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Health Insurance Schemes For People Outside Formal Sector Employment
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Book Synopsis Social Health Insurance for Developing Nations by : William C. Hsiao
Download or read book Social Health Insurance for Developing Nations written by William C. Hsiao and published by World Bank Publications. This book was released on 2007 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis Health Insurance Handbook by : Hong Wang
Download or read book Health Insurance Handbook written by Hong Wang and published by World Bank Publications. This book was released on 2012-01-18 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis The Impact of Health Insurance in Low- and Middle-Income Countries by : Maria-Luisa Escobar
Download or read book The Impact of Health Insurance in Low- and Middle-Income Countries written by Maria-Luisa Escobar and published by Rowman & Littlefield. This book was released on 2011-01-01 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309374065 Total Pages :141 pages Book Rating :4.3/5 (93 download)
Book Synopsis Approaches to Universal Health Coverage and Occupational Health and Safety for the Informal Workforce in Developing Countries by : National Academies of Sciences, Engineering, and Medicine
Download or read book Approaches to Universal Health Coverage and Occupational Health and Safety for the Informal Workforce in Developing Countries written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-07-06 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Universal health coverage (UHC) has been recognized by the World Health Organization as a key element in reducing social inequality and a critical component of sustainable development and poverty reduction. In most of the world UHC is sought through a combination of public and private-sector health care systems. In most low- and middle-income countries health systems are evolving to increasingly rely on the private sector because the public sector lacks the infrastructure and staff to meet all health care needs. With growing individual assets available for private-sector expenditure, patients often seek better access to technology, staff, and medicines. However, in low-income countries nearly 50 percent of health care financing is out-of-pocket. With the expected increase in the overall fraction of care provided through the private sector, these expenditures can be financially catastrophic for individuals in the informal workforce. In the global workforce of approximately 3 billion people, only 10 to 15 percent are estimated to have some type of access to occupational health services. The informal workforce is growing worldwide, and the degree to which its occupational health needs are satisfied depends on the capabilities of the general health care system. In July 2014, the Institute of Medicine held a workshop on approaches to universal health coverage and occupational health and safety for informal sector workers in developing countries. This report summarizes the presentations and discussions from this workshop. Approaches to Universal Health Coverage and Occupational Health and Safety for the Informal Workforce in Developing Countries identifies best practices and lessons learned for the informal workforce in developing countries in the financing of health care with respect to health care delivery models that are especially suitable to meeting a population's needs for a variety of occupational health issues, including the prevention of or mitigation of hazardous risks and the costs of providing medical and rehabilitation services and other benefits to various types of workers within this population. These experiences and lessons learned may be useful for stakeholders in moving the discussions, policies, and mechanisms forward to increase equitable access to quality health services without financial hardship for the informal workforce.
Book Synopsis Coverage Matters by : Institute of Medicine
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Book Synopsis Happiness and Economic Growth by : Andrew E. Clark
Download or read book Happiness and Economic Growth written by Andrew E. Clark and published by Oxford University Press, USA. This book was released on 2014 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Analyses the relationship between income and subjective well-being, and in particular in the context of developing countries. Several chapters focus on China and underline how the rise in unemployment and income inequality has undermined the well-being effects of economic development.
Book Synopsis Health Systems Financing by : World Health Organization
Download or read book Health Systems Financing written by World Health Organization and published by World Health Organization. This book was released on 2010 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This World Health Report was produced under the overall direction of Carissa Etienne ... and Anarfi Asamoa Baah ... The principal writers were David B. Evans ... [et al] -- t.p. verso.
Book Synopsis Moral Hazard in Health Insurance by : Amy Finkelstein
Download or read book Moral Hazard in Health Insurance written by Amy Finkelstein and published by Columbia University Press. This book was released on 2014-12-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Book Synopsis Ghana National Health Insurance Scheme by : Huihui Wang
Download or read book Ghana National Health Insurance Scheme written by Huihui Wang and published by World Bank Publications. This book was released on 2017-08-14 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.
Download or read book Going Universal written by Daniel Cotlear and published by World Bank Publications. This book was released on 2015-09-28 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is about 24 developing countries that have embarked on the journey towards universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable, through a systematic data collection that provides practical insights to policymakers and practitioners. Each of the UHC programs analyzed in this book is seeking to overcome the legacy of inequality by tackling both a “financing gap†? and a “provision gap†?: the financing gap (or lower per capita spending on the poor) by spending additional resources in a pro-poor way; the provision gap (or underperformance of service delivery for the poor) by expanding supply and changing incentives in a variety of ways. The prevailing view seems to indicate that UHC require not just more money, but also a focus on changing the rules of the game for spending health system resources. The book does not attempt to identify best practices, but rather aims to help policy makers understand the options they face, and help develop a new operational research agenda. The main chapters are focused on providing a granular understanding of policy design, while the appendixes offer a systematic review of the literature attempting to evaluate UHC program impact on access to services, on financial protection, and on health outcomes.
Book Synopsis Voluntary Health Insurance in Europe: Country Experience by : Sagan A.
Download or read book Voluntary Health Insurance in Europe: Country Experience written by Sagan A. and published by World Health Organization. This book was released on 2016-07-20 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.
Book Synopsis Government-Sponsored Health Insurance in India by : Gerard La Forgia
Download or read book Government-Sponsored Health Insurance in India written by Gerard La Forgia and published by World Bank Publications. This book was released on 2012-09-14 with total page 446 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents the first comprehensive review of all major government-supported health insurance schemes in India and their potential for contributing to the achievement of universal coverage in India are discussed.
Book Synopsis Employment and Health Benefits by : Institute of Medicine
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Book Synopsis Health Financing for Poor People by : Alexander S. Preker
Download or read book Health Financing for Poor People written by Alexander S. Preker and published by World Bank Publications. This book was released on 2004 with total page 476 pages. Available in PDF, EPUB and Kindle. Book excerpt: One of the most urgent development challenges facing many low and middle income countries is the need for adequate financing systems to pay for health care provision to the estimated 1.3 billion impoverished people living in rural areas or working in the informal sector in urban areas. This publication considers ways of improving the financing of health care at low income levels, as part of a global strategy for increased investment in health and poverty reduction. Topics discussed include: global and regional trends in healthcare financing; strengths and weaknesses of community-based health financing, and experiences in Asia and Africa; country case studies using household survey analysis from Senegal, Rwanda, India and Thailand; deficit financing; and the impact of risk sharing on achieving health system goals.
Book Synopsis The Economic Consequences of Health Shocks by : Adam Wagstaff
Download or read book The Economic Consequences of Health Shocks written by Adam Wagstaff and published by World Bank Publications. This book was released on 2005 with total page 21 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: "While there is a great deal of anecdotal evidence on the economic effects of adverse health shocks, there is relatively little hard empirical evidence. The author builds on recent empirical work to explore in the context of postreform Vietnam two related issues: (1) how far household income and medical care spending responds to health shocks, and (2) how far household consumption is protected against health shocks. The results suggest that adverse health shocks - captured by negative changes in body mass index (BMI) - are associated with reductions in earned income. This appears to be only partly - if at all - due to a reverse feedback from income changes to BMI changes. By contrast, there is a hint - the relevant coefficient is not significant - that adverse BMI shocks may result in increases in unearned income. This may reflect additional gifts, remittances, and so on, from family and friends following the health shock. Medical spending is found to increase following an adverse health shock, but not among those with health insurance. The impact for the uninsured is large, equal in absolute size to the income loss associated with a BMI shock. The lack of impact for the insured points to complete insurance against the medical care costs associated with health shocks, and is consistent with the very generous coverage of Vietnam's health insurance program in this period. The question arises: have Vietnamese households been able to hold their food and nonfood consumption constant in the face of these income reductions and extra medical care outlays? The results suggest not. For the sample as a whole, both food and nonfood consumption are found to be responsive to health shocks, indicating an inability to smooth nonmedical consumption in the face of health shocks. Further analysis reveals some interesting differences across different groups within the sample. Households with insurance come no closer to smoothing nonmedical consumption than uninsured households. Furthermore, and somewhat counterintuitively, better-off households - including insured households - fare worse than poorer households in smoothing their nonmedical consumption in the face of health shocks, despite the fact that in the case of insured households there are no medical bills associated with an adverse health event. Why the poor rely on dissaving and borrowing to such an extent, and do not apparently reduce their food and nonfood consumption following an adverse health shock while the better-off do, may be because the levels of food and nonfood consumption of the poor are simply too low relative to basic needs to enable them to cut back in the face of an adverse BMI shock."--World Bank web site.
Book Synopsis Private Voluntary Health Insurance in Development by : Alexander S. Preker
Download or read book Private Voluntary Health Insurance in Development written by Alexander S. Preker and published by World Bank Publications. This book was released on 2007 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis Extending Health Insurance to the Rural Population by :
Download or read book Extending Health Insurance to the Rural Population written by and published by World Bank Publications. This book was released on 2007 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: In 2003, after over 20 years of minimal health insurance coverage in rural areas, China launched a heavily subsidized voluntary health insurance program for rural residents. The authors use program and household survey data, as well as health facility census data, to analyze factors affecting enrollment into the program and to estimate its impact on households and health facilities. They obtain estimates by combining differences-in-differences with matching methods. The authors find some evidence of lower enrollment rates among poor households, holding other factors constant, and higher enrollment rates among households with chronically sick members. The household and facility data point to the scheme significantly increasing both outpatient and inpatient utilization (by 20-30 percent), but they find no impact on utilization in the poorest decile. For the sample as a whole, the authors find no statistically significant effects on average out-of-pocket spending, but they do find some-albeit weak-evidence of increased catastrophic health spending. For the poorest decile, by contrast, they find that the scheme increased average out-of-pocket spending but reduced the incidence of catastrophic health spending. They find evidence that the program has increased ownership of expensive equipment among central township health centers but had no impact on cost per case.
