Added value and possible areas of cooperation. Serge Heijnen Executive Secretary. Carrin et al. 2008 Key health financing options at different stages of the evolution towards universal coverage. Tax-based financing Social health insurance Mix of tax-based and social health insurance.
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Key health financing options at different
stages of the evolution towards universal coverage
Social health insurance
Mix of tax-based and
social health insurance
Mixes of community -, cooperative -
and enterprise-based health insurance and other private insurance. Social health insurance- type coverage for specific groups and limited tax-based financing
Health financing function
Actors and process: policy formulation and implementation
Sufficient, equitable, efficient revenue collection
Efficiency, equity in purchasing / provision
Health financing norms
Universal Coverage (UC): adequate health services coverage of the whole population (the breadth, depth and height of coverage)
Adapted from Carrin, et al. 2008
Systems thinking requires a deliberate and continuous approach to anticipate rather than to react, and to identify upstream points of leverage.
High leverage points are usually governance and information systems, but they receive least attention!
I would argue that the added value of the Dutch experience to countries that are exploring options to extend coverage lies particularly in:
Gradually strengthening the public stewardship role and information systems in health within a context of 1) dominant private care provision and financing – both for profit and not-for-profit and 2) a historically very weak role of the government in the health sector.
Our health system only works below sea-level. Successes are more difficult to copy than mistakes.
Invest more in “the brains of health systems”: individuals, institutions and infrastructures, next to offering direct care or insurance products / solutions.