User Fee – A Panacea in Health Care Financing?

2021 ◽  
Vol 8 (1) ◽  
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
User Fee

User Fee Policies to Promote Health Service Access for the Poor: A Wolf in Sheep's Clothing?

1997 ◽  
Vol 27 (2) ◽  
pp. 359-379 ◽  
Author(s):  
Steven Russell ◽  
Lucy Gilson
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Workers ◽  
Health Care Financing ◽  
Care Facility ◽  
Health Care Facility ◽  
Service Access ◽  
Disadvantaged Groups ◽  
The Poor ◽  
User Fee

An international survey of health service user fee and exemption policies in 26 low- and middle-income countries assessed whether user fee policies were supported by measures that protect the poor. In particular, it explored whether governments were introducing a package of supportive measures to promote service improvements that benefit disadvantaged groups and tackle differential ability to pay through an effective series of exemptions. The results show that many countries lack policies that promote access for disadvantaged groups within user fee systems and quality improvements such as revenue retention at the health care facility and expenditure guidelines for local managers. More significant policy failures were identified for exemptions: 27 percent of countries had no policy to exempt the poor; in contrast, health workers were exempted in 50 percent of countries. Even when an official policy to exempt the poor existed, there were numerous informational, administrative, economic, and political constraints to effective implementation of these exemptions. The authors argue that user fee policy should be developed more cautiously and in a more informed environment. Fees are likely to exacerbate existing inequities in health care financing unless exemptions policy can effectively reach those unable to pay.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

An Alternative Approach To User Fee Policy In The Primary Health Care Setting Of Bangladesh.

2020 ◽  
Author(s):  
Nazneen Akhter
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Complex Dynamics ◽  
Quality Care ◽  
Secondary Data ◽  
User Fees ◽  
Primary Health ◽  
Alternative Approach ◽  
Benefit Principle ◽  
User Fee

The concept of ascribing user fee in health care settings always remained a policy struggle and countries experienced different learning in this regards while implementing user fee at different tiers of health settings. The most exquisite learning among the many country specific evidences related to user fee are the match and mismatch between the equity principle and benefit principle while considering the client perspective. There is an added dimension of quality care which also add more complex dynamics into this concept since the quality care consideration has a double edged perspective both for clients and providers, where which one will get superiority over whom is a great question in health care, especially in the Primary Health care (PHC) of the country. In this reality the appropriate implementation guideline, followed by an appropriate practice of the administrative and management both service oriented and financial are of great importance in this user fee implementation consideration which always remained a challenge in the health care specially in remote care of PHC. This paper attempted a secondary data searching and scoping the available documents of Bangladesh and across the world to find an alternative approach to user fees policy where equity and benefit principle and quality - these three have to be placed in a well-constructed triad in PHC implementation which has been recommended as an alternative policy imperative in approaching user fees for Bangladesh PHC settings.

scholarly journals Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective

2021 ◽  
Author(s):  
Andrea M. Leiter ◽  
Engelbert Theurl
Keyword(s):  
Health Care ◽  
Panel Data ◽  
Health Care Financing ◽  
Value Added ◽  
The Elderly ◽  
Dynamic Panel Data ◽  
Individual Characteristics ◽  
Minor Importance ◽  
Data Set ◽  
Country Level

AbstractIn this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii) the share of compulsory health insurance as percent of total compulsory prepaid financing. In the econometric analysis, we refer to a panel data set comprising 154 countries and covering the time period 2000–2015. We apply a static as well as a dynamic panel data model. We find that the current structure of prepaid financing is significantly determined by its different forms in the past. The significant influence of GDP per capita, governmental revenues, the agricultural value added, development assistance for health, degree of urbanization and regulatory quality varies depending on the financing structure we look at. The share of the elderly and the education level are only of minor importance for explaining the variation in a country’s share of prepaid health care financing. The importance of the mentioned variables as determinants for prepaid health care financing also varies depending on the countries’ socio-economic development. From our analysis we conclude that more detailed information on indicators which reflect the distribution of individual characteristics (such as income, family size and structure and health risks) within a country’s population would be needed to gain deeper insight into the decisive determinants for prepaid health care financing.

COST CONTAINMENT AND ACCESS TO CARE: THE SHANGHAI HEALTH CARE FINANCING MODEL

2008 ◽  
Vol 53 (01) ◽  
pp. 27-41 ◽  
Author(s):  
WEIZHEN DONG
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Cost Containment ◽  
Access To Health Care ◽  
Health Care Cost ◽  
Health Care Expenditure ◽  
Health Care Financing ◽  
Insurance Scheme ◽  
Health Care Reforms ◽  
Medical Savings Account

The medical savings account (MSA) model of health care financing is viewed as a health care cost containment strategy. Yet, health care expenditure in Shanghai has increased sharply since the adoption of the MSA system. This paper looks into the health care reforms in Shanghai, especially since the introduction of the MSA scheme. From the Labor Insurance Scheme and Government Insurance Scheme to the Medical Savings Account scheme, ordinary Shanghai residents have not benefited from the most recent health care reforms. They have found medical care much less affordable. Disparity in access to health care access has become more evident than ever. Meanwhile, health care cost has increased sharply. China has benefited from an emphasis on prevention and primary care, but the government's recent policies give a high priority to catastrophic disease. This is not a cost-effective approach. Shanghai's health care system needs to break socioeconomic class boundaries if it is to construct a harmonious society. Shanghai's decision makers and various stakeholders have the resources and wisdom to face the challenge.

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