Health Financing Policy

The global movement toward universal health coverage (UHC) is accompanied by requests for large increases in government health spending in some countries. This combined with the global economic situation and stagnant economic growth across many low- and middle-income countries make it more critical than ever to place health financing discussions firmly in the context of macroeconomic and fiscal realities. Unfortunately, there is often a disconnect in decision making, with key fiscal decisions made in the absence of a clear understanding on the one hand of the potential consequences for the health sector, and on the other, the consequences for the country’s macroeconomic and fiscal position of increasing or reallocating government spending. Constructive health financing policy dialogue aims to reach a common understanding between health sector leaders and central budget authorities about policy objectives for the health sector and the resources needed to achieve those objectives, how much priority will be given to health in the government budget, and how the health sector will be held accountable for using funds effectively. This common understanding should be built on a realistic picture of the country’s macroeconomic and fiscal context, the constraints and competing priorities in the budget-setting process. When ministries of health and ministries of finance have a common understanding of macroeconomic and fiscal constraints, discussions can focus productively on using funds within the potential health resource envelope in the most effective way to achieve health system objectives. This guidance note outlines the key components of the macroeconomic, fiscal, and public financial management context that need to be considered for an informed health financing discussion at the country level. The guidance note is organized around four sets of questions that are key to placing the health financing dialogue in the context of a country’s macroeconomic and fiscal context. Each section points to measures, resources, and analytical tools that are available to assist in answering these questions for a specific country. The guidance note draws on case studies from 11 countries moving toward or sustaining universal health coverage conducted as part of the Japan†“World Bank Partnership Program on UHC as well as from other country examples.

This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.

Analyses the experience with the financing reforms implemented by the countries of Central Europe, Eastern Europe, the Cauxasus and Central Asia.

Given the central importance of public financing to make progress towards universal health coverage (UHC), government policy on benefit design, including both service entitlements and conditions of access, significantly influences health system performance. Benefit design considers how all public funds are used and should be based on evidence and developed through a systematic process involving key stakeholders. Reducing uncertainty over entitlements and conditions of access, in particular co-payments, both reduces barriers to accessing services and improves financial protection. Finally, aligning benefit design with a range of health financing policies, as well as service with delivery objectives, provides a powerful way through which policy makers can drive positive change in their health systems.

Focusing on the three health care financing functions, collection, pooling and purchasing, as well as on coverage, this book analyses the organization of health care financing in the Member States of the European Union, discusses the principal financing reform trends of recent years, and assesses the capacity of these to help ensure fiscal sustainability.

Tanzania is currently developing a Health Financing Strategy to provide a medium to long-term road map for a sustainable and integrated health financing system. This book is designed to inform this discussion by providing an analytical basis for the assessment of options, a series of policy options which could be considered

For humanitarian reasons and the concern for households' economic and health security, the health sector is at the center of global development policy. Developing countries and the international community are scaling up health systems to meet the Millennium Development Goals (MDGs) and are improving financial protection by securing long-term support for these gains. Yet money alone cannot buy health gains or prevent impoverishment due to catastrophic medical bills; well structured, results-based financing reforms are needed. Unfortunately, global evidence of successful health financing policies that can guide the reform effort is very limited and therefore the policy debate is often driven by ideological, one-size-fits-all solutions. Good Practices in Health Financing: Lessons from Reforms in Low- and Middle-Income Countries' attempts to begin to fill the void by systematically assessing health financing reforms in nine low- and middle-income countries that have managed to expand their health financing systems to both improve health status and protect against catastrophic medical expenses. The participating countries are: Chile, Colombia, Costa Rica, Estonia, the Kyrgyz Republic, Sri Lanka, Thailand, Tunisia, and Vietnam. The study seeks to identify common enabling factors of their good performance. While the findings for each country are important, collectively they send a clear message to the global community that more attention is needed to define good practice and then to evaluate and disseminate the global evidence base.

A collection of peer-reviewed articles and contributions to books, this overview of the finance of health insurance concentrates on developing countries. The material covers various financing strategies and explains how each can--or cannot--help improve the transition toward universal coverage. The model plans shown here are particularly useful for policy-makers and technical advisers who have to decide upon health financing policies--or are engaged in a debate about them--and the sample forms can be adjusted to the particular economic and political context of the developing countries involved. In addition, there are reminders that this process varies: in some countries, universal coverage may take time and require a step-by-step approach. In other developing countries, a swift transition to universal coverage may be quite feasible.