Governing mandatory health insurance : : learning from experience / / edited by William D. Savedoff, Pablo Gottret

• Record Nr.: UNINA9910782576103321
• Pubbl/distr/stampa: Washington, DC : , : World Bank, , [2008]; copyright 2008
• ISBN: 1-281-78747-7; 9786611787479; 0-8213-7549-0
• Descrizione fisica: xii, 277 pages : illustrations ; ; 23 cm
• Altri autori (Persone): SavedoffWilliam D; GottretPablo E <1959-> (Pablo Enrique)
• Disciplina: 368.38/2
• Soggetti: Health insurance; Health insurance - Europe; Health insurance - Latin America
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Note generali: Description based upon print version of record.
• Nota di bibliografia: Includes bibliographical references and index.
• Nota di contenuto: Contents; Foreword; Acknowledgments; Acronyms and abbreviations; Overview; Figure 1 Accountability through governance; Table 1 Mandatory health insurance models and implications for governance; 1 Governing mandatory health insurance: Concepts, framework, and cases; Box 1.1 This book; Box 1.2 Definitions of social health insurance; Figure 1.1 Health insurance schemes; Box 1.3 Serving many masters; Figure 1.2 Three key relationships influencing the behavior of mandatory health insurance entities; Figure 1.3 Accountability through effective governance; Box 1.4 A "fifth" model; Table 1.1 Mandatory health insurance models and implications for governanceTable 1.2 General characteristics of case study countries; Table 1.3 Decisionmaking authority by country and issue; 2 Good governance dimensions in mandatory health insurance: A framework for performance assessment; Table 2.1 Dimensions, features, and indicators of good governance in mandatory health insurance; Figure 2.1 Example for mandatory health insurance governance performance assessment; Figure 2.2 Costa Rica mandatory health insurance ; governance performance assessment; Figure 2.3 Estonia mandatory health insurance governance performance assessmentFigure 2.4 The Netherlands mandatory health insurance governance performance assessment; Figure 2.5 Chile mandatory health insurance governance performance assessment; 3 Costly success: An integrated health insurer in Costa Rica; Figure 3.1 Evolution of health insurance coverage in Costa Rica; Table 3.1 Influence of different parties on CCSS decisions; Box 3.1 Resolutions of the constitutional court; Figure 3.2 Population covered by the primary health care program, 1990-2003; Figure 3.3 Average length of stay in the hospital, 1990-2004Figure 3.4 External consultations per hour, 1990-2004; 4 Governing a single-payer mandatory health insurance system: The case of Estonia; Figure 4.1 Organizational structure of the Estonian Health Insurance Fund, 2006; Box 4.1 Sources of main regulations; Figure 4.2 Overview of the Estonian health financing system; Table 4.1 Influence on decisions made by the Estonian health financing system; Figure 4.3 Population satisfaction with access to care, 2001-05; Figure 4.4 Outpatient contacts and acute care admissions, 1985-2003; Figure 4.5 Out-of-pocket payment for health care, 1998-2004Figure 4.6 Share of households with high health payments, 1995, 2001, and 2002; Figure 4.7 Estonian Health Insurance Fund revenues and expenditures, 1992-2006; 5 Governing multiple health insurers in acorporatist setting: The case of the Netherlands; Figure 5.1 Three-compartment structure of health insurance before 2006; Table 5.1 Composition of health care financing by source; Box 5.1 Overview of the 2006 reforms; 6 Governing a hybrid mandatory health insurance system: The case of Chile; Figure 6.1 Governance forces in mandatory health insurance: The general case
• Sommario/riassunto: Although mandatory health insurance programs are being proposed or expanded in many developing countries, relatively little attention has been given to how these programs are governed. The available literature focuses almost exclusively on operational features that are important but will necessarily change over time-such as eligibility, benefit packages, and premiums. Governing Mandatory Health Insurance instead looks at the institutional and political forces that affect the behavior of such programs within their social and historical contexts and how five dimensions of governance-coherent dec