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作者 Preker, Alexander S
書名 Scaling Up Affordable Health Insurance : Staying the Course
出版項 Herndon : World Bank Publications, 2013
©2013
國際標準書號 9780821385791 (electronic bk.)
9780821382509
book jacket
說明 1 online resource (781 pages)
text txt rdacontent
computer c rdamedia
online resource cr rdacarrier
附註 Front Cover -- Title Page -- Copyright -- Contents -- Foreword -- Preface -- Acknowledgments -- Abbreviations and Acronyms -- 1. Introduction: Public Options, Private Choices -- Introduction -- Key Issues -- References -- Part 1 Major Policy Challenges: Preconditions for Scaling Up -- 2. Health Protection: More Than Financial Protection -- Introduction -- Social Health Insurance: Concepts, Definitions, and Observations -- Current Trends and Developments in Social Health Insurance -- Experiences in Scaling Up Social Health Insurance -- Achieving Universal Coverage by Scaling Up Social Health Insurance -- Conclusion -- Notes -- References -- 3. Making Health Insurance Affordable: Role of Risk Equalization -- Introduction -- Why Are Out-of-Pocket Health Expenses So Common? -- Subsidies for Health Insurance -- Mandatory Community Rating: Does One Premium Fit All? -- Economic Motives for Mandatory Health Insurance -- Conclusions and Discussion -- References -- 4. Reaching the Poor: Transfers from Rich to Poor and from Healthy to Sick -- What Is Social Health Insurance? -- Design Considerations -- Financing Mechanisms -- Notes -- References -- 5. Binding Constraints on Public Funding: Prospects for Creating "Fiscal Space" -- What Are the Sources of "Fiscal Space"? -- Issues That Arise in the Creation of "Fiscal Space" -- Concluding Remarks -- Notes -- References -- 6. Universal Coverage: A Global Consensus -- Introduction -- Shifting to Prepayment -- Policy Norms in Health Financing -- Key Questions -- Factors to Consider -- Toward a Comprehensive Framework -- Conclusion -- Note -- References -- Part 2 From Theory to Practice: Evidence from the Ground -- 7. The French Connection in Francophone Africa -- Introduction -- Current Status of Health Financing and Health Insurance -- Key Factors in the Development of Health Insurance
Prospects for the Development of Health Insurance -- Conclusions -- Annex 7A Statistical Annex -- Notes -- References -- 8. "Big-Bang" Reforms in Anglophone Africa -- Introduction -- Health Coverage and Insurance Arrangements -- Factors Underlying Resistance to Reform and Implementation -- Targeted Areas for Scaling Up Health Insurance Development -- Annex 8A Health Insurance Arrangements in Anglophone Africa, by Country -- Notes -- References -- 9. Moving from Intent to Action in the Middle East and North Africa -- Introduction -- Health Financing in MENA: Trends and Patterns -- Health Insurance in MENA -- Conclusions and Recommendations -- Annex 9A MENA: National Health Expenditure, 1995-2008 -- Annex 9B MENA: Health Financing and Insurance, Selected Countries -- Notes -- References -- 10. One-Step, Two-Step Tango in Latin America and the Caribbean -- Introduction -- Overview of the LAC Region -- Policy Challenges That Arise When Extending Coverage -- Strategies for Extending Health System Coverage: Social Insurance and Other Approaches -- Summary and Conclusions -- Notes -- References -- 11. Orient Express in South, East, and Pacific Asia -- Introduction -- Overview of Socioeconomic, Demographic, and Health Conditions -- Role of Private Insurance in Scaling Up -- Barriers to Scaling Up -- Factors Enabling Developed Asian Countries to Scale Up -- Scaling Up in Five Low- and Lower-Middle-Income Asian Countries -- Lessons and Conclusions -- Notes -- References -- 12. Bismarck's Unfinished Business in Western Europe -- The "Logic" of Health Insurance -- The Social Origins of Health Insurance -- The Extension of State Involvement in Health Insurance -- The Doctors' Struggle -- Broadening Coverage -- Deepening Coverage -- The Structure of the Health Insurance Market -- Economy and Governance -- Conclusions and Policy Lessons
Annex 12A Socioeconomic Data on Health Insurance, Selected West European Countries -- Annex 12B Overview of Health Financing and Social Health Insurance, Selected West European Countries -- Annex 12C The Conceptualization of Good Governance -- Notes -- References -- 13. From Cradle to Grave in the United Kingdom, Canada, Australia, and Elsewhere -- Introduction -- Past Achievements -- Major Outstanding Issues -- Two Different Reform Processes to Universal Access -- Legal Entitlement and Dimensions of Access -- Nature of Participation -- Financing Mechanisms -- Relevance of OECD Experience to the Developing World -- Revisiting Universal Entitlement -- Note -- References -- 14. Great Post-Communist Experiment in Eastern Europe and Central Asia -- Introduction -- Europe and Central Asia's SHI Reforms and Hypothesized Effects -- Methods -- Data -- Results -- Discussion and Conclusions -- Notes -- References -- Part 3 Implementation Challenges: Staying the Course -- 15. Political Economy of Reform -- Introduction: Why Political Economy? -- Agenda Setting: Getting Health Insurance onto the National Agenda -- Technical Design: What Affects the Contents of the Proposed Reforms? -- Adoption: Political Bargaining and the Legislative Process -- Implementation: Operationalizing the Reform -- Conclusions -- Notes -- References -- 16. Institutions Matter -- Introduction -- Political Economy of Health Financing Reforms -- Policy Options for Reform -- Notes -- References -- 17. Accountability and Choice -- Social Health Insurance: The Concept -- Social Health Insurance Models: A Typology -- Shaping the Institutional and Governance Infrastructure for SHI -- SHI Transitional Challenges: Transforming Groups and Stakeholders -- Meeting Transitional Challenges -- Conclusion: The Roles of the State Revisited -- Notes -- References
18. Regulatory and Supervisory Challenges -- Regulation, Supervision, and the Public-Private Mix -- Regulatory and Supervisory Activity -- Supervision and Regulation: Minimum Requirements -- Minimum Regulatory Requirements -- Health Care Providers and Suppliers -- Public-Private Partnerships -- Conclusions -- Annex 18A Adapting Accepted Insurance Principles to Private Voluntary Health Insurance -- Notes -- References -- 19. Implementing Change -- Introduction -- Design Elements for a Health Insurance Scheme -- Summary -- Notes -- References -- 20. New Development Paradigm -- Introduction -- The Old Paradigm -- How Did Universal Health Systems Grow? -- Why Does the Process Work Differently in Development Settings? -- Clients -- An Alternative Model for Health Systems: Beyond the Three Laws of Health Economics -- Conclusions -- Notes -- References -- Appendixes -- A. Theory of Social Health Insurance -- 1. Introduction and Overview -- 2. The Demand for Social Health Insurance -- 3. The Supply of Health Insurance -- 4. The Design of an Optimal Health Insurance Contract -- 5. The Limits of Social Health Insurance -- 6. Summary and Conclusions -- Notes -- Annex A Formal Model of Health Insurer Behavior in Terms of Innovation and Risk-Selection Effort -- Annex B Types and Efficiency Effects of Regulation -- References -- B. Empirical Evidence on Trends in Health Insurance -- Conceptual Framework -- Empirical Analysis of Health Insurance Development at the International Level -- Results -- Annex A Additional Data -- Notes -- References -- C. Compendium of Health Insurance Terms -- Note -- About the Coeditors and Contributors -- Coeditors -- Other Contributing Authors -- Index -- Boxes -- Figures -- Tables -- Back Cover
"Scaling Up Affordable Health Insurance: Staying the Course" is the fifth volume in a series of in-depth reviews on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs. Success in improving access and financial protection through community and private voluntary health insurance have led many countries to attempt to make membership compulsory and to offer subsidized insurance through the public sector. The protagonists are divided into several camps; from supporters of health insurance to opponents or skeptics. Today many low- and middle-income countries are no longer listening to this dichotomized debate between vertical and horizontal approaches to health care. Instead, they are experimenting with new and innovative approaches to health care financing. Health insurance is becoming a new paradigm for reaching the Millennium Development Goals. The research for this volume shows that when properly designed and coupled with public subsidies, health insurance can contribute to the well-being of poor and middle-class households, not just the rich. And it can contribute to development goals such as improved access to health care, better financial protection against the cost of illness, and reduced social exclusion. The book is organized into three main parts. Major policy directions in financing health care are discussed in Part 1, with a particular focus on the pre-conditions for scaling up. Part 2 moves from theory to practice with overviews and country level studies on health insurance development. Finally, part 3 highlights the implementation challenges
Description based on publisher supplied metadata and other sources
Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2020. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
鏈接 Print version: Preker, Alexander S. Scaling Up Affordable Health Insurance : Staying the Course Herndon : World Bank Publications,c2013 9780821382509
主題 Health insurance -- Developing countries.;Health services accessibility -- Economic aspects
Electronic books
Alt Author Lindner, Marianne E
Chernichovsky, Dov
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