Thursday, September 2, 2010

[EQ] Implementing health financing reform

Implementing health financing reform

World Health Organization WHO 2010, on behalf of the European Observatory on Health Systems and Policies

The editors:

Joseph Kutzin - Regional Advisor for Health Systems Financing and Head of the Barcelona Office for Health Systems Strengthening, WHO Regional Office for Europe.

Cheryl Cashin - Research Fellow at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California, Berkeley,USA.

Melitta Jakab - Senior Health Financing Policy Analyst at the Barcelona Office for Health Systems Strengthening, WHO Regional Office for Europe.

Available online PDF [425p.] at: http://bit.ly/bEFpqk


“…….the conceptual approach used for this study is guided by the assumption that lessons from experiences relating to implementation of health financing reforms can be derived by using
(1) a common set of explicit policy objectives as assessment criteria;
(2) a function-based framework as a basis for describing health financing systems and reforms; and
(3) identification and analysis of key contextual factors with implications for particular reform options and their effects.

This standardized approach to assessment and description will enable lessons to be generated, particularly from those countries that have carried out “deep” reforms of their financing systems. Such lessons will be of interest not just to the countries in transition, but for countries in other parts of the world as well.

 

A. Framework for analysis - The conceptual approach is built on three pillars (Fig. 1.1).

·          The first is a standard set of objectives for health financing policy derived from The world health report 2000 framework (WHO 2000). These serve as the criteria against which health financing reform experience is assessed.

·          Second is a standard approach to describing the functions and policies associated with all health financing systems (adapted from Kutzin 2001). The world health report 2000 identified health financing as one of the four functions of the health system3 and the health financing system consists of specific sub-functions and policies – revenue collection, pooling of funds, purchasing of services, and policies to define and ration benefit entitlements (most commonly through patient cost-sharing obligations).

·          The third pillar consists of a recognition and analysis of how key contextual factors limit the extent to which a country can sustain achievement of the policy objectives, and may affect the feasibility of implementing certain reform options. The most important of these is the fiscal context. This refers to the ability of government to mobilize tax and other public revenues….”

 

 

Content:

Part one: Background to health financing systems and reforms in countries in transition

Chapter 1 Conceptual framework for analysing health financing systems and the effects of reforms

Chapter 2 Understanding the legacy: health financing systems in the USSR and central and eastern Europe prior to transition

Chapter 3 Fiscal context and health expenditure patterns


Part two: Reforms in health financing functions

Chapter 4 Sources of funds and revenue collection: reforms and challenges

Chapter 5 Reforms in the pooling of funds
Chapter 6 Purchasing of health care services

Chapter 7 Coverage decisions: benefit entitlements and patient cost sharing


Part three: Improving the performance in health financing systems

Chapter 8 Financing capital costs and reducing the fixed costs of health systems

Chapter 9 Financing of public health services and programmes: time to look into the black box

Chapter 10 Aligning public expenditure and financial management with health financing reforms

Chapter 11 What role for voluntary health insurance?

Chapter 12 Strategies to address informal payments for health care


Chapter 13 Promoting accountability in health care financing institutions

William D. Savedoff, Hernan L. Fuenzalida-Puelma


Part four: Synthesis – lessons for policy from the experience of CE/EECCA countries on the implementation of health financing reforms

Chapter 14 Implementing health financing reform in CE/EECCA countries: synthesis and lessons learned

 

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho





IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.

[EQ] A Guided Tour of Concepts and Terms and a Short Glossary of Results-Based Financing RBF

Financial and Other Rewards for Good Performance or Results:
A Guided Tour of Concepts and Terms and a Short Glossary of Results-Based Financing RBF

Philip Musgrove
Results-Based Financing (RBF) for Health – The World Bank September 2010

Available online PDF [9p.] at: http://bit.ly/csUbfJ

“….Results-Based Financing (RBF) has been defined as "a cash payment or non-monetary transfer made to a national or subnational government, manager, provider, payer or consumer of health services after predefined results have been attained and verified. Payment is conditional on measurable actions being undertaken." RBF is an umbrella term because the definition is general and characterizes various programs in many countries. Different labels exist for essentially the same concept or are associated with different incentives and payment arrangements…..

 

“…..Paying for inputs, particularly paying salaries to health care providers, has two well-known virtues. Costs are predictable, apart from variations due to overtime pay and fluctuations in the quantities of variable inputs such as drugs and other consumables; and providers have no financial incentive to deliver excess services. Supplier-induced demand is not a problem.

 

However, it is just as well-known that salaried personnel, who earn the same amount independent of their output or production, also have no financial incentive to produce any more than the minimum required to stay employed. If they lack adequate non-financial incentives or motivation to do a good job in either quantity or quality, they may be tempted to produce less than is needed or deliver poor quality service. It is a fair starting point to say that anything that introduces financial or other rewards based on some definition of results represents an attempt to get away from simply paying for inputs, at least in part….”

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho





IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.

[EQ] The (Indispensable) Middle Class in Developing Countries; or, The Rich and the Rest, Not the Poor and the Rest

The (Indispensable) Middle Class in Developing Countries; or, The Rich and the Rest, Not the Poor and the Rest

Nancy Birdsall. 2010. CGD Working Paper 207. Washington, D.C.: Center for Global Development

Available online PDF [38p.] at: http://bit.ly/aZtR1g

This paper is forthcoming as a chapter in Ravi Kanbur and Michael Spence (eds.), Equity in a Globalizing World (World Bank)

“……………Inclusive growth is widely embraced as the central economic goal for developing countries, but the concept is not well defined in the development economics literature. Since the early 1990s, the focus has been primarily on pro-poor growth, with the “poor” being people living on less than one dollar a day, or in some regions two dollars a day.

 

The idea of pro-poor growth emerged in the early 1990s as a counterpoint to a concern with growth alone (measured in per-capita income) and is generally defined as growth which benefits the poor as much or more than the rest of the population. Examples include conditional cash transfers, which target the poor while minimizing the fiscal burden on the public sector, and donors’ emphasizing primary over higher education as an assured way to benefit the poor while investing in long-term growth through increases in human capital.

 

Yet these pro-poor, inclusive policies are not necessarily without tradeoffs in fostering long-run growth. In this paper I argue that the concept of inclusive growth should go beyond the traditional emphasis on the poor (and the rest) and take into account changes in the size and economic command of the group conventionally defined as neither poor nor rich, i.e., the middle class………..”

 


http://www.cgdev.org/content/publications/detail/1423994

 

 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho






IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.