Health Insurance Handbook : How toMake It Work

Wang, Hong ; Switlick, Kimberly ; Ortiz, Christine ; Zurita, Beatriz ; Connor, Catherine

World Bank

关键词: ABILITY TO PAY;    ACCESS TO HEALTH CARE;    ACCESS TO HEALTH SERVICES;    ACCESS TO SERVICES;    ACTUARIES;   

DOI  :  10.1596/978-0-8213-8982-9
RP-ID  :  66234

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Many countries that subscribe to theMillennium Development Goals (MDGs) have committed toensuring access to basic health services for their citizens.Health insurance has been considered and promoted as themajor financing mechanism to improve access to healthservices, as well as to provide financial risk protection.In Africa, several countries have already spent scarce time,money, and effort on health insurance initiatives. Ethiopia,Ghana, Kenya, Nigeria, Rwanda, and Tanzania are just a fewof them. However, many of these schemes, both public andprivate, cover only a small proportion of the population,with the poor less likely to be covered. In fact, unlesscarefully designed to be pro-poor, health insurance canwiden inequity as higher income groups are more likely to beinsured and use health care services, taking advantage oftheir insurance coverage. The purpose of this handbook is toprovide policy makers and health insurance designers withpractical, action-oriented support that will deepen theirunderstanding of health insurance concepts, help themidentify design and implementation challenges, and definerealistic steps for the development and scaling up ofequitable, efficient, and sustainable health insuranceschemes. The handbook takes policy makers and healthinsurance designers through a step-by-step series ofconsiderations and tasks that need to be achieved. Thehandbook's philosophy is to not be dogmatic,ideological, or prescriptive. This handbook was prepared tobe used in a six-day regional workshop. Clearly, healthinsurance design is an intensive political and technicalprocess that takes much longer than six days. Theexpectation for the workshop is that by the end of the week,each team has a clear idea of next steps that they couldtake back home to engage other stakeholders and move towardscaling up and improving the performance of health insurancein their country.