eBook

Health insurance handbook : how to make it work

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

2012,2011

Overview

Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, 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 few of them. However, many of these schemes, both public and private, cover only a small proportion of the population, with the poor less likely to be covered. In fact, unless carefully designed to be pro-poor, health insurance can widen inequity as higher income groups are more likely to be insured and use health care services, taking advantage of their insurance coverage. The purpose of this handbook is to provide policy makers and health insurance designers with practical, action-oriented support that will deepen their understanding of health insurance concepts, help them identify design and implementation challenges, and define realistic steps for the development and scaling up of equitable, efficient, and sustainable health insurance schemes. The handbook takes policy makers and health insurance designers through a step-by-step series of considerations and tasks that need to be achieved. The handbook's philosophy is to not be dogmatic, ideological, or prescriptive. This handbook was prepared to be used in a six-day regional workshop. Clearly, health insurance design is an intensive political and technical process that takes much longer than six days. The expectation for the workshop is that by the end of the week, each team has a clear idea of next steps that they could take back home to engage other stakeholders and move toward scaling up and improving the performance of health insurance in their country.

• Publisher: World Bank,World Bank Publications,The World Bank
• Subject: ABILITY TO PAY / ACCESS TO HEALTH CARE / ACCESS TO HEALTH SERVICES / ACCESS TO SERVICES / ACTUARIES / ADMINISTRATIVE COSTS / ADMINISTRATIVE EFFICIENCY / ADVERSE SELECTION / Africa / BASIC HEALTH SERVICES / BURDEN OF DISEASE / CAR ACCIDENT / CHILD HEALTH / CLINICS / COMMUNITY HEALTH / COMPREHENSIVE HEALTH INSURANCE / CONDOMS / CONSUMERS / CONTRIBUTION RATE / COST CONTROL / COST OF SERVICES / COST SHARING / DECISION MAKING / DEMAND FOR HEALTH / DEMAND FOR HEALTH CARE / DEMAND FOR SERVICES / DETERMINANTS OF HEALTH / Developing Countries / DIAGNOSIS / DISADVANTAGED POPULATIONS / DOCTORS / DRUGS / Educational policy / EMERGENCY CARE / EPIDEMICS / Ethiopia / EXERCISES / FAMILIES / FAMILY INCOME / FAMILY PLANNING / FEE FOR SERVICE / Finance / FINANCIAL BARRIERS / FINANCIAL CATASTROPHE / FINANCIAL MANAGEMENT / FINANCIAL PROTECTION / FINANCIAL RESOURCES / FINANCIAL RISK / FINANCIAL RISK PROTECTION / FINANCING HEALTH CARE / FRAUD / FREE CARE / GOVERNMENT POLICIES / HEALTH CARE / HEALTH CARE COVERAGE / HEALTH CARE DELIVERY / HEALTH CARE EXPENDITURE / HEALTH CARE FACILITIES / HEALTH CARE PROVIDERS / HEALTH CARE REFORM / HEALTH CARE SERVICES / HEALTH CARE UTILIZATION / HEALTH CENTERS / HEALTH CONDITIONS / HEALTH COSTS / HEALTH EDUCATION / HEALTH EXPENDITURE / HEALTH EXPENDITURES / HEALTH FACILITIES / HEALTH FINANCING / HEALTH FINANCING SYSTEM / HEALTH INDUSTRY / HEALTH INSURANCE / HEALTH INSURANCE COVERAGE / HEALTH INSURANCE FUND / HEALTH INSURANCE PLAN / HEALTH INSURANCE PROGRAM / HEALTH INSURANCE SCHEME / HEALTH INSURANCE SCHEMES / HEALTH INSURANCE SYSTEM / HEALTH INTERVENTIONS / HEALTH ORGANIZATION / HEALTH OUTCOMES / HEALTH POLICY / HEALTH POLICY OBJECTIVES / HEALTH PROFESSIONALS / HEALTH PROMOTION / HEALTH PROVIDERS / HEALTH REFORM / HEALTH SECTOR / HEALTH SERVICE / HEALTH SERVICES / HEALTH SPENDING / HEALTH STATUS / HEALTH SYSTEM / HEALTH SYSTEMS / HEALTH WORKERS / HEALTH · FUNDING / HIGH FERTILITY / HIV/AIDS / HOSPITAL BEDS / HOSPITAL CAPACITY / HOSPITAL CARE / HOSPITAL SECTOR / HOSPITALIZATION / HOSPITALS / HOUSEHOLD INCOME / HUMAN RESOURCES / ILLNESS / IMMUNIZATION / IMPROVEMENTS IN HEALTH / INCENTIVES FOR PROVIDERS / INCOME / INCOME COUNTRIES / INCOME GROUPS / INCOME POPULATION / INDEXES / INEFFICIENT DELIVERY / INFECTIOUS DISEASES / INFLATION / INFORMAL PAYMENTS / INFORMAL SECTOR / INFORMAL SECTOR WORKERS / INFORMATION SYSTEM / INFORMATION SYSTEMS / INPATIENT CARE / INSURANCE AGENCIES / INSURANCE CLAIMS / INSURANCE COMPANIES / INSURANCE FUNDS / INSURANCE LAW / INSURANCE PACKAGE / INSURANCE PLAN / INSURANCE PREMIUM / INSURANCE SYSTEMS / Insurance, Health -- economics / Insurance, Health -- organization & administration / INSURERS / International bank for reconstruction and development / LABOR MARKETS / LEGAL FRAMEWORK / LIFE INSURANCE / LOW-INCOME COUNTRIES / MARKETING / MEDICAL BENEFITS / MEDICAL EXPENSES / MEDICAL INSURANCE / Medical service / MEDICAL SERVICES / MEDICARE / MEDICINES / Money / MORAL HAZARD / MORBIDITY / MORTALITY / MUTUAL AID / NATIONAL HEALTH / NATIONAL HEALTH INSURANCE / NATIONAL HEALTH SERVICE / Nigeria / NONGOVERNMENTAL ORGANIZATIONS / NURSES / OUTPATIENT CARE / OUTPATIENT SERVICES / PATIENT / PATIENTS / PHARMACIES / POCKET PAYMENTS / Poverty relief / PREGNANT WOMEN / PREVENTIVE CARE / PRIMARY CARE / PRIMARY HEALTH CARE / PRIMARY HEALTH CARE SERVICES / PRIVATE CLINICS / PRIVATE HEALTH INSURANCE / PRIVATE INSURANCE / PRIVATE SECTOR / PROFESSIONAL ASSOCIATIONS / PROGRAMS / PROVIDER PAYMENT / PROVISION OF SERVICES / PUBLIC HEALTH / PUBLIC HEALTH INSURANCE / PUBLIC SECTOR / QUALITY CONTROL / QUALITY OF HEALTH / REIMBURSEMENT RATES / REINSURANCE / RISK SHARING / SCHOOL HEALTH / SCREENING / SICKNESS FUNDS / SOCIAL HEALTH INSURANCE / SOCIAL INSURANCE / SOCIAL SECURITY / SUPPLY OF HEALTH PROVIDERS / SUSTAINABILITY / Sustainable development / UNEMPLOYMENT / VACCINATIONS / WORKERS
• ISBN: 0821389823, 9780821389829, 082138953X, 9780821389539