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Addiction to a bad idea, especially in low- and middle-income countries: Contributory health insurance.
Soc Sci Med
March 2023
WHO Barcelona Office for Health Systems Strengthening, Barcelona, Spain.
Despite limited evidence of successful development and implementation of contributory health insurance and low and middle income countries, many countries are in the process implementing such schemes. This commentary summarizes all available evidence on the limitations of contributory health insurance including the lack of good theoretical underpinning and the considerable evidence of inequity and fragmentation created by such schemes. Moreover, the initiation of a contributory health insurance scheme has not been found to increase revenues to the health sector or help health countries achieve universal health coverage.
View Article and Find Full Text PDFUniversal health coverage from multiple perspectives: a synthesis of conceptual literature and global debates.
BMC Int Health Hum Rights
July 2015
Institute of Public Health, Medical Faculty, University of Heidelberg, Heidelberg, Germany.
Background: There is an emerging global consensus on the importance of universal health coverage (UHC), but no unanimity on the conceptual definition and scope of UHC, whether UHC is achievable or not, how to move towards it, common indicators for measuring its progress, and its long-term sustainability. This has resulted in various interpretations of the concept, emanating from different disciplinary perspectives. This paper discusses the various dimensions of UHC emerging from these interpretations and argues for the need to pay attention to the complex interactions across the various components of a health system in the pursuit of UHC as a legal human rights issue.
View Article and Find Full Text PDFPolicy choices for Medicaid and Medicare waivers.
Gerontologist
February 1999
Heller Graduate School, Brandeis University, Waltham, MA 02254, USA.
This article reviews the authority and processes for issuing Medicare and Medicaid waivers, highlights waiver-based differences in states' home- and community-based (HCB) service systems, and critiques emerging efforts to capitate, integrate, and privatize the long-term care system. Potential pitfalls relate to payment rates, risk, service substitution, accountability, and drains on HCB infrastructure. Before merging HCB services into larger prepaid systems, policy makers are advised to examine implementation challenges, resist ad hoc fixes, clarify HCB entitlements, and strengthen current infrastructure.
View Article and Find Full Text PDFHMOs and the seriously mentally ill--a view from the trenches.
Community Ment Health J
June 1996
Directions for Mental Health, Inc., Clearwater, Florida 34624, USA.
The role of HMOs in health care policy, specifically in treating individuals with long-term persistent illness, is a matter of debate. The following is a response to a summary of the research to date entitled "Health Maintenance Organizations and Persons with Severe Mental Illness" previously published in this journal. The author argues that capitated pre-paid payment mechanisms can and should be considered separately from the decision of funding an HMO or other managed care structure.
View Article and Find Full Text PDFDiversity in provision and utilization of maternal and child health care in an urban area of Brazil.
Ann Trop Paediatr
September 1986
Health services in Brazil are characterized by a multiplicity of providers. While many are ultimately funded from public sources, notably the National Social Security Scheme, a large proportion are provided by the private sector. This variety of providers of health care has hindered the development of comprehensive care and the coverage of those in greatest need.
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