Healthcare for all at affordable prices is still a major but universally elusive goal. Everyone spends money on healthcare, and it is the most impoverishing consumption item. Thus, most governments (and the United Nations) promote Universal Health Coverage — each country's unique blend of tools for healthcare financing, including taxes, subsidies and market controls.Most people in low- and middle-income countries (LMICs) have no health insurance of any kind. And most LMIC governments lack the political will, information, or resources to require their citizens to buy health insurance themselves or to subsidize insurance for all who cannot afford the price. This book deals with financing voluntary and contributory health insurance for resource-poor and rural groups in LMICs.This book addresses three issues. The first is how to catalyse demand for health insurance and develop insurance literacy among the largely illiterate and innumerate target population, using training programs to build an enabling consensus, allowing locals to create and administer such schemes. The second involves the process of developing simplified methods for risk assessment, which can help to underwrite risks, price the micro health insurance schemes, and ensure proper implementation. The third issue is formulating a compelling business case which would make this health insurance affordable, financially sustainable, and operationally scalable.This book develops insurance education and financial literacy for students of economics, business administration, insurance, development studies, and social work to prepare them for practical work as implementers, policymakers, or evaluators. A supplementary section for teachers and students includes comprehension questions.

This book is the first and only study on implementing Universal Health Coverage in poor, rural and informal settings, with end-to-end guidance for rolling out a demand-driven and needs-based health insurance model. The chapters are comprehensive, covering topics such as data collection and analysis for contextual risk assessment, the design of suitable benefits packages, how to price microinsurance, insurance education for illiterate or innumerate populations, the setting up of governance bodies and training staff for key roles, and information management.The book contains insights gained from years of fieldwork in several countries and is valuable reading for undergraduate and graduate students and practitioners of health microinsurance. As a companion to the author's first book, Financing Micro Health Insurance: Theory, Methods and Evidence, this book provides the only current source of information on implementing health microinsurance. The practical guidelines to setting up and operating a microinsurance scheme are accompanied by impact evaluation, chapter exercises and Issue Briefs that present examples of using tools that are necessary for successful implementation.

Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice

Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Colombia embarked in 1993 on a fifteen-year effort to cover its entire population with insurance, in combination with greater freedom to choose among providers. A decade later Mexico followed suit with a program tailored to its federal system. Several African nations have introduced new programs in the past decade, and many are testing options for reform. For the past twenty years, Eastern Europe has been shifting from government-run care to insurance-based competitive systems, and both China and India have experimental programs to expand coverage. These nations are betting that insurance-based health care financing can increase the accessibility of services, increase providers' productivity, and change the population's health care use patterns, mirroring the development of health systems in most OECD countries. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance–based care is key to the public policy debate of whether to extend insurance to low-income populations—and if so, how to do it—or to serve them through other means. Using recent household data, this book presents evidence of the impact of insurance programs in China, Colombia, Costa Rica, Ghana, Indonesia, Namibia, and Peru. The contributors also discuss potential design improvements that could increase impact. They provide innovative insights on improving the evaluation of health insurance reforms and on building a robust knowledge base to guide policy as other countries tackle the health insurance challenge.

Annotation This volume views community-based microinsurance as an incremental first step to improved financial protection and better access to health services for the poor. While community-based financing can be structured in various ways, this volume focuses on reinsurance as a mechanism for improving micro-level health insurance units. It outlines strategies and policies that can be applied by countries and donors to improve access to health care services.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Health insurance is the mechanism used to respond to uncertainty and risk aversion to illness. Health insurance, whether private, public, or mixed, serves as the main structural foundation for health systems across countries. Its objectives are to minimize the financial burden of medical expenses on people and to enhance population health. Globally, there is a great diversity of health systems and even greater variation among them. There are substantial differences in health systems and health insurance between low- and middle-income nations. The primary explanation for this could be the disparities in the resources available to fund the health system. High-income countries have the financing ability to fund the provision of health care, whereas low- and medium-income countries have a harder time funding health care. Another challenge health systems face nowadays is the achievement of the United Nations Sustainable Development Goal 3: healthy lives and promoting well-being for all. To create resilient and sustainable health systems that guarantee healthy lives and foster well-being for people of all ages, many countries are redesigning their healthcare systems by improving financing, access, and coverage. This book discusses these issues in different health systems around the world, in low-, middle-, and high-income countries.