Priority Setting in Universal health coverage: Choosing services. The Three Dimensions (policy choices). Coverage. Health. Universal. How does one choose needed services?. What types of services to consider: preventive, promotive, curative, rehabilitative, palliative
in Universal health coverage:
Begin from CHOICE results (cluster of disease or health sector as a whole)
Use checklist to identify excluded interventions of equity or priority setting interest
Use quantitative techniques to explore concerns & illustrate impact of alternative choices
What resources will be released or foregone?
What existing treatments will have to be displaced?
What health benefits will be foregone?
What is society willing to pay for a more equitable choice of interventions?
At a mental health budget level of $3.50 per capita (India), efficiency results from CHOICE suggest funding the following conditions:
No funding would be allocated to treatment of bipolar disorder or schizophrenia on efficiency grounds alone
However, equity & priority-setting considerations (checklist):
Conditions severe, chronic, lifelong
Not curable, limited capacity to benefit
Bad luck in the health lottery
Interventions are the only means to help
Fig. 2. Health care choices in a low-income and middle-income country. The vertical axis indicates the level of public subsidy, the right-side horizontal axis refers to the population volume classified as poor and non-poor, and the left-side horizontal axis represents clinical health services divided into the minimum and the essential packages. Public subsidies should be close to 100% for the minimum package for the poor. In low-income countries the subsidy should fall, perhaps quite sharply, as resources extend to the non-poor or to interventions outside the minimum package. In middle-income countries the subsidy could extend to the non-poor and can finance part of the essential package only if the minimum package is assured for the poor and all cost-effective services are covered for the entire population (WDR93).
Public fiannce share
Public fiannce snare