eBook

Governing mandatory health insurance : learning from experience

Savedoff, William D., World Bank, Gottret, Pablo E. (Pablo Enrique)

2008

Overview

Although mandatory health insurance programs are being proposed or expanded in many developing countries, relatively little attention has been given to how these programs are governed. The available literature focuses almost exclusively on operational features that are important but will necessarily change over time—such as eligibility, benefit packages, and premiums. Governing Mandatory Health Insurance instead looks at the institutional and political forces that affect the behavior of such programs within their social and historical contexts and how five dimensions of governance—coherent decision-making structures, stakeholder participation, transparency and information, supervision and regulation, and consistency and stability—can influence the long-term performance of health insurance programs in terms of coverage, financial protection, efficiency, and sustainability. Governing Mandatory Health Insurance addresses these issues by drawing on the experiences of four countries—Chile, Costa Rica, Estonia, and the Netherlands. It shows how governance works in these countries and extracts lessons for developing countries with mandatory health insurance programs, focusing on the mechanisms for assuring solvency, financial protection, and health care services of good quality.

• Publisher: World Bank,World Bank Publications,The World Bank,Washington, DC : World Bank
• Subject: ACCESS TO HEALTH CARE / ACCESS TO HEALTH CARE SERVICES / ACCESS TO HEALTH SERVICES / ACCOUNTABILITY MECHANISMS / ACUTE CARE / ADVERSE SELECTION / APPLICABLE LAW / BUDGET CONSTRAINTS / CAPITAL REQUIREMENTS / CAPITATION / CHOICE OF PROVIDERS / COMPENSATION / CONSUMER PROTECTION / CONSUMERS / CONTRIBUTION RATES / COSTS OF HEALTH CARE / CRIME / Cross-cultural studies / Cross-national analysis / DECISIONMAKING / DENTAL CARE / DIAGNOSIS / DISCLOSURE OF INFORMATION / ENVIRONMENTAL PROTECTION / ETHICAL STANDARDS / Europe / EXPENDITURES / FEE-FOR-SERVICE / FINANCIAL MARKETS / FINANCIAL PROTECTION / FINANCIAL SUPERVISION / FINANCIAL SYSTEMS / FOOD SAFETY / Governance / HEALTH CARE COSTS / HEALTH CARE EXPENDITURES / HEALTH CARE FINANCING / HEALTH CARE INSURANCE / HEALTH CARE PROFESSIONALS / HEALTH CARE PROGRAM / HEALTH CARE PROVIDER / HEALTH CARE PROVIDERS / HEALTH CARE QUALITY / HEALTH CARE SERVICES / Health economics / HEALTH FINANCING / HEALTH FINANCING SYSTEM / HEALTH INSURANCE / Health insurance -- Cross-cultural studies / Health insurance -- Europe / Health insurance -- Latin America / HEALTH INSURANCE AUTHORITIES / HEALTH INSURANCE COVERAGE / HEALTH INSURANCE DEFICITS / HEALTH INSURANCE FUND / HEALTH INSURANCE FUNDS / HEALTH INSURANCE MARKET / HEALTH INSURANCE MARKETS / HEALTH INSURANCE SCHEME / HEALTH INSURANCE SCHEMES / HEALTH INSURANCE SYSTEM / HEALTH INSURER / HEALTH INSURERS / HEALTH OUTCOMES / HEALTH PLAN / HEALTH PROGRAMS / HEALTH SERVICE / HEALTH SERVICES / HEALTH STATUS / HEALTH SYSTEM / HEALTH SYSTEM PERFORMANCE / HEALTH SYSTEMS / ILLNESS / INCENTIVES FOR PROVIDERS / INCOME / INFORMATION SYSTEMS / INSURANCE AGENCIES / INSURANCE FUNCTION / INSURANCE PLANS / INSURANCE SYSTEMS / Insurance, Health -- Cross-cultural studies / Insurance, Health -- Europe / Insurance, Health -- Latin America / Latin America / LATIN AMERICAN / LAWS / LOW-INCOME COUNTRIES / Mandatory Programs -- organization & administration -- Europe / Mandatory Programs -- organization & administration -- Latin America / MARKET INSTITUTIONS / MEDICAL ASSOCIATION / MEDICAL BENEFITS / MEDICAL CARE / MEDICAL CARE COSTS / MEDICAL CARE EXPENDITURES / MEDICAL EXPENDITURES / MEDICAL EXPENSES / MEDICAL INSURANCE / MEDICAL SERVICES / MIGRANTS / MORAL HAZARD / MULTIPLE INSURERS / NATIONAL HEALTH / NATIONAL HEALTH INSURANCE / NATIONAL HEALTH INSURANCE FUND / National Health Programs -- organization & administration -- Europe / National Health Programs -- organization & administration -- Latin America / NATIONAL HEALTH SERVICE / NATIONAL HEALTH SERVICES / NUTRITION / PATIENTS / PENSION FUNDS / POCKET PAYMENT / POCKET PAYMENTS / POLITICAL DEBATES / POLLUTION / PRESCRIPTIONS / PRIMARY CARE / PRIMARY HEALTH CARE / PRIVATE HEALTH INSURANCE / PRIVATE INSURANCE / PRIVATE INSURERS / PRIVATE SECTOR / PROVIDER PAYMENT / PROVISION OF CARE / PROVISION OF HEALTH CARE / PROVISION OF SERVICES / PUBLIC ADMINISTRATION / PUBLIC HEALTH / PUBLIC HEALTH INSURANCE / PUBLIC INSURERS / PUBLIC PROVISION / PUBLIC SECTOR / QUALITY OF CARE / Regulation / RESEARCH PROGRAM / SICKNESS FUNDS / SOCIAL HEALTH INSURANCE / SOCIAL INSURANCE / SOCIAL INSURANCE SYSTEMS / SOCIAL SECURITY / SOCIAL SECURITY SCHEMES / SOCIAL WELFARE / SOLVENCY / SUSTAINABILITY / TREATMENTS / TUBERCULOSIS / UNEMPLOYMENT / UNEMPLOYMENT INSURANCE / WESTERN EUROPE / WORKERS
• ISBN: 0821375482, 9780821375488, 0821375490, 9780823175482, 0823175480, 9780821375495