Scaling Up Affordable Health Insurance: Staying the Course is
the fifth volume in a series of in-depth reviews on the role of health
care financing in improving access for low-income populations to needed
care, protecting them from the impoverishing effects of illness, and
addressing the important issues of social exclusion in government
financed programs. Success in improving access and financial protection
through community and private voluntary health insurance have led many
countries to attempt to make membership compulsory and to offer
subsidized insurance through the public sector. The protagonists are
divided into several camps; from supporters of health insurance to
opponents or skeptics. 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
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. The book is organized into three main
parts. Major policy directions in financing health care are discussed
in Part 1, with a particular focus on the pre-conditions for scaling
up. Part 2 moves from theory to practice with overviews and country
level studies on health insurance development. Finally, part 3
highlights the implementation challenges.
The IFC and the World Bank are committed to helping low- and middle-income countries scale up financing mechanisms like health insurance that help make health services more sustainable and protect the population against the impoverishing effects of illness. The authors and contributors to this book provide a unique review of the global experience in scaling up health insurance during the 20th and early 21st centuries. The book provides an in-depth analysis of the historical, political, institutional, and economic underpinnings of health insurance from around the world.
- Guy Ellena, Director, Manufacturing, Agribusiness, and Services International Finance Corporation
What are the reasons for the existence and growth of social health insurance? And, are there limits to social health insurance? Social health insurance often has a noble beginning,
being presented to the population as a technical solution for overcoming market failures in private insurance markets and addressing equity considerations. Too often during the design
and implementation phases, however, politicians seeking election or reelection introduce elements that undermine both the efficiency and equity objectives that might otherwise have been
achieved through broad coverage under social health insurance.
-Peter Zweifel, Professor Emeritus of Economics, University of Zurich
During the past century, health insurance has played a major role in financing health care and protecting people from the financial hardships of illness in Western Europe and other developed regions of the world. This book provides a unique and comprehensive review of the political, economic, and institutional challenges that low- and middle-income countries
face in similarly scaling up health insurance coverage and benefits for their populations.
- Kees J. Storm, Chairman, Health Insurance Fund, Anheuser-Busch InBev S.A. and KLM N.V., Vice Chairman, Unilever and Pon Holdings B.V., Supervisory Board, AEGON N.V. Board of Directors, Baxter International Inc.
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