The authors present a model of political competition, in a multi-dimensional policy space and with policy-oriented candidates, to analyse the problem of health care finance. In this model, health care is either financed publicly (by means of general taxation) or privately (by means of a co-payment). The extent of these two components (as well as the overall tax schedule in the country) is the outcome of the process of political competition. The model shows that, in equilibrium, parties propose policies that implement the latest (and most expensive) medical techniques available.
Resource allocation and health financing
The political economy of health care finance
Moreno-Ternero JD, Roemer JE: World Institute for Development Research (WIDER), 2006
Cost-effectiveness analysis of HIV chemoprophylaxis
Grant R, Lama J, Goicochea P, et al: The Sixteenth International AIDS Conference, August 2006
Ethical guidelines require that research on effectiveness of HIV chemoprophylaxis be performed in populations where the intervention would be feasible if the trials demonstrate efficacy with acceptable safety. Population effects and cost effectiveness were simulated using a mathematical model that considers heterosexual and homosexual transmission, higher infectiousness in early and late infection, age and sex effects on susceptibility, risk behavior variation, condom replacement, known age-sex partner preferences, and primary and secondary drug resistance. The article describes the findings and relevant conclusions drawn.
Financing mental health services in low- and middle-income countries
Dixon A, McDaid D, Knapp M, Curran C: Health Policy and Planning 21 (3), March 2006
Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries undergoing transition there has been a decline in coverage. The paper explores the impact of health care financing arrangements on the efficient and equitable utilization of mental health services. Through a review of the literature and a number of country case studies, the paper examines the impact of financing mental health services from out-of-pocket payments, private health insurance, social health insurance and taxation. The implications for the development of financing systems in low- and middle-income countries are discussed.
Health budget should meet Abuja Declaration
The Daily Mirror Reporter (Zimbabwe), 20 September 2006
In a presentation before the parliamentary portfolio committee on health and child welfare yesterday, the health ministry said its budgetary allocation for next year should conform to the declaration. This article presents its argument that in Zimbabwe, the Ministry of Health and Child Welfare budget should at least meet the Abuja Declaration target of a minimum of 15% of the government budget going to Ministry of Health.
Further details: /newsletter/id/31771
Health budgets in Africa
Wemos
In 2005, Wemos together with several Southern organizations conducted case studies in Ghana, Zambia, Kenya and Uganda on the role of the International Monetary Fund (IMF) in determining budgets for health, particularly for health workers' salaries. Achieving the health related Millennium Development Goals (MDGs) requires a substantial financial injection in the health sectors of low-income countries. Public expenditure, however, is restricted by IMF macroeconomic policies and conditions, through ceilings on the public sector wage bill. The report describes the findings and conclusions of the four case studies.
Health insurance: Is it globally relevant
Berset P: Geneva Health Forum, 31 August 2006
Financing of health systems is well known for raising controversial ideas and provoking stormy debate. Should a prepayment system be applied to deficient health systems in under-developed countries? Different judgements on the global relevance of insurance are presented.
Oxfam urges massive investment in health systems
Oxfam press release, 14 August 2006
Oxfam International today urged donor nations and developing country governments to scale up their investment in health systems to address the critical shortage of health workers and crumbling infrastructure. "For the first time in human history, we have the resources to stop HIV/AIDS from killing millions of people. What we do not know is whether our leaders will muster the generosity to save these lives," said Dr, Mohga Kamal Yanni, senior health and HIV policy advisor for Oxfam International.
Priority setting of health interventions: The need for multi-criteria decision analysis
Baltussen R, Niessen L: Cost Effectiveness and Resource Allocation 4:14, 21 August 2006
Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research.
Investing in health for development: Experiences from national follow-up to the Commission on Macroeconomics and Health
Spinaci S, Currat L, Shetty P, Crowell V, Kehler J
This report presents country experiences in developing and shaping work to address long-term planning for the health sector. It identifies areas of action to which the national commissions have contributed, from mobilising political will and building much-needed evidence, to strengthening national planning processes. These lay the groundwork for sustainable improvements in health for the world’s poor people. The report clarifies the most intractable challenges that have impeded faster health progress, and gives concrete examples of how countries have started to address them through an integrated approach to health sector development and financing.
Medical bills push people deeper into poverty
McIntyre D, Thiede M, Dahlgren D, Whitehead M: ID21 Health, 28 July 2005
In some developing countries public health clinics charge patients for medical consultations. These medical fees, together with a loss of earnings due to ill health, have catastrophic consequences for families already living in poverty.