Health Insurance (original) (raw)
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How health insurance affects the delivery of health care in developing countries
1992
Financial crisis is a common state of affairs in the government health sector of many developing countries, and an increasing number are considering implementing user charges and insurance programs to shift some of the financial burden for health services away from direct budget allocations by a health ministry. Although they are often implemented as ways of mobilizing additional resources, prices
BMJ Global Health
IntroductionSeveral low-income and middle-income countries (LMICs) have implemented health insurance programmes to foster accessibility to healthcare and reduce catastrophic household health expenditure. However, there is little information regarding the population coverage of health insurance schemes in LMICs and on the relationship between coverage and health expenditure. This study used open-access data to assess the level of health insurance coverage in LMICs and its relationship with health expenditure.MethodsWe searched for health insurance data for all LMICs and combined this with health expenditure data. We used descriptive statistics to explore levels of and trends in health insurance coverage over time. We then used linear regression models to investigate the relationship between health insurance coverage and sources of health expenditure and catastrophic household health expenditure.ResultsWe found health insurance data for 100 LMICs and combined this with overall health ...
Social Science & …, 2006
This paper presents the findings of a critical review of studies carried out in low-and middle-income countries (LMICs) focusing on the economic consequences for households of illness and health care use. These include household level impacts of direct costs (medical treatment and related financial costs), indirect costs (productive time losses resulting from illness) and subsequent household responses. It highlights that health care financing strategies that place considerable emphasis on out-of-pocket payments can impoverish households. There is growing evidence of households being pushed into poverty or forced into deeper poverty when faced with substantial medical expenses, particularly when combined with a loss of household income due to ill-health. Health sector reforms in LMICs since the late 1980s have particularly focused on promoting user fees for public sector health services and increasing the role of the private for-profit sector in health care provision. This has increasingly placed the burden of paying for health care on individuals experiencing poor health. This trend seems to continue even though some countries and international organisations are considering a shift away from their previous pro-user fee agenda. Research into alternative health care financing strategies and related mechanisms for coping with the direct and indirect costs of illness is urgently required to inform the development of appropriate social policies to improve access to essential health services and break the vicious cycle between illness and poverty. r
Health Policy, 2011
Objectives: We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden. Methods: We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries. Results: Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden. Conclusion: To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.
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Health Insurance for economically disadvantaged people in LMICs: What are the best options
The choice of a health care financing system can have both good, unintended, and devastating consequences on access to and delivery of quality affordable universal health care of a country. This paper aims to explore successful factors of health insurance schemes and health policies that will ensure universal health coverage for all without anyone left out. The chapter explores equity or fairness as defined by the theory of justice to elucidate why there tend to be inequities in health insurance coverage. It proposes measures that could be adopted to ensure social health protection and financial sustainability of health financing schemes to achieve universal health coverage in Lowand Middle-Income Countries (LMICs). Good health is an essential capital good for promoting well-being and longevity, and quality health care is a derivative of good health among other social and economic determinants of health. Universal health insurance schemes provide financial risk protection for many population groups, especially the less privileged, against catastrophic episodes of illness and injury. However, inequities in health care are pervasive and has impoverish many because of catastrophic health care expenditures. Many LMICs are exploring and developing different health care financing mechanisms to finance health care for the less privileged, while advanced nations are proposing new methods, revising, or reviving their national health policies to ensure equitable and sustainable health care for all.
International Journal of Health Planning and Management, 1992
Many developing countries are considering insurance as an option for increasing resource availability in the health sector in order to alleviate financial crisis. In addition to its impact on revenues, however, an insurance program also affects the efficiency and equity of health service delivery. This article examines these consequences of health insurance by reviewing a number of critical institutional characteristics of insurance programs in four developing countries-Brazil, China, Korea and Zaire-and assessing their impact on the efficiency and equity of the health sector. The characteristics highlighted in the article are: the system for reimbursing providers; the services covered by insurance; the role of the insurer; the extent of beneficiary cost-sharing; and, the extent of the population covered by the insurance program. Indicators of health sector efficiency and equity affected by these characteristics reviewed are: cost escalation; resource allocation; the use of specific medical technologies; and, equity of access to services. Efficiency and equity problems are found to arise from the financial incentives facing providers coupled with their powerful influence over both the supply and demand for personal health services. Experience suggests that these problems are magnified when an insurer serves merely as a financial conduit for reimbursing providers. Efficiency and equity goals can be more effectively promoted by an insurance institution which actively organizes the entry of consumers into the health system and removes the financial incentives that encourage providers to increase the volume and cost of services.