Social Health Insurance for Developing Nations

Hsiao, William C. ; Shaw, R. Paul

Washington, DC:World Bank

关键词: ABILITY TO PAY;    ACCESS TO HEALTH SERVICES;    ACCOUNTING;    ADMINISTRATIVE COSTS;    ADMINISTRATIVE SUPPORT;   

DOI  :  10.1596/978-0-8213-6949-4
RP-ID  :  41171

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Good health is necessary for well-beingbut also has another critical impact: it causes poverty, inthat large health expenditures can bankrupt families. Manynations are now hoping that formally mandated social healthinsurance (SHI), involving payroll taxes, will provide asolution. This report examines the principles, design, andpractices of SHI for low and middle-income nations and thenecessary conditions for its viability and sustainability,with a focus on design and implementation issues. Thisvolume presents five country case studies to provideevidence and greater detail on key issues that arise atdifferent stages of implementation in low-income countries.They have been selected to reflect on a continuum andtimeline of operational stages, beginning with the initialdesign and legislation of SHI, the first phase ofimplementation, the expansion to cover larger segments ofthe population, and on up to completion, whereby SHI becomesthe predominant form of health care financing in a country.Accordingly, Kenya has been selected for illustration of thedesign stage, Ghana for initiation, the Philippines forextension of population coverage, Colombia for SHI andreform of health care delivery, and Thailand for universalcoverage and reform of health care delivery. This sequencingand implied timeline of case studies allows this report toreflect on two questions. First, where can a country expectto be in relation to designing and implementing SHI in, say,10 years? Second, as countries gain experience with SHI,what can they expect to offer or achieve in terms ofvariations in benefit design, who administers SHI, and howproviders are contracted and paid?