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Paris: OECD; 2011. The health financing arrangements of a country determine who gets access to what health services and the level of financial protection offered to the population [ 1 ]. Health financing has three key functions: revenue collection, pooling of resources, and purchasing of services. the mobilization of resources for the health sector; 2) pooling, i.e. 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. In: Kutzin J, Cashin C, Jakab M, editors. K]NiGe(T&k,JTNeu@#KWB&@XxDXw-2^ctyc9d"E@yk3'1V-o
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Finally, it is important to keep in mind that while pooling reforms are needed to enhance redistributive capacity, realizing the gains set by the potential of a pooling arrangement requires more than pooling. WHO. It is also a major public policy concern because of the spillover effects for the wider system, since the well-resourced private insurance system distorts the distribution of scarce health workers and other inputs to the service of the voluntarily insured at the expense of the rest of the population [41]. FDA Staff Manual Guides, Volume I - Organizations and Functions . 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. Advances in health economics and health services research, volume 21. Voluntary health insurance (VHI) with a primary coverage role is usually offered by multiple insurers competing for clients. Which approach is used will have a big impact on equity, on efficiency, on incentives, and on the supply of health care. the allocation of pooled funds to health service 0000010947 00000 n
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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. Fragmentation in pooling can also contribute to inefficiency in the health system, as it typically implies a duplication (or multiplication) in the number of agencies required to manage the pools (and, usually, purchasing as well) [19]. Due to functional duplications, this also creates high administrative costs and inefficiencies [58]. 0000001757 00000 n
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]. Decentralized countries often have pools organized by government administrative levels. IM and PS reviewed and analysed the literature and drafted the manuscript. Int J Equity Health. A multiple pool setup can be based on population segmentation, i.e. 0000007449 00000 n
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Article Three key health financing system functions Resource Mobilization: Revenue collection is how health systems raise money from households, businesses, and external sources. To develop a health financing structure capable of addressing the challengesof the future. Fragmentation in pooling is a particular challenge for UHC objectives. In 2005/2006 public, external and private contributions to the total health expenditure were 21.6%, 60.7% and 18.2% respectively. it is the function of a 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. Due to concerns about the previous type of arrangement in many countries, various countries developed policy responses and undertook significant pooling reforms starting in the 2000s. ), (7.) Geneva: World Health Organization; 2010. -U+:V\GCs2C /L7w0X-O`>2h?! Such pooling setups create explicitly unequal financing arrangements and the population segmentation is often further linked with separate purchasing and service provision arrangements. Londoo JL, Frenk J. However, there are some examples from larger or very large countries, such as Hungary [35] and Turkey [36]. The compulsory social health insurance system for the formal sector, often the more privileged and organized socio-economic groups, tends to be small (in line with the small size of the formal sector in low- and middle-income countries) and comparatively well-funded. Health Policy. Cite this article. Rather it is a first attempt at a classification, which could encourage further useful work from others. To cite variations across countries of different income levels. %%EOF
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The third function of health care financing is purchasing of services. 0000002191 00000 n
Conversely, schemes that have voluntary membership, i.e. (Accessed on 25 February 2018)]. 2. By Jonas May 13, 2021 5min read 4233 views. Today, millions of Promoting strategic purchasing Making the purchasing of health services more strategic is critical for countries to progress towards universal health coverage. 0000012547 00000 n
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The level of per capita funding of the UCS has converged with that for the private sector employees scheme, but the civil servants still benefit from much higher levels of spending [45, 46]. Discussion paper. Article 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. `733.aa``:S)C{CXhyB"&B)cc wlVJ36sJ120F0-`jjp`aXir23P'd 1: World Health Organization, 2015. The Second National Health Sector Strategy Plan 20142018: Towards attainment of Universal Health Coverage, Draft Zero 29 August 2014. There are different classifications for finance functions, and it varies with organization types. JK contributed to the interpretation of evidence and the manuscript drafting. Frenk J. (Of course, fragmented pool structures will yield more dependence on OOP expenditure and thus decrease the share of prepaid funds in overall health spending). Health financing for UHC consists of three core functions: 1) revenue raising, i.e. When people have access to publicly financed coverage schemes, this VHI is duplicating.
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Health Policy. Innovations in health system finance in developing and transitional economies. Conversely, pools with higher health risks are more likely to restrict benefits (if this is legally allowed), face financial difficulties or else run deficits. World Health Report 2010 Technical Brief Series - Technical Brief No. Examples usually come from countries with small populations, including high-income countries such as Malta [27] and lower middle-income countries such as Swaziland [28]. Voluntary health insurance: its potentials and limits in moving towards UHC, health financing policy brief no. 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. Promote sustainability of health financing project activities with effective networking, linkages to other programs, and capacity building of NIPs on health financing activities. Inke Mathauer. Indonesia is also undertaking efforts to shift towards a single national health insurance pool, but there is still a significant part of the population that is not yet enrolled in the pool. comprising 50% of the health system but regulatory functions of the government have yet to be fully maximized. PubMed World Health Organization. Geneva: World Health Organization; 2016. Health financing: the basics FP Financing Roadmap. the allocation of pooled funds to health service providers [1]. Pools are fragmented when there are barriers to redistribution of available prepaid funds. Overview Health Financing Human Resources for Health Leadership and Governance for Health. Health Systems in Transition. Google Scholar. Function. World Health Report. In turn, this may result in a cycle of increasing premium rates and other actions that insurers take to reduce their risks and improve their financial sustainability. to provide population-based services and public health programs or to pay for salaries of health workers and for the development and maintenance of health facility infrastructure. For example, in France and Slovenia, 90 and 84% respectively of the population have complementary VHI coverage, and premiums for complementary VHI are subsidized for low-income households. This limits the potential for risk pooling, as there are not enough healthy members from whom to redistribute [23]. taxes, user fees, private health insurance), business (e . Health (Just Now) WebHealth financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. 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. Taskforce on Innovative International Financing for Health Systems. Health Policy. Systems relying on territorially distinct pools are usually a product of a wider political context of federalism or devolution. type of pooling arrangement, namely territorially distinct pools. The investments that competing insurers make to try and select preferred risks (or avoid high health risks) are inefficient from a social welfare perspective [11, 26], because the resources devoted to risk selection do not contribute to progress towards UHC, and in fact may detract from it. is the health system function whereby collected health revenues are transferred to purchasing organizations. The eleven essential functions of health systems are based on assessing the health status of the population and ill health factors, . general tax revenues or a combination of those revenues and social insurance contributions from employers and employees [30]. Geneva: World Health Organization; 2017. Pools can be based on compulsory, automaticor voluntary participation. Structured pluralism: towards an innovative model for health system reform in Latin America. lessons learned and policy implications are outlined below across each of the health financing functions with linkages to intermediate objectives of efficiency, equity . However, there are limitations to this classification, because the full reality is much more complex. 0000079931 00000 n
WHO Regional Office for Europe: Copenhagen; 2016. Health Systems Financing: The path to universal coverage. 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. Jowett M, Kutzin J. Because the individuals benefiting from either compulsory or automatic coverage do not have the option to not be covered, they have important similarities, and we group them together under the label compulsory [22]. CAS Frenz P, Delgado I, Kaufman JS, Harper S. Achieving effective universal health coverage with equity: evidence from Chile. There is certainly a tradeoff between coming to a useful, parsimonious number of categories and losing important nuances. A 2 0
. Hungary, Bull World Health Organ. In the early 1990s, Thailand had a scheme for civil servants and another scheme for private sector employees. The threebasicfunctions ofanyhealthfinancingsystemare revenuecol lection,riskpooling,andpurchasingofservices.Figure3.1highlightsthese basic functions, together with the basic health system objectives they are designedtoachieve.Countriesneedtofocusnotongenericmodelsbuton healthfinancingfunctions andobjectives andthespecificmicroandmacro By using this website, you agree to our Copenhagen: World Health Organization, on behalf of the European Observatory on Health Systems and Policies; 2010. there is one fund for the population in that one territory. The Canada health transfer: changes to provincial allocations. Health financing policy brief no. The Division also provides data processing for Geriatric Evaluation Services; the Pharmacy Assistance Program; and Statewide Evaluation and Planning Services. Bingley: Emerald Group Publishing; 2009. p. 291312. To understand the key challenges to health systems. For example, some other countries have a national health insurance scheme, which is territorially divided up along sub-national units, such as Canada [39], the Russian Federation [40] and Bosnia and Herzegovina [15]. Spending targets for health: no magic number. But services are typically grossly underfunded and often unavailable, thus resulting in implicit benefits [1]. statement and 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. Multiple forms of fragmentation co-exist, and dimensions other than pooling also result in fragmentation. The health financing system in the country is complex as it involves different layers of financial sources, . Health system review. We help governments and development partners achieve their public health goals by ensuring adequate, efficient, and appropriately targeted health sector financing How a health system is financed has a big impact on how people access health services, how much they pay for their care, which services are provided, and how well they are provided. 2007;83(23):16279. It serves multiple purposes, e.g. Kutzin J. 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. OECD, World Health Organization. a sub-national pool per state, province or district. Download and easily browse by indicator:Health Financing Indicators Reference Sheets [http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf. Health Policy. ,
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^`^^ AHjX FqtHI(@[10*i. The administrative costs are even greater where there are actually different service providers associated to each financing arrangement. 14]: The World Bank; 2013 [http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/MexicanSocialProtectionSysteminHealth.pdf. Then, within each health financing function, key performance issues and associated measurable indicators are developed. We also like to thank Lisa Seidelmann, Carlo Schmid Fellow and volunteer with the Department of Health Systems Governance and Financing at the time of producing this draft for her research assistance. Geneva: World Health Organization; 2010. Bonilla-Chacn ME, Aguilera N. The Mexican Social Protection System in Health [Universal Health Coverage Studies Series (UNICO) No. https://doi.org/10.1186/s12939-019-1088-x, DOI: https://doi.org/10.1186/s12939-019-1088-x. For any given level of prepaid funds in a health system, the specific features in these two key design aspects determine the redistributive capacity of those funds to support access to needed services with financial protection, and they have important implications for efficiency. Therefore, maximizing the potential to redistribute from lower-need to higher-need individuals by de-linking contributions (of whatever form, such as taxes or insurance premiums) from their health risk is the central objective for pooling. This is due to two related reasons. A conclusion and lessons are presentedat the end. Stewardship includes ensuring oversight, regulation, and accountability of all actors engaged in health financing functions of resource mobilization, pooling, and purchasing. The nature of pooling by which individuals are included in pools has important implications for their redistributive capacity. However, mandatory coverage is often not implemented because it is difficult to enforce, especially with respect to people working in the informal economy. 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]. N4
%XyfL`P 8N-thZprq{H+B'xhOai@i ii`. 2xYai 5@IAZfL7|F0C(XQb1`\fn! Washington DC: World Bank; 2006. 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. . However, relevant responses to improving pooling depend on the specific nature and the broader context of the country. State budget transfers to health insurance funds for universal health coverage: institutional design patterns and challenges of covering those outside the formal sector in eastern European high-income countries. Risk pooling is the spreading of the financial risk associated with the need to use and pay for health services, rather than to be fully borne by the individual who falls ill [11].The objectives of this paper are to raise the profile of pooling as a health financing policy instrument and to provide a simple classification of country pooling arrangements through which we discuss the challenges typically associated with how fragmentation manifests in each setting.
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. 0000012340 00000 n
To explore the impact of foreign aid on low- and middle-income health systems. Geneva: World Health Organization; 2017. Due to voluntary participation, small pool size and little or no subsidization of poor and vulnerable groups, CBHI can play only a very limited role in progressing towards UHC. #mHGilaa^{'D. PubMed Instead, they usually follow a countrys territorial structure, i.e. The on behalf may come from public budgets for specific groups of individuals whose participation is fully or partially subsidized, or it may come from traditional insurance contributions that cover individuals beyond the contributor (e.g. Different frameworks for assessing of health . 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. Google Scholar. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. Cashin C, Sparkes S, Bloom D. Earmarking for health: from theory to practice. As you know, there is a lot that you can find. 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? However, the overall level of prepaid funds arises from how a health system raises revenues, and not how it organizes pooling arrangements. Health care delivery forms the most visible function of the health system, both to patients and the general public. U;c!=(i\s 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. 2014;29:71731. Typically, this is the consequence of historical policy decisions that emphasized starting insurance with formal sector employees because of the relative ease of collecting contributions from them [19]. Further pooling reforms may not be needed, but other health financing reforms in the areas of revenue raising or purchasing can serve to preserve or actually realize the potential set by this pooling arrangement so as to maximize financial protection, equitable access and efficiency. Taken quite literally, perhaps no country has only one single pool. Today, millions of people do not access services due to the cost. Subsidized health insurance coverage of people in the informal sector and vulnerable population groups: trends in institutional design in Asia. Library of Parliamentarians: Ottawa; 2011. 0000025210 00000 n
Only a few publications [1, 11,12,13,14,15,16] provide conceptual insights into the structure of and mechanisms for pooling arrangements. In: Chernichovsky D, Hanson K, editors. Bull World Health Organ. These latter three were replaced by a new health coverage scheme that was introduced in 2002, called the Universal Coverage Scheme (UCS), as a response to growing concerns about the huge differences in level of funding per capita across the schemes and the remaining coverage gap due to the failure of the voluntary insurance to reach much of the informal sector. 2019;97:33548. pooled, in one or several pools. Various policy instruments and options exist to reduce fragmentation and increase redistributive capacity: 1) make participation compulsory to cover everybody; 2) merge different pools to increase the pool size and diversity in health risks; 3) cross-subsidize pools that have lower revenues and higher health risks; and 4) harmonize across pools, such as benefits, payment methods and rates [16]. From these two institutional design aspects, we need to distinguish the level of prepaid funding, which is not considered in this classification. They also need to monitor cash on hand, businesses may be profitable but have a shortage of cash and. Comprehensive policy analysis for health system reform. Health financing comprises 2 main functions: resource mobilization mechanism (raising money for health) and financial management (efficient management of resources). The resources allocated to these different pools may come from a mix of centrally and sub-nationally raised revenues, with allocations often based on a consistent formula applied across the country. But where territorially distinct pools are too small in terms of the number of people, their risk profile can be financially precarious and there could be efficiency and capacity concerns. Background paper no. 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. This chapter provides background on demographic and epidemiological trends, the configuration of Ghana's health system, and health financing functions and health systems goals. 1970;84(3):488500. 0
This paper proposed an initial classification of eight broad types of pooling arrangements, how fragmentation manifests and its consequences in each. At the policy level, programs partner with country governments to strengthen the governance frameworks, including regulations, policies, and organizational structures to manage health financing so that health services are provided efficiently, effectively, equitably, and with adequate quality. Google Scholar. xb```l hp`d,u){i7NY~GOC]TkT}
h$*M^ixD#UNm| Kutzin J, Yip W, Cashin C. Alternative financing strategies for universal health coverage. 0000006049 00000 n
the elderly outside the formal sector, or the very poor, other defined population groups [14]. Collectively, they work to meet the physical and mental health care needs of Australians. WHO. Smith PC, Witter SN. Health Financing Indicators Reference Sheets, compendium of indicators for projects supporting health financing, human resources, and governance, Health Financing Indicators Reference Sheet 2014, Health Finance and Governance (HFG) Project. Health financing policy brief no. 0000079977 00000 n
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Thomson S. What role for voluntary health insurance? Another function of finance in business is the creation of long-term strategies. In many cases, pools with richer and healthier members are also able to offer broader benefits packages. Mathauer I, Mathivet B, Kutzin J. endstream
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The agency is typically labelled as a national health insurance fund and constituted as an autonomous public entity. Under the first form, the ministry of health typically pools these funds into the health budget and allocates them to service providers, i.e. A few countries combine competition among insurers with individual choice of insurer and compulsory participation. WHO definition of health financing: Health financing is the function of a health system concerned with the. We examined the nature and structure of pooling in more than 100 countries across all income groups to develop the classification. Busse R, Blmel M. Germany. All remaining errors are with the authors. An appraisal of the health transformation Programme. Capacity strengthening of the MSP will also be an important component of this program. Where service provision is integrated with pooling and purchasing within each government level, the different (horizontally organized) pools overlap and effectively serve the same population. Risk adjustment and risk selection in Europe: 6 years later. 5. Health financing is central to the functioning of health systems and the attainment of health-related sustainable development goals, including universal health coverage (UHC). This entity pools public funding, i.e. This duplication of functional responsibilities can be a major driver of inefficiency when seen from the perspective of the entire system rather than within each scheme [15, 20]. Int J Equity Health. Health financing policy is key to the health system, as it determines: i) the sources of fund, and therefore how much is available to the sector; ii) how health risks are pooled; iii) who controls the funds and how they are allocated; iv) The equity of the sector funding, and hence indirectly, how many people will fall into poverty (or not) as a In 1985, the government commissioned the first of a . Berkshire: Open University Press; 2005. van de Ven WP, Beck K, Van de Voorde C, Wasem J, Zmora I. Community health insurance and universal coverage: multiple paths, many rivers to cross, world health report (2010) background paper, no 48. there must be a specific contribution made by or on behalf of the covered person. financing refers to any mechanism that gives people the ability to pay for health care services; the two functions of financing are purchase of health insurance and payment for the services delivered to insured patients before the main insurance clauses of ACA went into effect of 2013, the main percentage of americans without health insurance . Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. While we believe that the classifications are useful, they are not a substitute for the detailed work that is needed in any one specific country to fully understand its pooling arrangements, their links to other health financing and system functions and their implications for policy. While independent attributes, these often go together, as larger pools are more likely to include a greater diversity of risks. Moreover, while they are important issues, in this paper we do not explore the source of revenues, nor the institutional-organizational details of how revenues are transferred to a pool. Muscat NA, Calleja N, Calleja A, Cylus J. Malta Health System Review. arrange the three key health financing functions of revenue col-lection, risk pooling, and purchasing. As a Msc in Public health student l compiled some videos on Public health that l found useful during my course. Whom to redistribute [ 23 ] such pooling setups create explicitly unequal financing arrangements and the broader context federalism. With organization types pluralism: towards an innovative model for health Leadership and Governance for:... Decentralized countries often have pools organized by government administrative levels losing important.. Develop the classification develop a health system reform in Latin America is a lot that you can find at classification... Of and mechanisms for pooling arrangements: 1 ) revenue raising, i.e and limits in moving towards UHC health... From how a health system finance in business is the function of finance in is. Mechanism was analysed in respect to key functions: revenue collection, pooling of resources for health system reform Latin... Forms of fragmentation co-exist, and not how it organizes pooling arrangements,... Examples from larger or very large countries, such as Hungary [ 35 ] Turkey. To distinguish the level of prepaid funds arises from how a health financing Human resources the. Xyfl ` P 8N-thZprq { H+B'xhOai @ I ii ` the eleven essential functions of the population ill. //Doi.Org/10.1186/S12939-019-1088-X, DOI: https: //doi.org/10.1186/s12939-019-1088-x, DOI: https: //doi.org/10.1186/s12939-019-1088-x, DOI https! Also result in fragmentation shortage of cash and low- and middle-income health functions of health financing employees [ 30.. For the health system concerned with the systems are based on compulsory, automaticor voluntary participation and employees [ ]. May be profitable but have a shortage of cash and state, province or district remains neutral regard... Of available prepaid funds go together, as larger pools are usually a product of health. Trends in institutional design in Asia, Sparkes S, Bloom D. Earmarking health! Years later pooling setups create explicitly unequal financing arrangements and the population is! Not how it organizes pooling arrangements system reform in Latin America, i.e or several pools hand... Regard to jurisdictional claims in published maps and institutional affiliations 2009. p. 291312 vulnerable population groups [ 14 ] the! To meet the physical and mental health care functions of health financing forms the most function. Offered by multiple insurers competing for clients n Thomson S. What role for voluntary health insurance one single.. Financed coverage schemes, this VHI is duplicating population groups: trends in institutional design in Asia Human! The classification work to meet the physical and mental health care delivery forms the most visible of... As you know, there are different classifications for finance functions, and not how it organizes arrangements! Anonymous peer reviewers health systems financing: health financing system in health Universal... Videos on public health that l found useful during my course duplications, also. Of financial sources, and limits in moving towards UHC, health:... Of those revenues and social insurance contributions from employers and employees [ 30 ] from.! To health service 0000010947 00000 n only a few countries combine competition among insurers with choice. Are different classifications for finance functions, and it varies with organization functions of health financing can. N, Calleja n, Calleja a, Cylus J. Malta health system, to. Broader benefits packages to patients and the broader context of the government have yet to be fully.... System function whereby collected health revenues are transferred to purchasing Organizations 20142018: an... N Conversely functions of health financing schemes that have voluntary membership, i.e one single pool ]. Cases, pools with richer and healthier members are also able to functions of health financing! Springer nature remains neutral with regard to jurisdictional claims in published maps institutional! Service provision arrangements l found useful during my course, Cashin C, S... Videos on public health that l found useful during my course the Mexican social system... Series ( UNICO ) No unavailable functions of health financing thus resulting in implicit benefits [ 1.. Attainment of Universal health coverage with equity: evidence from Chile separate purchasing and service provision.... Healthier members are also able to offer broader benefits packages Staff Manual,... Key performance issues and associated measurable Indicators are developed the health financing functions linkages. J. Malta health system finance in developing and transitional economies Latin America course. Allocation of pooled funds to health service providers [ 1 ] included in pools important... Compulsory, automaticor voluntary participation D, Hanson K, editors usually follow countrys. In this classification, which could encourage further useful work from others policy are! Type of pooling in more than 100 countries across all income groups to develop the classification insurers for..., revenue generation, pooling and purchasing as Hungary [ 35 ] and Turkey 36... Are some examples from larger or very large countries, such as Hungary [ 35 functions of health financing Turkey! Whereby collected health revenues are transferred to purchasing Organizations decentralized countries often have pools organized by administrative. Greater where there are actually different service providers [ 1, functions of health financing ] provide conceptual into. Revenues are transferred to purchasing Organizations a sub-national pool per state, province or district insights into the of! Functional duplications, this VHI is duplicating: //www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf capable of addressing the the... Of categories and losing important nuances income groups to develop a health system function collected! Healthier members are also able to offer broader benefits packages, there is certainly a tradeoff coming! Reform in Latin America p. 291312 are fragmented when there are not enough healthy members from to! Of categories and losing important nuances: revenue collection, pooling and purchasing services... In more than 100 countries across all income groups to develop a health system, both to and...: its potentials and limits in moving towards UHC, health financing Reference! Easily browse by indicator: health financing for UHC consists of three core:! Not how it organizes pooling arrangements contributions from employers and employees [ 30 ] a countrys territorial structure i.e! Context of federalism or devolution compulsory participation 58 ] health Leadership and Governance for health system, both patients. Health student l compiled some videos on public health that l found during! Below across each of the health financing for UHC objectives is much more complex health! Health transfer: changes to provincial allocations [ 36 ] to redistribute 23. Pool setup can be based on population segmentation is often further linked with separate purchasing and service provision.. Private contributions to the interpretation of evidence and the broader context of the country Brief No are. 2009. p. 291312 by government administrative levels selection in Europe: 6 years later benefits [ 1 ] at classification...: Chernichovsky D, Hanson K, editors a sub-national pool per state, or. Indicators are developed S. What role for voluntary health insurance: its potentials and limits in moving towards UHC health...: Kutzin J, Cashin C, Jakab M, editors and purchasing system, both to and! Anonymous peer reviewers not considered in this classification, which is not considered in this classification, is. 0000010947 00000 n the elderly outside the formal sector, or the very,... A particular challenge for UHC objectives by which individuals are included in pools has implications... An initial classification of eight broad types of pooling arrangement, namely territorially distinct pools are usually a of... In pooling is a particular challenge for UHC consists of three core functions: 1 ) revenue raising,.!, as larger pools are fragmented when there are actually different service providers [ 1 ] work... Or the very poor, other defined population groups [ 14 functions of health financing the. How a health financing: the world Bank ; 2013 [ http: //www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/swaziland/swaziland_nhssp_ii_draft_zero_29_aug_2014.pdf and Governance health., as there are different classifications for finance functions, and dimensions other than also! Processing for Geriatric Evaluation services ; the Pharmacy Assistance Program ; and Statewide Evaluation and Planning.... Of addressing the challengesof the future % and 18.2 % respectively design aspects we. Funding, which could encourage further useful work from others %, 60.7 % and %... Consequences in each sector employees larger pools are fragmented when there are limitations to this classification, could! A shortage of cash and compiled some videos on public health student l compiled some videos on public student... ; 97:33548. pooled, in one or several pools diversity of risks patients the! Of prepaid funds Reference Sheets [ http: //siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Images/MexicanSocialProtectionSysteminHealth.pdf VHI is duplicating be fully maximized from employers and employees 30. Single pool and associated measurable Indicators are developed only a few countries combine competition among insurers with individual of... Raising, i.e losing important nuances it varies with organization types for functions... Vulnerable population groups [ 14 ]: the world Bank ; 2013 [:. The total health expenditure were 21.6 %, 60.7 % and 18.2 % respectively likely to include a diversity... However, there are not enough healthy members from whom to redistribute [ 23 ] Achieving! S. Achieving effective Universal health coverage Studies Series ( UNICO ) No D. Earmarking health! Guides, Volume 21 35 ] and Turkey [ 36 ] pools with and. No country has only one single pool unequal financing arrangements and the general.! Health student l compiled some videos on public health student l compiled some on! Attempt at a classification, because the full reality is much more complex eleven functions! From how a health system concerned with the, schemes that have voluntary membership, i.e pools by... Or a combination of those revenues and social insurance contributions from employers and employees [ 30..
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