Transcript Health Financing - Studentportalen

Overview
Basic functions
Revenue collection
 Pooling of resources
 Purchasing of services

Health Financing Models
National Health Service Systems
 Social Health Insurance
 Private Health Insurance
 Community Based Health Insurance
 Direct purchases by consumers

Three basic principles
1.
2.
3.
Raise enough revenues to provide
individuals with a basic package of
essential services and financial
protection against catastrophic health
expenditure
Manage these revenues to pool health
risks equitably and efficiently
Ensure the purchase of health services
in ways that are allocatively and
technically efficient.
Patterns and effectiveness of
current health spending

10% of Global GDP is spent on health
 12% of this is spent in LIC and MIC
 78% is spent in HIC
In LIC 50% of spending is from Out of
Pocket Payment
 Public share of total health expenditure:

 LIC 30%
 MIC 50%
 HIC 65%
Patterns and effectiveness cont

Social health insurance institutions:
 LIC; 2%
 MIC; 15%
 HIC; 30%

External sources:
 LIC; 8%
(In 12 countries in SSA external sources finance
more than 30% of health expenditure)
 MIC; >1%
How effective is health spending
for outcome?
Greater improvements in health
outcomes are associated with stronger
institutions and higher investments in
other health related sectors, such as
education and infrastructure.
 Impact of government health spending
on maternal mortality and child mortality
 Impact of external funding on maternal
mortality and child mortality

Health financing functions and
sources of revenues

Collecting revenues
 LIC, about 18% of GDP

Risk pooling
 Pooling of risk in LIC is weak and
fragmented

Resource allocation and purchasing
 Implications for cost, access, quality, and
consumer satisfaction
Fiscal space
The budgetary room that allows a
government to provide resources for a
desired purpose.
Increasing taxes
 Reallocations within the budget
 Borrowing resources
 Receive grants from external sources

Health spending and health
policy
Poverty Reduction Strategy Papers;
PRSP
 Medium Term Expenditure Framework;
MTEF
 Public Expenditure Tracking Study and
Public Expenditure Review; PETS/PER

Health Financing Challenges in
LIC
Mobilizing domestic resources
 Securing more external funding
 Improving risk pooling
 Increasing efficiency and equity of public
spending
