Transcript Politics of Healthcare Financing

Politics of Healthcare Financing
Ravi Duggal
[email protected]
PHA3 Cape Town
Quote…
• Health is one of the goods of life to which
man has a right; wherever this concept
prevails the logical sequence is to make all
measures for the protection and
restoration of health to all, free of charge;
medicine like education is then no longer a
trade - it becomes a public function of the
State ... Henry Sigerist
Healthcare is a Social Good
• Recognizing that markets in healthcare fail
• Learning from global experience about the
criticality of public financing for equity and
universal access to healthcare
• Health and healthcare are acknowledged
human rights and hence demand strong state
obligations and actions
• Healthcare Financing (HCF) for above must
remain under control of the state for sake of
equity and justice
Politics of HCF at Country Level
• What is the character of the political economy of
healthcare and its financing?
• Is healthcare financing and provision an
organized system?
• How politicized is healthcare? Political Champion
• Strength and accountability of public finance –
Tax:GDP ratio, transparency of budgets, tax
expenditures, tax evasion, tax architecture…
• Resources for healthcare – taxes, insurance,
extractives, donor dependence, philanthropy,
OOPs….
Politics of HCF Globally
• The political economy of finance capital – tax
havens, transfer pricing, FTTs
• The Insurance malaise
• South-north resource flows – HRH migration,
medical tourism, generics..
• Donors and philanthropy contributing to
fragmentation of healthcare
Critical Issues on HCF for PHM
• Global Level
– Engaging global finance capital to net new revenues
– Calculate south-north resource flows to swap with
debt
– Advocating for donor funds to general budgets
• Country Level
– Pushing for organizing provision and financing of
healthcare into a system
– Getting a political champion on board