Employer-financed health insurance systems, like those used in the United States, distort firms labor demand and adversely affect the economy. Since such costs vary with employment rather than hours worked, firms have an incentive to increase output by increasing worker hours rather than employment. This paper constructs a heterogeneous agent general equilibrium model where individuals differ with respect to their productivity and employment opportunities. The authors generate steady state results for several alternative models for financing health insurance: one in which health insurance is financed primarily through employer contributions that vary with employment; a second where insurance is funded through a non distortionary, lump-sum tax; and a third where insurance is funded by a payroll tax. They further measure the effects of each of the alternatives on output, employment, hours worked and inequality. These findings can be compared with East and Southern African communities that employ such employer-financed health insurance systems.
Resource allocation and health financing
The World Health Assembly has in the past three years passed several resolutions on health financing and health worker shortages - yet there has been an overall increase in annual African deaths resulting from lack of sustainable health finance and health worker shortages. The worlds Health Ministers must now move from passing resolutions to effecting resolutions and emergency action to end the deaths of over 8 million Africans a year from preventable and treatable diseases.
The pace of redressing inequities in the distribution of scarce health care resources in Namibia has been slow. This is due primarily to adherence to the historical incrementalist type of budgeting that has been used to allocate resources. Those regions with high levels of deprivation and relatively greater need for health care resources have been getting less than their fair share. To rectify this situation, which was inherited from the apartheid system, there is a need to develop a needs-based resource allocation mechanism. Principal components analysis was employed to compute asset indices from asset based and health-related variables, using data from the Namibia demographic and health survey of 2000. The asset indices then formed the basis of proposals for regional weights for establishing a needs-based resource allocation formula.
The Africa Public Health Rights Alliance “15% Now!” Campaign has called on the new Chair of SADC President Levy Patrick Mwanawasa to make it a priority of his term of office to ensure that alongside upholding Democracy and Good Governance, all SADC countries emulate the leadership of Botswana and meet the Abuja African Union pledge to allocate at least 15% of national budgets to health. President Mwanawasa assumed SADC leadership at the end of the last summit that ended on the 17th of August. In a statement issued in Lusaka, the Campaigns coordinator Rotimi Sankore stated:“SADC leaders must realise that they have no choice but to follow the lead of Botswana in meeting the Abuja 15% pledge. Its really a choice between meeting the 15% commitment now, or presiding over mass burials of citizens between now and 2015 when they should have met the health based Millennium Development Goals”.
Since 1994, considerable progress has been made in transforming the South African health care system, implementing programmes that improve the health of the population, and improving access to health care services. However, amid escalating health care costs disparities continue to exist between the public and private health sectors. The implementation of a national or social health insurance remains elusive despite three government-appointed committees on the matter.
This report calls for a move from tracking expenditures on specific health programs in an uncoordinated way to coherent and long-term support to improve government budgetary and financial systems in the developing world; to institutionalizing standard approaches to documenting and analyzing health sector expenditures; and to providing more timely, predictable and forward‑looking data on external assistance to the health sector.
This paper estimates the monetary costs of the 19 million unsafe abortions that take place every year around the world. This includes the direct costs of treatment related morbidity and mortality to health systems, and indirect costs to the national economy and households – the cost to women when they suffer from abortion complications whilst they receive treatment and recuperate from such treatment.
About one-third of foreign aid from developed countries is now channelled through or directly to civil society in developing countries. There is a significant change in the way donors give support to civil society, including pooling donor support through national and regional intermediaries; multiple funding agencies and adoption of a variety of support models. Based on a detailed analysis of seven country case studies (Botswana, Lesotho, Malawi, Namibia, South Africa, Zambia and Zimbabwe), the findings challenge the conventional wisdom and advance the civil society agenda in certain key ways.
Uninsured risk has substantial welfare costs, not just in the short run, but also in terms of perpetuating poverty. This paper discusses the scope for extending insurance to the poor, drawing mainly on examples from Latin American and Caribbean countries. It is argued that insurance provision to the poor could play an important role in a comprehensive system of protection against risk, including other ex-ante measures such as promoting credit and savings as insurance, as well as a credible overall ex-post safety net. Insurance provision is best promoted via a partner-agent model, in which a local finance institution with close links to relatively poor communities teams up with an established insurer to deliver low-cost, tailored products, such as life, health, property and weather insurance.The paper also argues for the involvement of local indigenous risk-sharing and finance institutions as intermediaries to maximise the ability to reach the poor and the overall welfare benefits.
The report sets out a Ten Point Plan for achieving the necessary reform of Overseas development aid. It calls on donors and southern governments to make vital changes to improve aid so it can effectively play its role in helping to make poverty history.