Publication:
Health Insurance Handbook : How to Make It Work

Loading...
Thumbnail Image
Files in English
English PDF (3.7 MB)
8,416 downloads
English Text (5.88 KB)
83 downloads
Published
2012-01-18
ISSN
Date
2012-03-19
2012-04-04
Editor(s)
Abstract
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.
Link to Data Set
Citation
โ€œWang, Hong; Switlick, Kimberly; Ortiz, Christine; Zurita, Beatriz; Connor, Catherine. 2012. Health Insurance Handbook : How to Make It Work. World Bank Working Paper ; No. 219. ยฉ World Bank. http://hdl.handle.net/10986/5913 License: CC BY 3.0 IGO.โ€
Associated URLs
Associated content
Report Series
Report Series
Other publications in this report series
  • Publication
    Greening Digital in Korea
    (Washington, DC, 2022-02) World Bank
    Digital technologies are making a significant impact on societies, economies, and the physical world, presenting both opportunities and challenges for the green agenda. Applications of these technologies in sectors such as energy, urban, transport, and agriculture are creating new possibilities for climate change mitigation strategies. However, the rapid expansion of digital technologies increases energy usage too, and is therefore also increasing greenhouse gas (GHG) emissions. In seeking to address these challenges, the World Bankโ€™s Digital Development Global Practice (DD) will publish a flagship report on Digital Development Opportunities for Climate Change, which will assess opportunities for greening with information communication technology (ICT), as well as opportunities for greening the ICT sector itself. To inspire and inform this flagship report, DD studied Koreaโ€™s experience in greening its ICT sector, with support from the Korean Green Growth Trust Fund. The Republic of Korea was selected for the case study due to its experience in both the digital and green sectors, and its status as a globally recognized ICT powerhouse. The country was also an early adopter of a green policy agenda, and is integrating DNA (data, network, and AI) into these policies. The government announced a national policy vision of โ€œLow Carbon, Green Growthโ€ in 2008 and has taken concrete steps to build a solid foundation for the green transition, through legislation, standardization, information-based instruments, economic instruments, research and development (R&D), and green procurement. More recently, the country has been aligning its green ICT strategy with the broader national GHG reduction target. Korea's experience can offer meaningful lessons to other countries looking to reduce the ICT sectorโ€™s climate impact. It shows that public policies have an important impact on the ICT market. The policy tools that can spur decarbonization of the ICT sector include green government procurement, information-based instruments, economic instruments, and provision of guidelines on green business practices. Keys to success in applying such tools include strong and early political commitment; long-term planning and comprehensive policies; prioritization; research and development (R&D) and investment; and a governance structure that allows a whole-of-government approach. Additionally, Koreaโ€™s experience shows that renewable energy will play an increasingly important role in reducing GHG emissions from the energy-intensive ICT industry. Koreaโ€™s experience also underscores the fact that more evidence and analysis are needed to measure and determine the effectiveness of policy and regulatory pathways for greening the ICT sector.
  • Publication
    Environmental Implications of a Central Bank Digital Currency (CBDC)
    (Washington, DC : World Bank, 2022-07) Lee, Soohyang; Park, Jinhee
    Two-thirds of central banks in the East Asia and Pacific (EAP) region have started researching or testing the implementation of a Central Bank Digital Currency (CBDC). At the same time, the region accounts for one-third of world CO2 emissions and is vulnerable to climate risks. As the Group of 7 (G7), European Central Bank (ECB), and Bank of England (BoE) have stated in their public statements, it is increasingly important to consider environmental impact when designing CBDC. However, only a few brief studies have been done on this subject, which will be crucial for the region. This Note explores the environmental implications of CBDC by comparing technical mechanisms and energy consumption within its distributed structure. It also illustrates differences in ecological footprint between CBDC and other payment methods (cryptocurrency, cash, and card networks). As the legitimacy of CBDC is backed by the trust of central banks, CBDC does not need to prove its legitimacy through its technological structure. Therefore, CBDC does not require the energy-intensive consensus or mining mechanisms used by a cryptocurrency, so its energy consumption is lower (comparable to that of a credit card system). CBDC can be designed to use various systems, such as Real Time Gross Settlement (RTGS), Distributed Ledger Technology (DLT), or a mixture of both. Careful deliberation to meet the objectives and implications will be important as CBDC can be a catalyst for financial innovation.
  • Publication
    Assessing Incentives to Increase Digital Payment Acceptance and Usage
    (World Bank, Washington, DC, 2022-01-18) Allen, Jeff; Carbo Valverde, Santiago; Chakravorti, Sujit; Rodriguez-Fernandez, Francisco; Pinar Ardic, Oya
    An important step to achieve greater financial inclusion is to increase the acceptance and usage of digital payments. Although consumer adoption of digital payments has improved dramatically globally, the acceptance and usage of digital payments for micro, small, and medium-sized retailers (MSMRs) remain challenging. Using random forest estimation, The authors identify 14 key predictors out of 190 variables with the largest predictive power for MSMR adoption and usage of digital payments. Using conditional inference trees, they study the importance of sequencing and interactions of various factors such as public policy initiatives, technological advancements, and private sector incentives. The authors find that in countries with low point of sale (POS) terminal adoption, killer applications such as mobile phone payment apps increase the likelihood of P2B digital transactions. They also find the likelihood of digital P2B payments at MSMRs increases when MSMRs pay their employees and suppliers digitally. The level of ownership of basic financial accounts by consumers and the size of the shadow economy are also important predictors of greater adoption and usage of digital payments. Using causal forest estimation, they find a positive and economically significant marginal effect for merchant and consumer fiscal incentives on POS terminal adoption on average. When countries implement financial inclusion initiatives, POS terminal adoption increases significantly and MSMRsโ€™ share of person-to-business (P2B) digital payments also increases. Merchant and consumer fiscal incentives also increase MSMRsโ€™ share of P2B electronic payments.
  • Publication
    The Behavioral Professional
    (Washington, DC : World Bank, 2022) Lourenรงo, Joana S.; Vakis, Renos; Zoratto, Laura
    Over the past decade, governments, multilateral organizations, and think tanks have been increasingly using behavioral science as an additional tool to understand and tackle complex policy challenges in several sectors. Yet despite this increase in the use of behavioral science for policy design, little attention has been given so far to those individuals responsible for designing and implementing public policies and programs: policy professionals. This note aims to achieve three objectives. first, it highlights recent examples building on work done by the eMBeD team and the World Bank at large on how behavioral bottlenecks can hinder key development goals, from ensuring inclusive and equitable education for all (SDG4) to ensuring good health and well-being (SDG3), among others. Second, the note presents a behavioral framework highlighting the individual, group and institutional contexts that affect policy professionals. Finally, it showcases the relevance of the behavioral approach to a broad range of areas - including public service design, corruption and accountability, service design, access and delivery, civil servantsโ€™ performance - by pinpointing common bottlenecks faced, and potential solutions to overcome them.
  • Publication
    Sustainable Cities Towards A Green, Resilient and Inclusive Recovery
    (Washington, DC, 2022-03) World Bank
    Cities are key to unlocking a climate-smart future for all, as they account for more than 50 percent of the global population, about 70 percent of global energy-related CO2 emissions and 80 percent of global GDP. Urban centersโ€™ share of emissions is expected to grow as the urban population is projected to increase by 2.3 billion people by 20502. As the world recovers from the COVID-19 crisis, cities will present a huge opportunity to rebuild in a way that is climate friendly and meets some of the worldโ€™s ambitious climate targets. Cities are viewed as the source of and the solution to many of today's economic, social, and environmental challenges. This is not only because of the concentration of population and economic assets in urban areas, but also because local authorities perform key functions that impact the quality of life of their residents. From an urban management perspective, the leading resource and knowledge sharing platform is the GEF funded Global Platform for Sustainable Cities (GPSC), hosted by the World Bank. The GPSC states that achieving sustainability requires the balanced accomplishment of outcomes against four pillars, namely (1) robust economic growth, prosperity, and competitiveness across all parts of the city; (2) protection and conservation of ecosystems and natural resources into perpetuity; (3) mitigation of greenhouse gas (GHG) emissions while fostering overall city resilience; and (4) inclusiveness and livability, mainly through the reduction of city poverty levels and inequality. The Urban Sustainability Framework (USF), developed to outline the areas of work and support by the GPSC, offers a very useful representation of both outcomes as well as enabling actions and requirements (such as spatial data and good governance) cities could focus on.
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Vietnam : Learning from Smart Reforms on the Road to Universal Health Coverage
    (World Bank Group, Washington, DC, 2014-08) Barroy, Helene; Jarawan, Eva; Bales, Sarah
    Universal Health Coverage is a powerful framework for a nation aiming to protect their population against health risks. However, countries face multiple challenges in implementing, achieving and sustaining UHC strategies. Sharing and learning from diverse country experiences may enable to foster global and country progress toward that goal. The study seeks to contribute to the global effort of sharing potentially useful lessons to address policy concerns on the design and implementation of UHC strategies in LMICs. Vietnam is one of the LMICs that have taken relatively quick and effective actions to expand health coverage and improve financial protection in the last two decades. The country study, first, takes stock of UHC progress in Vietnam, examining both the breadth and the depth of health coverage and assessing financial protection and equity outputs (chapter one). Chapter two includes an in-depth analysis of some of the major success strategies and policy actions that the country took to expand health coverage and financial protection for all, including for the poor. Chapter three focuses on some of the UHC-related challenges that the country faces in pursuing expansion and sustaining UHC. Vietnam s experience suggests that, moving toward greater UHC outputs, the system must be constantly adjusted, and that UHC strategies must be adaptive, those used in the past to cover the formal sector and the poor may turn out inadequate to reach the uninsured in the informal sector.
  • Publication
    The Long March to Universal Coverage : Lessons from China
    (World Bank, Washington DC, 2013-01) Liang, Lilin; Langenbrunner, John C.
    The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to, and affordability of, health services. The Chinese government announced the national three-year reform plan in 2009, after which the country has made remarkable progress toward achieving nearly universal health coverage. The recent health reform initiatives under the 12th Five-Year Plan (2011-2015) continue to center on five areas. Building on recent experience, more effort is directed toward a structural change of the health system and building an environment that will facilitate policy implementation. This includes optimizing resource distribution, encouraging hospital competition, strengthening regulation and accountability, and enhancing human resources and information technology. While China has successfully extended the breadth of Health Coverage to the Poor (HCP), its scope (the comprehensiveness of services covered) and depth (the degree of financial risk protection) appear to be insufficient. Hospital admissions have increased significantly; suggesting improved access, up to 50 percent of current admissions may be amenable to more cost-effective outpatient care. Thus, it is critical to look into problems beyond the HCP program design, such as institutional arrangements, intergovernmental transfers, and supply constraints. This case study concludes with a discussion of the impacts of HCP and the needed next steps to advance HCP as an intermediate objective to the country's longer-term goals of equitable access and high quality of services.
  • Publication
    Who Pays? Out-of-Pocket Health Spending and Equity Implications in the Middle East and North Africa
    (World Bank, Washington, DC, 2010-11) Elgazzar, Heba; Raad, Firas; Arfa, Chokri; Mataria, Awad; Salti, Nisreen; Chaaban, Jad; Salehi-Isfahani, Djavad; Fesharaki, Sanaz; Majbouri, Mehdi
    Ensuring affordable, effective health care and financial protection against the adverse effects of household out-of-pocket (OOP) health expenditures represents an important policy objective in most countries, yet relatively little evidence exists regarding patterns and implications of household health expenditures in the Middle East and North Africa (MENA) region. This paper examines the scope of out-of-pocket expenditures and their implications on living standards and policy reforms in six MENA countries including Yemen, the West Bank and Gaza, Egypt, Iran, Tunisia, and Lebanon. Results show that OOP payments represent a relatively high share of total national health care financing at 49 percent on average in the MENA region as of 2006. Households pay an average of 6 percent of their total household expenditure on health. Most of this OOP is spent on medications, doctor visits and diagnostic services. Lower-income and rural households generally face greater financial risk; yet this is reversed where private health services are utilized and paid for more frequently by higher-income groups. 7 to 13 percent of households face particularly high OOP payments, or catastrophic expenditures equal to at least 10 percent of household spending. Poverty rates tend to increase by up to 20 percent after health care spending is accounted for. Results are discussed in light of ongoing policy efforts to strengthen social protection for health care.
  • Publication
    Islamic Republic of Iran - Health Sector Review : Volume 1. Main Report
    (Washington, DC, 2008-06) World Bank
    The Government of the Islamic Republic of Iran has stated its commitment to improving the health and nutritional status of the population as articulated in the Interim Country Assistance Strategy (CAS), which lists as priorities addressing nutritional deficiencies, expanding coverage of basic health services, and improving efficiency of the health system and the quality of service at all levels. This health sector review is consistent with this in that it provides the platform and evidence base for such reform. It is also in-line with part three of the current Fourth Five-Year Plan, which includes health development, human security and social justice priority, the reduction of illness from malnutrition, increasing public health service coverage, and increasing access to quality health services while reducing the financial burden on the families. The objective of this study is to provide a comprehensive review and diagnostic of the performance of the health sector in the Islamic Republic of Iran. The government is quite advanced in the type of analysis it already undertakes on various aspects of the sector (e.g., burden of diseases, national health accounts, and utilization analysis). However, a consolidation of this information and analysis that encompasses several major elements of the health sector has not been done recently. The health sector review, through a synthesis of available data and other information on the health sector attempts to: (i) assess the strengths, challenges, and opportunities facing the current health system; (ii) offer analytic assessments of the health policies and plans; and (iii) provide a framework for developing strategic options as well as short- and medium-term recommendations and action plans to achieve the goals identified in the country's Fourth Five-Year Plan. The review is also intended to provide a platform for discussions on possible areas of collaboration between the Government of the Islamic Republic of Iran and the World Bank on the health sector.
  • Publication
    Universal Health Coverage for Inclusive and Sustainable Development : A Synthesis of 11 Country Case Studies
    (Washington, DC: World Bank, 2014-06-25) Maeda, Akiko; Araujo, Edson; Cashin, Cheryl; Harris, Joseph; Ikegami, Naoki; Reich, Michael R.
    The goals of Universal Health Coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey that have achieved UHC are showing how these programs can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low income and middle-income countries (LMICs), where most of the world s poor live.

Users also downloaded

Showing related downloaded files

  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countriesโ€™ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africaโ€™s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africaโ€™s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomesโ€”in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet servicesโ€”and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earningsโ€”dampen peopleโ€™s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africaโ€™s countries must implement complementary and mutually reinforcing policies to strengthen both consumersโ€™ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforceโ€”one projected to become the worldโ€™s largest by the end of this century.
  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentinaโ€™s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentinaโ€™s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentinaโ€™s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the countryโ€™s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    Europe and Central Asia Economic Update, Spring 2025: Accelerating Growth through Entrepreneurship, Technology Adoption, and Innovation
    (Washington, DC: World Bank, 2025-04-23) Belacin, Matias; Iacovone, Leonardo; Izvorski, Ivailo; Kasyanenko, Sergiy
    Business dynamism and economic growth in Europe and Central Asia have weakened since the late 2000s, with productivity growth driven largely by resource reallocation between firms and sectors rather than innovation. To move up the value chain, countries need to facilitate technology adoption, stronger domestic competition, and firm-level innovation to build a more dynamic private sector. Governments should move beyond broad support for small- and medium-sized enterprises and focus on enabling the most productive firms to expand and compete globally. Strengthening competition policies, reducing the presence of state-owned enterprises, and ensuring fair market access are crucial. Limited availability of long-term financing and risk capital hinders firm growth and innovation. Economic disruptions are a shock in the short term, but they provide an opportunity for implementing enterprise and structural reforms, all of which are essential for creating better-paying jobs and helping countries in the region to achieve high-income status.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure studentsโ€™ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Morocco Economic Update, Winter 2025
    (Washington, DC: World Bank, 2025-04-03) World Bank
    Despite the drought causing a modest deceleration of overall GDP growth to 3.2 percent, the Moroccan economy has exhibited some encouraging trends in 2024. Non-agricultural growth has accelerated to an estimated 3.8 percent, driven by a revitalized industrial sector and a rebound in gross capital formation. Inflation has dropped below 1 percent, allowing Bank al-Maghrib to begin easing its monetary policy. While rural labor markets remain depressed, the economy has added close to 162,000 jobs in urban areas. Moroccoโ€™s external position remains strong overall, with a moderate current account deficit largely financed by growing foreign direct investment inflows, underpinned by solid investor confidence indicators. Despite significant spending pressures, the debt-to-GDP ratio is slowly declining.