Publication: Public Ends, Private Means : Strategic Purchasing of Health Services
Loading...
Published
2007
ISSN
Date
2012-05-30
Author(s)
Abstract
Public Ends, Private Means: Strategic purchasing of value for money in health services is part of a series of World Bank publications on ways to make public spending on health care more efficient and equitable in developing countries. It reviews the underlying economics in terms of agency theory, behavioral science, contract theory, transaction costs, and public choice theory. It provides a synthesis of the institutional environment needed for countries to shift to strategic purchasing, organizational incentives that need to be in place, and management capacity that needs to be strengthened. The volume is supplemented with a CD that presents six regional reviews of current resource allocation and purchasing (RAP) arrangements.
Link to Data Set
Citation
“Preker, Alexander S.; Liu, Xingzhu; Velenyi, Edit V.; Baris, Enis. Preker, Alexander S.; Liu, Xingzhu; Velenyi, Edit V.; Baris, Enis, editors. 2007. Public Ends, Private Means : Strategic Purchasing of Health Services. © World Bank. http://hdl.handle.net/10986/6683 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Financing Health Care in East Asia and the Pacific : Best Practices and Remaining Challenges(World Bank, 2011-06-16)This is an exciting time in East Asia and the Pacific region. No region will appear to be moving so rapidly. In this dynamic environment, many countries in the region have been approaching the World Bank requesting technical assistance and knowledge about health financing best practices and options. There is great interest in expanding knowledge sharing and learning from other East Asian and Pacific countries about their experiences in health financing. Moreover, some common issues appear to be emerging: universal insurance, options for financing health insurance, institutional setups of health financing options, provider payment mechanisms, equity considerations, ways to reach the poor and impoverished, and ways to meet the challenges of a changing demographics and epidemiologic profile. Under a generous grant from the Health, Nutrition, and population hub in the World Bank in fiscal year 2008, the region was requested to provide an overview of health financing systems in the region. This overview examined the different health financing mechanisms in terms of performance on dimensions of efficiency and equity and in terms of relative roles of government. In addition, the analysis was to identify, gaps in knowledge needing to be addressed strengthen and reform existing health financing mechanisms and thereby expand health coverage and benefits.Publication Health Insurance Handbook : How to Make It Work(World Bank, 2012-01-18)Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well as to provide financial risk protection. In Africa, several countries have already spent scarce time, money, and effort on health insurance initiatives. Ethiopia, Ghana, Kenya, Nigeria, Rwanda, and Tanzania are just a few of them. However, many of these schemes, both public and private, cover only a small proportion of the population, with the poor less likely to be covered. In fact, unless carefully designed to be pro-poor, health insurance can widen inequity as higher income groups are more likely to be insured and use health care services, taking advantage of their insurance coverage. The purpose of this handbook is to provide policy makers and health insurance designers with practical, action-oriented support that will deepen their understanding of health insurance concepts, help them identify design and implementation challenges, and define realistic steps for the development and scaling up of equitable, efficient, and sustainable health insurance schemes. The handbook takes policy makers and health insurance designers through a step-by-step series of considerations and tasks that need to be achieved. The handbook's philosophy is to not be dogmatic, ideological, or prescriptive. This handbook was prepared to be used in a six-day regional workshop. Clearly, health insurance design is an intensive political and technical process that takes much longer than six days. The expectation for the workshop is that by the end of the week, each team has a clear idea of next steps that they could take back home to engage other stakeholders and move toward scaling up and improving the performance of health insurance in their country.Publication Private Voluntary Health Insurance in Development : Friend or Foe?(Washington, DC: World Bank, 2007)This volume presents findings of a World Bank review of the existing and potential role of private voluntary health insurance in low- and middle-income countries and is the third volume in a series of reviews of health care financing. Also, this volume is about managing risk. Not the risk of national or man-made disasters but the risk of illness. The developing world is plagued by many of the historical scourges of poverty: infectious disease, disability, and premature death. As countries pass through demographic and epidemiological transition, they face a new wave of health challenges from chronic diseases and accidents. In this respect, illness has both a predictable and an unpredictable dimension. Contributors to this volume emphasize that the public sector has an important role to play in the health sector, but they demonstrate that the private sector also plays a role in a context in which private spending and delivery of health services often composes 80 percent of total health expenditure. Managing risks in the private sector begins at the household level. Private voluntary health insurance is merely an extension of such nongovernmental ways to deal with the risk of illness and its impoverishing effects in low- and middle-income countries. The authors examine frameworks for analyzing health financing and health insurance. They conclude that most studies are hampered by lack of data on the impact of private voluntary health insurance on broad social goals, such as financial protection. They find no overall consensus on the impact of voluntary health insurance on public health activities or on the quality, innovation, and efficiency of personal health services.Publication Global Marketplace for Private Health Insurance : Strength in Numbers(Washington, DC: World Bank, 2010)The development challenges of addressing health problems in low- and middle-income countries are daunting but not insurmountable. There are now known and affordable interventions to deal with many aspects of the HIV/AIDS crisis as well as the continued challenge posed by malaria and other major infectious diseases. Three major development objectives of health insurance in low- and middle income countries are highlighted in this volume: securing sustainable financing for health care providers that serve the health needs of vulnerable populations; providing financial protection against the impoverishing cost of illness; and reducing social exclusion from organized health financing and delivery systems. Private health insurance schemes can address the needs of the poor and other vulnerable populations with appropriate combinations of subsidies, risk pooling, household savings, and user charges. The authors of this book argue in favor of a multipillar approach to health care financing in low- and middle-income countries that combines these instruments in addressing the underlying development objectives described above, while putting a strong emphasis on private voluntary health insurance. In this way, private means can make a significant contribution to public ends.Publication Social Health Insurance for Developing Nations(Washington, DC: World Bank, 2007)Good health is necessary for well-being but also has another critical impact: it causes poverty, in that large health expenditures can bankrupt families. Many nations are now hoping that formally mandated social health insurance (SHI), involving payroll taxes, will provide a solution. This report examines the principles, design, and practices of SHI for low and middle-income nations and the necessary conditions for its viability and sustainability, with a focus on design and implementation issues. This volume presents five country case studies to provide evidence and greater detail on key issues that arise at different stages of implementation in low-income countries. They have been selected to reflect on a continuum and timeline of operational stages, beginning with the initial design and legislation of SHI, the first phase of implementation, the expansion to cover larger segments of the population, and on up to completion, whereby SHI becomes the predominant form of health care financing in a country. Accordingly, Kenya has been selected for illustration of the design stage, Ghana for initiation, the Philippines for extension of population coverage, Colombia for SHI and reform of health care delivery, and Thailand for universal coverage and reform of health care delivery. This sequencing and implied timeline of case studies allows this report to reflect on two questions. First, where can a country expect to be in relation to designing and implementing SHI in, say, 10 years? Second, as countries gain experience with SHI, what can they expect to offer or achieve in terms of variations in benefit design, who administers SHI, and how providers are contracted and paid?
Users also downloaded
Showing related downloaded files
Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.Publication World Development Report 2017(Washington, DC: World Bank, 2017-01-30)Why are carefully designed, sensible policies too often not adopted or implemented? When they are, why do they often fail to generate development outcomes such as security, growth, and equity? And why do some bad policies endure? This book addresses these fundamental questions, which are at the heart of development. Policy making and policy implementation do not occur in a vacuum. Rather, they take place in complex political and social settings, in which individuals and groups with unequal power interact within changing rules as they pursue conflicting interests. The process of these interactions is what this Report calls governance, and the space in which these interactions take place, the policy arena. The capacity of actors to commit and their willingness to cooperate and coordinate to achieve socially desirable goals are what matter for effectiveness. However, who bargains, who is excluded, and what barriers block entry to the policy arena determine the selection and implementation of policies and, consequently, their impact on development outcomes. Exclusion, capture, and clientelism are manifestations of power asymmetries that lead to failures to achieve security, growth, and equity. The distribution of power in society is partly determined by history. Yet, there is room for positive change. This Report reveals that governance can mitigate, even overcome, power asymmetries to bring about more effective policy interventions that achieve sustainable improvements in security, growth, and equity. This happens by shifting the incentives of those with power, reshaping their preferences in favor of good outcomes, and taking into account the interests of previously excluded participants. These changes can come about through bargains among elites and greater citizen engagement, as well as by international actors supporting rules that strengthen coalitions for reform.Publication The Role of Desalination in an Increasingly Water-Scarce World(World Bank, Washington, DC, 2019-03)The cost of desalination has been plummeting over the years. As a result, desalination has become a viable option for certain strategic uses. Today, over 20,000 desalination plants in more than 150 countries supply about 300 million people with freshwater every day. Initially a niche product for energy rich and water scarce cities, particularly in the Middle East, the continued decrease in cost and environmental viability of desalination has the potential to significantly expand its use - particularly for rapidly growing water scarce coastal cities. Desalination can be seen as one option in a portfolio water supply sources, including traditional surface water and groundwater sources as well as wastewater reuse, to meet growing water demand gap. Although still relatively expensive, desalination offers the potential to enhance system reliability. As renewable sources of energy such as wind and solar expand, and as advances in concentrate management techniques make discharges from desalination plants much cheaper and safer, the prospect of producing freshwater from the sea without increasing greenhouse gases and without significant damages to the local environment become more promising.Publication Global Economic Prospects, January 2024(Washington, DC: World Bank, 2024-01-09)Note: Chart 1.2.B has been updated on January 18, 2024. Chart 2.2.3 B has been updated on January 14, 2024. Global growth is expected to slow further this year, reflecting the lagged and ongoing effects of tight monetary policy to rein in inflation, restrictive credit conditions, and anemic global trade and investment. Downside risks include an escalation of the recent conflict in the Middle East, financial stress, persistent inflation, weaker-than-expected activity in China, trade fragmentation, and climate-related disasters. Against this backdrop, policy makers face enormous challenges. In emerging market and developing economies (EMDEs), commodity exporters face the enduring challenges posed by fiscal policy procyclicality and volatility, which highlight the need for robust fiscal frameworks. Across EMDEs, previous episodes of investment growth acceleration underscore the critical importance of macroeconomic and structural policies and an enabling institutional environment in bolstering investment and long-term growth. At the global level, cooperation needs to be strengthened to provide debt relief, facilitate trade integration, tackle climate change, and alleviate food insecurity.Publication World Development Report 2018(Washington, DC: World Bank, 2018)Every year, the World Bank's World Development Report takes on a topic of central importance to global development. The 2018 Report, Learning to Realize Education's Promise, is the first ever devoted entirely to education. Now is an excellent time for it: education has long been critical for human welfare, but is even more so in a time of rapid economic change. The Report explores four main themes. First, education's promise: Education is a powerful instrument for eradicating poverty and promoting shared prosperity, but fulfilling its potential requires better policies - both within and outside the education system. Second, the learning crisis: Despite gains in education access, recent learning assessments show that many young people around the world, especially from poor families, are leaving school unequipped with even the most foundational skills they need for life. At the same time, internationally comparable learning assessments show that skills in many middle-income countries lag far behind what those countries aspire to. Third, promising interventions to improve learning: Research from areas such as brain science, pedagogical innovations, or school management have identified interventions that promote learning by ensuring that learners are prepared, that teachers are skilled as well as motivated, and that other inputs support the teacher-learner relationship. Fourth, learning at scale: Achieving learning throughout an education system will require more than just scaling up effective interventions. Change requires overcoming technical and political barriers by deploying salient metrics for mobilizing actors and tracking progress, building coalitions for learning, and being adaptive when implementing programs.