Health Financing Revisited: A Practitioner's Guide

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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.

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Product Details

  • ISBN-13: 9780821365854
  • Publisher: World Bank Publications
  • Publication date: 3/30/2006
  • Series: Stand Alones Series
  • Edition description: New Edition
  • Pages: 336
  • Product dimensions: 5.90 (w) x 8.90 (h) x 0.80 (d)

Table of Contents

Acronyms and Abbreviations
Overview 1
The numbers 2
Patterns and effectiveness of current health spending 3
Health financing functions and sources of revenues 4
Risk pooling mechanisms 7
Development assistance for health 12
Realities of government spending and policy levers 14
Health financing challenges in low-income countries 15
Health financing challenges in middle-income countries 18
Learning from high-income countries 20
1 Health transitions, disease burdens, and health expenditure patterns 23
Demographic dynamics 24
The epidemiological transition and health spending 28
Implications of demographic and epidemiological transitions for health financing 32
Global distribution of health expenditures 34
Sources of health spending 36
Annex 1.1 Population pyramids and global health expenditures by region and income group 39
2 Collecting revenue, pooling risk, and purchasing services 45
Health financing functions: definitions and implications 46
Revenue collection and government financing of health services 49
Risk pooling, financial protection, and equality 54
Risk pooling and prepayment 58
Purchasing 61
Health financing policies and fiscal space to increase health spending 63
Annex 2.1 Classifications of health financing systems 66
3 Risk pooling mechanisms 73
State-funded health care systems 75
Social health insurance 82
Community-based health insurance 96
Voluntary health insurance 103
Annex 3.1 The four types of financial risk in voluntary/private health insurance 115
4 External assistance for health 123
Trends in official development assistance 125
Trends in private financial flows 131
Trends in health aid 133
The effectiveness of aid 138
Recent efforts to revamp aid 150
5 Improving health outcomes 161
Government health expenditures 163
Reaching the Millennium Development Goals for health 164
Annex 5.1 Government health expenditures, donor funding, and health outcomes: data and methods 170
6 Increasing the efficiency of government spending 185
Institutions and policies at the country level 187
Policy instruments to improve public sector management 189
Targeting health expenditures 198
Decentralizing health care 201
7 Financing health in low-income countries 209
Health spending by region 211
The cost of the Millennium Development Goals 214
Public sources of revenue for health 218
Private sources of revenue for health 227
Equity and efficiency of health spending in low-income countries 236
Annex 7.1 Four models to estimate the cost of the Millennium Development Goals for health at the country level 244
8 Financing health in middle-income countries 249
Commonality and variations in health systems 250
Common health financing challenges 252
Revenue mobilization 254
Risk pooling 259
Purchasing services 265
Other considerations 272
Annex 8.1 Summary of recent health reforms in middle-income countries 273
9 Financing health in high-income countries 279
Main reform trends in high-income countries 280
Coverage decisions and benefit entitlements 282
Collection of funds 290
Pooling of funds 298
Purchasing and remuneration of providers 302
Index 311
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