This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.

Why did President Clinton's efforts to reform the financing of American health care fail? For years to come, politicians and scholars of public policy will revisit the debate over Clinton's health care plan. What did planners do right? And what did they do wrong? How can the mistakes of that experience be avoided in the future? What steps can now be taken to achieve some measure of reform in smaller pieces? In The Problem That Won't Go Away, economists, political scientists, sociologists, public opinion experts, and government staff offer answers to these and other crucial questions. They recount the history of the Clinton health care plan, present several alternative strategies the administration might have pursued, and conclude that none was likely to achieve the administration's goals of universal coverage and cost containment. Many support the view that the administration, Congress, and the nation lacked the political consensus and the information to credibly describe the effects of any single bill to reform the U.S. health care system. In that case, was the only option available to the administration to reach for goals far more modest than those it sought? Health care financing as a national political issue will not go away. Pressure to cut public spending to balance the budget means that medicare and medicaid will stay in the legislative spotlight; the retirement of the baby-boom generation in the beginning of the next century promises large increases in the cost of medicare; and a flood of new and costly medical technologies will continue to put financial pressure on everyone responsible for paying for health insurance. But, as this book illustrates, the nature of the debate in the years after the demise of the Clinton plan will be altogether different from that of the past several decades.

This volume focuses on nine countries that have completed, or are well along in the process of carrying out, major health financing reforms. These countries have significantly expanded their people's health care coverage or maintained such coverage after prolonged political or economic shocks (e.g., following the collapse ofthe Soviet Union). In doing so, this report seeks to expand the evidence base on "good performance" in health financing reforms in low- and middle-income countries. The countries chosen for the study were Chile, Colombia, Costa Rica, Estonia, the Kyrgyz Republic, Sri Lanka, Thailand, Tunisia, and Vietnam.

The United States spends more on health care than any other nation in the world, yet millions of Americans cannot afford basic care for acute illnesses, few are insured against the costs of long-term care, and many frequently used medical procedures have never been fully evaluated. The goals of controlling spiraling health care costs and extending insurance coverage or even maintaining current insurance coverage seem to be in conflict. But progress can be made on both goals if they are tacked together. Henry Aaron evaluates these critical issues and explores how adequate care can be provided without fueling inflation. Because the current arrangements for financing America's health care cannot endure, Aaron contends that a major national debate on the restructuring of the U.S. system of financing health care is inescapable, and major legislation is likely. Serious and Unstable Condition offers a guide that is crucial to understanding the reform debate. It explains the important economic issues of health care as a background for evaluating both the current system and proposals for change. Aaron compares the U.S. system of health care financing with certain foreign systems and reviews major options for reform. He cautions that unless the health insurance system is radically changed, the number of uninsured will continue to increase and costs will continue to escalate. He then offers his own comprehensive plan to address these problems.