Format:
1 online resource (246 pages)
ISBN:
9780821375495
,
0821375490
,
0823175480
,
9780821375488
,
0821375482
,
9780823175482
Content:
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.
Content:
Contents -- Foreword -- Acknowledgments -- Acronyms and abbreviations -- Overview -- Defining mandatory health insurance -- Defining governance -- Framework -- Dimensions of good governance -- Case studies -- Lessons from governance trends -- Dimensions of governance -- Contextual factors -- Remaining questions for research -- 1 Governing mandatory health insurance: Concepts, framework, and cases -- Introduction -- Overview and trends -- Some definitions -- An analytical framework -- Four case studies -- 2 Good governance dimensions in mandatory health insurance: A framework for performance assessment -- Introduction -- Good governance dimensions of mandatory health insurance -- Coherent decisionmaking structures -- Stakeholder participation -- Transparency and information -- Supervision and regulation -- Consistency and stability -- Methodology: Measuring MHI governance performance -- Results: MHI governance assessment in four countries -- Summary -- 3 Costly success: An integrated health insurer in Costa Rica -- Editors' introduction -- The trajectory toward universal coverage -- Governance of CCSS -- System performance -- Effect of governance on performance -- Annex 3.1 Dimensions, features, and indicators of good governance in mandatory health insurance: Costa Rica -- Interviewees -- 4 Governing a single-payer mandatory health insurance system: The case of Estonia -- Editors' introduction -- Brief history and overview of the health insurance system -- Context -- Governance of the Estonian health insurance system -- Performance of the Estonian health insurance system -- Governance and performance -- Summary -- Annex 4.1 Dimensions, features, and indicators of good governance in mandatory health insurance: Estonia -- 5 Governing multiple health insurers in acorporatist setting: The case of the Netherlands -- Editors' introduction.
Note:
Description based on publisher supplied metadata and other sources
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Contents; Foreword; Acknowledgments; Acronyms and abbreviations; Overview; Figure 1 Accountability through governance; Table 1 Mandatory health insurance models and implications for governance; 1 Governing mandatory health insurance: Concepts, framework, and cases; Box 1.1 This book; Box 1.2 Definitions of social health insurance; Figure 1.1 Health insurance schemes; Box 1.3 Serving many masters; Figure 1.2 Three key relationships influencing the behavior of mandatory health insurance entities; Figure 1.3 Accountability through effective governance; Box 1.4 A "fifth" model
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Table 1.1 Mandatory health insurance models and implications for governanceTable 1.2 General characteristics of case study countries; Table 1.3 Decisionmaking authority by country and issue; 2 Good governance dimensions in mandatory health insurance: A framework for performance assessment; Table 2.1 Dimensions, features, and indicators of good governance in mandatory health insurance; Figure 2.1 Example for mandatory health insurance governance performance assessment; Figure 2.2 Costa Rica mandatory health insurance governance performance assessment
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Figure 2.3 Estonia mandatory health insurance governance performance assessmentFigure 2.4 The Netherlands mandatory health insurance governance performance assessment; Figure 2.5 Chile mandatory health insurance governance performance assessment; 3 Costly success: An integrated health insurer in Costa Rica; Figure 3.1 Evolution of health insurance coverage in Costa Rica; Table 3.1 Influence of different parties on CCSS decisions; Box 3.1 Resolutions of the constitutional court; Figure 3.2 Population covered by the primary health care program, 1990-2003
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Figure 3.3 Average length of stay in the hospital, 1990-2004Figure 3.4 External consultations per hour, 1990-2004; 4 Governing a single-payer mandatory health insurance system: The case of Estonia; Figure 4.1 Organizational structure of the Estonian Health Insurance Fund, 2006; Box 4.1 Sources of main regulations; Figure 4.2 Overview of the Estonian health financing system; Table 4.1 Influence on decisions made by the Estonian health financing system; Figure 4.3 Population satisfaction with access to care, 2001-05; Figure 4.4 Outpatient contacts and acute care admissions, 1985-2003
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Figure 4.5 Out-of-pocket payment for health care, 1998-2004Figure 4.6 Share of households with high health payments, 1995, 2001, and 2002; Figure 4.7 Estonian Health Insurance Fund revenues and expenditures, 1992-2006; 5 Governing multiple health insurers in acorporatist setting: The case of the Netherlands; Figure 5.1 Three-compartment structure of health insurance before 2006; Table 5.1 Composition of health care financing by source; Box 5.1 Overview of the 2006 reforms; 6 Governing a hybrid mandatory health insurance system: The case of Chile
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Figure 6.1 Governance forces in mandatory health insurance: The general case
Additional Edition:
ISBN 9780821375488
Additional Edition:
Erscheint auch als Druck-Ausgabe ISBN 9780821375488
Language:
English
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