Publication: Scaling Up Affordable Health Insurance : Staying the Course
Date
2013-05
ISSN
Published
2013-05
Author(s)
Preker, Alexander S.
Lindner, Marianne E.
Chernichovsky, Dov
Schellekens, Onno P.
Abstract
As the world recently turned its
attention to the struggle of expanding health insurance
coverage for 40 million people in the United States, it is
important not to forget the 4 billion people in low- and
middle-income countries that face the same hardship.
Millions of the poor have already fallen back into poverty
as a result of the ongoing global financial crisis. Millions
more are at risk before full recovery. It is the poor and
most vulnerable that are at greatest risk due to lack of
protection against the impoverishing effects of illness. The
research for this volume shows that, when properly designed
and coupled with public subsidies, health insurance can
contribute to the well-being of poor and middle-class
households, not just the rich. And it can contribute to
development goals such as improved access to health care,
better financial protection against the cost of illness, and
reduced social exclusion. Opponents vilify health insurance
as an evil to be avoided at all cost. To them, health
insurance leads to overconsumption of care, escalating
costs-especially administrative costs-fraud and abuse,
shunting of scarce resources away from the poor, cream
skimming, adverse selection, moral hazard, and an
inequitable health care system. Today many low-and
middle-income countries are no longer listening to this
dichotomized debate between vertical and horizontal
approaches to health care. Instead, they are experimenting
with new and innovative approaches to health care financing.
Health insurance is becoming a new paradigm for reaching the
Millennium Development Goals (MDGs). They emphasize the need
to combine several instruments to achieve three major
development objectives in health care financing: 1)
sustainable access to needed health care; 2) greater
financial protection against the impoverishing cost of
illness; and 3) reduction in social exclusion from organized
health financing instruments. The use of insurance was
recommended to pay for less frequent, higher-cost risks and
subsidies to cover affordability for poorer patients to
higher-frequency, lower-cost health problems.
Citation
“Preker, Alexander S.; Lindner, Marianne E.; Chernichovsky, Dov; Schellekens, Onno P.. 2013. Scaling Up Affordable Health Insurance : Staying the Course. © Washington, DC: World Bank. http://openknowledge.worldbank.org/entities/publication/715a253e-8db1-53f2-9a8b-8343bd1fa76e License: CC BY 3.0 IGO.”