Module: Health systems, economics and policy

Topic 5


Topic 5: Health System Financing

Objectives/learning outcomes

 

Students will be able to:

  • Understand health financing concepts – prepayment, pooling, progressive and regressive financing, out of pocket, co-payment and user charges
  • Analyse health financing systems from the perspective of equity

Seminar

SEMINAR DATES  29 AND 30 OCTOBER

Analysing health care financing

Students will discuss the following:

1. For each financing model, analyse who bears the financial risk of ill health (illustrate your answer with examples from the literature).

2. What does scaling up mean in the context of health financing?

3. Critically examine a concrete example of scaling up.

Presentations will be made by Sadhana, Sarah and Christina (group 1); Andreas, Tosin, Storm (group 2); Saadia, Amelia, David (group 3). Presenters may divide the tasks among themselves. 

Set Reading

Joseph Kutzin. Anything goes on the path to universal health coverage? No. Bull World Health Organ. (October 2012, in press) available as pdf (Read it here)

World Health Organization (2008) World Health Report 2008. Geneva: WHO, chapter 2.

World Health Organization (2005) Achieving universal coverage: technical brief for policy-makers (Read it here)

The following resources are optional:

World Health Assembly resolutions 58.33 and 64.9 plus accompanying background papers by secretariat. (http://www.who.int/ipcs/publications/wha/en/).

Garret L (2009) All for universal health coverage, The Lancet; 374: 1294-99. (Read it here)

Kutzin et al (2009) Bismarck meets Beveridge on the Silk Road, Bull World Health Organ 2009;87:549–554. (Read it here)

World Health Organization (2009) Thinking of introducing social health insuarnce? Technical brief for policy-makers (Read it here)

 

Lecture: Financing and redistribution

Health system financing is an important tool of redistribution and access to health care depends to a great extent on how it is financed. Almost all health care systems involve some form of cross-subsidisation from the rich to the poor in order to address resource and health inequalities. This characteristic is known in Europe as solidarity.  Redistribution through the financing system is a major determinant of access to services. Whilst the policy of pursuing universality by abolishing user charges and out of pocket payments is well established, charges of some sort are also increasingly advocated as a means of generating more resources for health systems. 

Lecture Notes and Powerpoints