Savedoff, William D.Gottret, Pablo2012-05-292012-05-292008978-0-8213-7548-8https://hdl.handle.net/10986/6526This book provides guidance to countries that want to reform or establish mandatory health insurance (MHI) by specifically addressing governance. It elucidates the role played by the social, political, and historical context in conditioning how MHI systems are governed and, in turn, how governance structures influence the health insurance systems' performance. The book describes the forms of governance that are associated with success, in particular, the regulatory institutions required to guide the system toward its social goals; the oversight mechanisms that monitor and correct the system; and the internal management of the health insurance institutions themselves. It highlights five governance dimensions: coherent decision making structures, stakeholder participation, transparency and information, supervision and regulation, and consistency and stability that influence the coverage, financial protection, and efficiency of MHI entities, and show how these operate in particular countries. Detailed analysis of governance arrangements in four countries: Chile, Costa Rica, Estonia, and the Netherlands, provide nuanced lessons for establishing health insurance systems that can truly serve the social goals of improved health, reduced financial insecurity, and greater equity.en-USCC BY 3.0 IGOACCESS TO HEALTH CAREACCESS TO HEALTH CARE SERVICESACCESS TO HEALTH SERVICESACCOUNTABILITY MECHANISMSACUTE CAREADVERSE SELECTIONAPPLICABLE LAWBUDGET CONSTRAINTSCAPITAL REQUIREMENTSCAPITATIONCHOICE OF PROVIDERSCOMPENSATIONCONSUMER PROTECTIONCONSUMERSCONTRIBUTION RATESCOSTS OF HEALTH CARECRIMEDECISIONMAKINGDENTAL CAREDIAGNOSISDISCLOSURE OF INFORMATIONENVIRONMENTAL PROTECTIONETHICAL STANDARDSEXPENDITURESFEE-FOR-SERVICEFINANCIAL MARKETSFINANCIAL PROTECTIONFINANCIAL SUPERVISIONFINANCIAL SYSTEMSFOOD SAFETYHEALTH CARE COSTSHEALTH CARE EXPENDITURESHEALTH CARE FINANCINGHEALTH CARE INSURANCEHEALTH CARE PROFESSIONALSHEALTH CARE PROGRAMHEALTH CARE PROVIDERHEALTH CARE PROVIDERSHEALTH CARE QUALITYHEALTH CARE SERVICESHEALTH FINANCINGHEALTH FINANCING SYSTEMHEALTH INSURANCEHEALTH INSURANCE AUTHORITIESHEALTH INSURANCE COVERAGEHEALTH INSURANCE DEFICITSHEALTH INSURANCE FUNDHEALTH INSURANCE FUNDSHEALTH INSURANCE MARKETHEALTH INSURANCE MARKETSHEALTH INSURANCE SCHEMEHEALTH INSURANCE SCHEMESHEALTH INSURANCE SYSTEMHEALTH INSURERHEALTH INSURERSHEALTH OUTCOMESHEALTH PLANHEALTH PROGRAMSHEALTH SERVICEHEALTH SERVICESHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEM PERFORMANCEHEALTH SYSTEMSILLNESSINCENTIVES FOR PROVIDERSINCOMEINFORMATION SYSTEMSINSURANCE AGENCIESINSURANCE FUNCTIONINSURANCE PLANSINSURANCE SYSTEMSLATIN AMERICANLAWSLOW-INCOME COUNTRIESMARKET INSTITUTIONSMEDICAL ASSOCIATIONMEDICAL BENEFITSMEDICAL CAREMEDICAL CARE COSTSMEDICAL CARE EXPENDITURESMEDICAL EXPENDITURESMEDICAL EXPENSESMEDICAL INSURANCEMEDICAL SERVICESMIGRANTSMORAL HAZARDMULTIPLE INSURERSNATIONAL HEALTHNATIONAL HEALTH INSURANCENATIONAL HEALTH INSURANCE FUNDNATIONAL HEALTH SERVICENATIONAL HEALTH SERVICESNUTRITIONPATIENTSPENSION FUNDSPOCKET PAYMENTPOCKET PAYMENTSPOLITICAL DEBATESPOLLUTIONPRESCRIPTIONSPRIMARY CAREPRIMARY HEALTH CAREPRIVATE HEALTH INSURANCEPRIVATE INSURANCEPRIVATE INSURERSPRIVATE SECTORPROVIDER PAYMENTPROVISION OF CAREPROVISION OF HEALTH CAREPROVISION OF SERVICESPUBLIC ADMINISTRATIONPUBLIC HEALTHPUBLIC HEALTH INSURANCEPUBLIC INSURERSPUBLIC PROVISIONPUBLIC SECTORQUALITY OF CARERESEARCH PROGRAMSICKNESS FUNDSSOCIAL HEALTH INSURANCESOCIAL INSURANCESOCIAL INSURANCE SYSTEMSSOCIAL SECURITYSOCIAL SECURITY SCHEMESSOCIAL WELFARESOLVENCYSUSTAINABILITYTREATMENTSTUBERCULOSISUNEMPLOYMENTUNEMPLOYMENT INSURANCEWESTERN EUROPEWORKERSWorld Bank10.1596/978-0-8213-7548-8