1 / 12

Health Insurance in low-income countries

Health Insurance in low-income countries. Where is the evidence that it works? Esme Berkhout Health policy advisor Oxfam Novib Oxfam International, Action for Global Health, Medecins du Monde, Save the Children UK, Plan, Global Health Advocates and Act Up Paris. Content. Global context

kerem
Download Presentation

Health Insurance in low-income countries

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health Insurance in low-income countries Where is the evidence that it works? Esme Berkhout Health policy advisor Oxfam Novib Oxfam International, Action for Global Health, Medecins du Monde, Save the Children UK, Plan, Global Health Advocates and Act Up Paris

  2. Content • Global context • Expectations • National/local reality • Coverage • Main concerns • Recommendations

  3. Global context • Right to health & social security • 1.3 billion people lack access • 100 million pushed into poverty • User fees: inequitable • Pre-payment and riskpooling preferred ILO global campaign (2001), WHA 58.33 (2005) Berlin conference and plan of action (2005), Paris conference (2007 & 2008), Africa-EU strategic partnership (2007), IFC strategy (2007), Providing for Health (G8, 2007)

  4. Expectations • Increases resources • More predictable • Cross-subsidization • Reduces uncertainty for citizens • Contributes to better quality health care

  5. National/local reality • Does not live up to expectations • Relatively few people are reached • The poorest & vulnerable: most excluded • Can only work for the poor through: • strong government stewardship • sufficient public funding • NGOs jointly concerned

  6. Private health insurance • Coverage rate in LICs < 10% • Premium related to risk profile: discrimination & exclusion • Typically cover higher income groups • Regulation: up to 30% of revenue

  7. Micro health insurance • Coverage worldwide ~35 million (mostly Asia) • Targets poor people • Low premiums & benefits package (India) • Can reduce catastrophic health expenditure • Has limited effect on reducing OOP

  8. Community based health insurance • Coverage ~2 million people in Africa (0.2%) • Not for profit, based on solidarity among group of (poor) people • Excludes poorest and most vulnerable groups (Armenia, Rwanda) • Members continue to depend on OOP to cover 40% of health needs

  9. Social health insurance • Widespread in OECD, Latin-America and Eastern Europe • Mandatory, premiums in proportion to income • Difficult to extend to the poor & informal (Ghana 38% coverage 2006) • Positive example of Thailand

  10. Main concerns • Waiting for realization of rights • Policies for achieving universal access? • Public funding too low • Insurance won’t fill funding gap • Potential threat to equity and universal access

  11. Recommendations • Consider Insurance in relation to universal access, equity and efficiency • Set out a timeline towards universal access, and ensure financing • Consultation with civil society, including the most vulnerable groups • Pay particular attention to equity • Increase public resources • Support abolition user fees

  12. Questions?

More Related