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Chapter 5 - Financing Health Care

Revenue Raising, Pooling, and Purchasing

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press:  08 December 2022

By
David B. Evans ,
Awad Mataria ,
Christoph Kurowski  and
Martin Schmidt
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
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Summary

High performance health financing requires funding levels that are adequate, sustainable and resilient to meet country health goals, pooling that is sufficient to spread the financial risks of ill-health across the population, and spending that is both efficient and equitable to assure the desired levels of health service coverage, quality, and financial protection for all people. This chapter describes the various components of health financing and how they interact to determine how rapidly countries can approach the goal of Universal Health Coverage.

Keywords

High-performance health financingRevenue generationPoolingPurchasingEfficiencyEquityHealth financing sustainabilityHealth financing resilienceL&MIC
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 67 - 82
Publisher: Cambridge University Press
Print publication year: 2022

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References

International Monetary Fund. Fault lines widen in the global recovery. 2021. www.imf.org/en/Publications/WEO/Issues/2021/07/27/world-economic-outlook-update-july-2021 (accessed December 29, 2021).Google Scholar
Kurowski, C., Evans, D. B., Tandon, A., et al. From double shock to double recovery: implications and options for health financing in the time of COVID-19. 2021. https://openknowledge.worldbank.org/handle/10986/35298 (accessed December 29, 2021).Google Scholar
Kurowski, C., Evans, D. B., Tandon, A., et al. From double shock to double recovery: implications and options for health financing in the time of COVID-19. Technical update – widening rifts. 2021. https://openknowledge.worldbank.org/bitstream/handle/10986/35298/From_Double_Shock_to_Double_Recovery%20Revision%2020210916.pdf?sequence=7 (accessed December 29, 2021).CrossRefGoogle Scholar
Kurowski, C., Evans, D. B., Irwin, A.. et al. Scaling what works: convergence on health financing policies for universal health coverage in low- and middle-income countries (forthcoming).Google Scholar
World Health Organization. The World Health Report 2010: Health Systems Financing – the Path to Universal Coverage. Geneva, World Health Organization, 2010. https://apps.who.int/iris/handle/10665/44371 (accessed December 29, 2021).Google Scholar
World Bank. High-performance financing for universal health coverage: driving sustainable, inclusive growth in the 21st century. 2021. www.worldbank.org/en/topic/universalhealthcoverage/publication/high-performance-health-financing-for-universal-health-coverage-driving-sustainable-inclusive-growth-in-the-21st-century (accessed December 29, 2021).Google Scholar
World Health Organization. Financing for universal health coverage: dos and don’ts. 2019. https://p4h.world/en/news/financing-universal-health-coverage-dos-and-donts (accessed December 29, 2021).Google Scholar
Gottret, P., Schieber, G., Waters, H. R.. Good practices in health financing: lessons from reforms in low and middle-income countries. 2008. https://openknowledge.worldbank.org/handle/10986/6442 (accessed December 29, 2021).Google Scholar
World Health Organization. Global health expenditure database. 2021. https://apps.who.int/nha/database (accessed November 29, 2021).Google Scholar
World Health Organization. Global expenditure on health: public spending on the rise? 2021. https://apps.who.int/iris/bitstream/handle/10665/350560/9789240041219-eng.pdf (accessed December 29, 2021).Google Scholar
Hamadeh, N., Van Rompaey, C., Metreau, E.. New World Bank country classifications by income level: 2021–2022. 2021. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups (accessed December 29, 2021).Google Scholar
Saksena, P., Hsu, J., Evans, D. B.. Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS Med 2014; 11(9): e1001701.Google Scholar
World Bank. First universal health coverage financing forum: raising funds for health. Background paper. 2016. https://thedocs.worldbank.org/en/doc/5d7befa83cbafe469a1f9a5d591eb443-0140062021/related/Background-Paper-First-Annual-UHC-Financing-Forum-DRM.pdf (accessed December 29, 2021).Google Scholar
Tandon, A., Cain, J., Kurowski, C., et al. Intertemporal dynamics of public financing for universal health coverage: accounting for fiscal space across countries. 2018. https://openknowledge.worldbank.org/handle/10986/31211 (accessed December 29, 2021).Google Scholar
Baum, A., Hodge, A., Mineshima, A., et al. Can they do it all? Fiscal space in low-income countries. IMF Working Paper. 2015. www.imf.org/en/Publications/WP/Issues/2017/05/05/Can-They-Do-It-All-Fiscal-Space-in-Low-Income-Countries-44889 (accessed December 29, 2021).CrossRefGoogle Scholar
Barroy, H., Sparkes, S., Dale, E., et al. Can low- and middle-income countries increase domestic fiscal space for health: a mixed-methods approach to assess possible sources of expansion. Health Syst Reform 2018; 4(3): 214–226.Google Scholar
Task Force on Fiscal Policy for Health. Health taxes to save lives: employing effective excise taxes on tobacco, alcohol, and sugary beverages. 2019. www.bloomberg.org/public-health/building-public-health-coalitions/task-force-on-fiscal-policy-for-health (accessed December 29, 2021).Google Scholar
World Health Organization. Health taxes: a primer for WHO staff. 2018. https://apps.who.int/iris/bitstream/handle/10665/275715/WHO-HGF-EAE-HealthTaxes-2018-Primer-eng.pdf?sequence=1&isAllowed=y/ (accessed December 29, 2021).Google Scholar
International Monetary Fund. Government financial statistics manual. 2001. www.imf.org/external/pubs/ft/gfs/manual/ (accessed December 29, 2021).Google Scholar
Yazbeck, A. S., Savedoff, W. D., Hsiao, W. C., et al. The case against labor-tax-financed social health insurance for low- and low-middle-income countries. Health Aff (Millwood) 2020; 39(5): 892–897.CrossRefGoogle ScholarPubMed
Cashin, C., Sparks, S. Bloom, D.. Earmarking for health: from theory to practice. Health Financing Working Paper 5. 2017. https://apps.who.int/iris/bitstream/handle/10665/255004/9789241512206-eng.pdf (accessed December 29, 2021).Google Scholar
Ozer, C., Bloom, D., Valle, A. M., et al. Health earmarks and health taxes: what do we know? 2020. https://openknowledge.worldbank.org/handle/10986/34947 (accessed December 29, 2021).Google Scholar
Kaboré, R. M. C., Solberg, E., Gates, M., et al. Financing the SDGs: mobilising and using domestic resources for health and human capital. Lancet 2018; 392(10158): 1605–1607.CrossRefGoogle ScholarPubMed
Smith, P. C., Witter, S. N.. Risk pooling in health care financing: the implications for health system performance. Health, Nutrition and Population Discussion Paper. 2004. https://openknowledge.worldbank.org/handle/10986/13651 (accessed December 29, 2021).Google Scholar
Spaan, E., Mathijssen, J., Tromp, N., et al. The impact of health insurance in Africa and Asia: a systematic review. Bull World Health Organ 2012; 90(9): 685–692.Google Scholar
Mathauer, I., Saksena, P., Kutzin, J.. Pooling arrangements in health financing systems: a proposed classification. Int J Equity Health 2019; 18(1): 198.Google Scholar
Mathauer, I., Mathivet, B., Kutzin, J.. Community based health insurance: how can it contribute to progress towards UHC? Health Financing Policy Brief 3. 2017. www.who.int/publications/i/item/WHO-HIS-HGF-PolicyBrief-17.3 (accessed December 29, 2021).Google Scholar
Mathauer, I., Kutzin, J.. Voluntary health insurance: its potentials and limits in moving towards UHC. 2017. www.who.int/publications/i/item/WHO-HIS-HGF-Health-Financing-Policy-Brief-18.5 (accessed December 29, 2021).Google Scholar
Kutzin, J.. Why does public finance matter for UHC? 2016. www.who.int/health_financing/events/JosephKutzin-why-does-public-finance-matter-for-uhc.pdf (accessed December 29, 2021).Google Scholar
Geruso, M., Layton, T. J.. Selection in health insurance markets and its policy remedies. J Econ Perspect 2017; 31(4): 23–50.Google Scholar
Thomson, S., Jeurissen, P.. Single vs multiple competing purchasing agencies: analysis of options for the health system in Cyprus. 2017. www.euro.who.int/__data/assets/pdf_file/0011/339662/WHO_005-Cyprus-SCREEN.pdf (accessed December 29, 2021).Google Scholar
Wagstaff, A., Flores, G., Hsu, J., et al. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health 2018; 6(2): e169–e179.Google Scholar
Saksena, P., Hsu, J., Evans, D. B.. Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS Med 2014; 11(9): e1001701.Google Scholar
Smith, O., Nguyen, S. N.. Getting better: improving health system outcomes in Europe and Central Asia. 2013. https://openknowledge.worldbank.org/handle/10986/13832 (accessed December 29, 2021).Google Scholar
World Health Organization. Tracking Universal Health Coverage: 2021 Global Monitoring Report. Geneva, World Health Organization, 2021. www.who.int/publications/i/item/9789240040618 (accessed December 29, 2021).Google Scholar
Mathauer, I., Dale, E., Jowett, M., et al. Purchasing health services for universal health coverage: how to make it more strategic? 2019. https://apps.who.int/iris/handle/10665/311387 (accessed December 29, 2021).Google Scholar
Fitzpatrick, A.. The impact of public health sector stockouts on private sector prices and access to healthcare: evidence from the anti-malarial drug market. J Health Econ 2021; 81: 102544.Google Scholar
World Bank. Second annual UHC financing forum greater efficiency for better health and financial protection. 2017. https://thedocs.worldbank.org/en/doc/5d7befa83cbafe469a1f9a5d591eb443-0140062021/related/Background-Paper-Second-Annual-UHC-Financing-Forum-FORUM.pdf (accessed December 29, 2021).Google Scholar
Disease Control Priorities. Home page. 2018. http://dcp-3.org (accessed December 29, 2021).Google Scholar
Perrot, J.. Different approaches to contracting in health systems. Bull World Health Organ 2006; 84(11): 859–866.Google Scholar
Vong, S., Raven, J., Newlands, D.. Internal contracting of health services in Cambodia: drivers for change and lessons learned after a decade of external contracting. BMC Health Serv Res 2018; 18(1): 375.Google Scholar
Ensor, T., Tiwari, S.. Demand-side financing in health in low-resource settings. In Revill, P., Suhrcke, M., Moreno-Serra, R., et al., eds., Global Health Economics: Shaping Health Policy in Low- and Middle-Income Countries. Singapore, World Scientific Publishing, 2020, pp. 217–237.CrossRefGoogle Scholar
Glassman, A., Duran, D., Fleisher, L., et al. Impact of conditional cash transfers on maternal and newborn health. J Health Popul Nutr 2013; 31(4 Suppl. 2): 48–66.Google Scholar
Hunter, B. M., Harrison, S., Portela, A., et al. The effects of cash transfers and vouchers on the use and quality of maternity care services: a systematic review. PLoS One 2017; 12(3): e0173068.Google Scholar
Kwon, S., Kim, E.. Sustainable health financing for COVID-19 preparedness and response in Asia and the Pacific. 2022. https://ideas.repec.org/a/bla/asiapr/v17y2022i1p140-156.html (accessed February 4, 2022).CrossRefGoogle Scholar

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