Private health insurance plays a large and increasing role around the world. This paper reviews international experiences and shows that private health insurance is significant in countries with widely different income levels and health system structures. It contrasts trends in private health insurance expansion across regions and highlights countries with particularly important experiences of private coverage. It then discusses the regulatory approaches and policies that can structure private health insurance markets in ways that mobilize resources for health care, promote financial risk protection, protect consumers and reduce inequities. The paper argues that policy makers need to confront the role that private health insurance will play in their health systems and regulate the sector appropriately so that it serves public goals of universal coverage and equity.
Public-Private Mix
The objective of this study was to explore the economic costs and sources of financing for different public–private partnership (PPP) arrangements to tuberculosis (TB) provision involving both workplace and non-profit private providers in South Africa. The financing required for the different models from the perspective of the provincial TB programme, provider, and the patient are considered.
Privatisation has been promoted throughout the world for the last 20 years. The advantages are supposed to be increased efficiency, lower prices, greater investment, and greater dynamism than public ownership. It has been seen as a central policy element in transforming former communist states into market economies. It has been promoted wordwide by international institutions including the IMF, the World Bank and the OECD, and by multinational companies. The EU is in principle neutral on privatisation, but in practice encourages PPPs. Privatisation has been made especially attractive because of economic policies aimed at reducing the borrowing of governments at national and municipal level. This dociment discusses futher the impact of reform on industry, workers in health and trade unions.
In 1999, the U.S. Agency for International Development launched the NetMark, in partnership with the Academy for Educational Development, to reduce the human cost caused by malaria. Since its launch, NetMark has developed partnerships with 37 African and 9 international commercial partners. NetMark's mission is to reduce malaria cases and deaths in Africa by increasing the availability, affordability and use of insecticide-treated bednets (ITN) through partnerships with commercial net and insecticide manufacturers, their African distributors, ministries of health, and NGOs. To accomplish this goal, NetMark works through public-private partnership to achieve both short and long-term public health impact. NetMark's model, based on efficient and effective delivery of ITNs, could easily be applied to other areas of malaria prevention.
Adequate and appropriate vehicles are essential for health service delivery. These are required for transport and transfer of patients from community to health facilities and between levels of health care delivery of essential equipment, medicines and other supplies to point of service delivery transport of health workers for supervisory visits, to attend meetings and training sessions and for administrative purposes. A transport management system that is efficiently and cost effectively run is essential to ensure availability of vehicles for health service delivery when required.
When leaders of governments, international organisations, corporations, nongovernmental organisations and faith-based groups came together on 14 December 14 in Washington, they jump started an ambitious public-private effort to save lives from the preventable and treatable mosquito-borne disease of malaria.
According to the UN Under-Secretary General, the private sector in Africa, although still in its infancy and not as organised as in other parts of the world, is expanding at a very fast rate, is contributing to growth and poverty reduction and that the state, by expanding economic space, has been central to this development. However, there is much that remains to be done both by the state and the private sector to realise the full possibilities of the sector’s contribution to African development.
In recent years there has been increasing interest in the role played by the private sector in providing health services in low- and middle-income countries. Many countries have a vibrant and growing private sector, which is perceived by some to respond to the failures of the public sector to provide affordable, accessible, convenient and high quality services. There has been little investigation, however, of the extent to which interventions can be successful in expanding access to those who are difficult to reach and to provide services that are 'genuinely pro-poor'. This chapter offers a systematic review of the literature on the equity impact of private sector interventions.
Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. This paper reviews this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries. The paper documents how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control. Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored. The paper concludes by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care.
The policy of hospital autonomy is contingent on the idea that market forces can discipline hospitals and so improve their performance. This article contests that idea from two perspectives. There is scarce evidence to assess the validity of the market forces model or of either conflicting model. The operation of health sector reform is multi-faceted, time lagged and beset by inter-relationships between multiple variables. Research funding is usually small scale and haphazard. This paper seeks to draw together evidence across four countries (the UK, Zambia, Indonesia and Colombia) where evidence of hospital performance in the wake of reform is relatively robust, in an attempt to identify patterns of response to reform.