the Global Center for Health Economics and Policy Research at the University of California, Berkeley, the Handbook features academics and practitioners from more than a dozen countries. Contributors are from the London School of Economics and Political Science, Pompeu Fabra University in Barcelona, University of York, University of Oslo, London School of Hygiene and Tropical Medicine, University of California - Berkeley, Stanford University, Johns Hopkins University, University of Toronto, University of Oxford, Harvard Medical School, OECD, the World Health Organization and the World Bank, many of whom have also acted as economic and policy advisors to government and non-governmental organizations across the world. Experts in these areas who provide critical analyses and relevant data for further exploration and research include: Thomas E Getzen, Executive Director of the International Health Economics Association (iHEA); Douglas E Hough, Associate Scientist and Associate Director of the Master in Healthcare Management programme at the Bloomberg School of Public Health of John Hopkins University; Guillem López-Casasnovas, former President of iHEA and member of the Advisory Council of the Spanish Health and Social Welfare Ministry and of the Advisory Council of the Catalan Health Ministry since 1984; Alistair McGuire, Professor of Health Economics at the London School of Economics and Political and advisor to a number of governments and governmental bodies across Europe; Tor Iversen, Research Director at the Health Economics Research Programme at the University of Oslo and former member of the iHEA Arrow Award Committee 2007-2011; William H Dow, Professor and Associate Dean for Research at University of California ,Berkeley and former Senior Economist for the Council of Economic Advisors (White House); Audrey Laporte, the Director of the Canadian Centre for Health Economics; Alexander S Preker, President and CEO of Health Investment & Financing Corporation; Ayda Yurekli, who initiated and developed the World Health Organization TaXSiM simulation model that has been used by many Ministries of Finance around the world for the development of tax policies; Marko Vujicic, Managing Vice President of the Health Policy Resources Center at the American Dental Association; Mark Sculpher, Director of the Programme on Economic Evaluation and Health Technology Assessment at the University of York and former President of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) (2011-2012); and Peter Berman, who has had almost 40 years of experience in global health and was formerly a Lead Health Economist at the World Bank. The Handbook spans across three volumes. The chapters deal with key global issues in health economics, are evidence-based, and offer innovative policy alternatives and solutions. The Handbook's approach toward global health economics and public policy will make it a useful resource for health economists, policymakers, private sector companies, NGOs, government decision-makers and those who manage healthcare systems.