Governing Mandatory Health Insurance : Learning from Experience

This book provides guidance to countries that want to reform or establish mandatory health insurance (MHI) by specifically addressing governance. It elucidates the role played by the social, political, and historical context in conditioning how MHI...

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Bibliographic Details
Main Authors:	Savedoff, William D., Gottret, Pablo
Format:	Publication
Language:	English en_US
Published:	Washington, DC : World Bank 2012
Subjects:	ACCESS TO HEALTH CARE ACCESS TO HEALTH CARE SERVICES ACCESS TO HEALTH SERVICES ACCOUNTABILITY MECHANISMS ACUTE CARE ADVERSE SELECTION APPLICABLE LAW BUDGET CONSTRAINTS CAPITAL REQUIREMENTS CAPITATION CHOICE OF PROVIDERS COMPENSATION CONSUMER PROTECTION CONSUMERS CONTRIBUTION RATES COSTS OF HEALTH CARE CRIME DECISIONMAKING DENTAL CARE DIAGNOSIS DISCLOSURE OF INFORMATION ENVIRONMENTAL PROTECTION ETHICAL STANDARDS EXPENDITURES FEE-FOR-SERVICE FINANCIAL MARKETS FINANCIAL PROTECTION FINANCIAL SUPERVISION FINANCIAL SYSTEMS FOOD SAFETY HEALTH CARE COSTS HEALTH CARE EXPENDITURES HEALTH CARE FINANCING HEALTH CARE INSURANCE HEALTH CARE PROFESSIONALS HEALTH CARE PROGRAM HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE QUALITY HEALTH CARE SERVICES HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH INSURANCE HEALTH INSURANCE AUTHORITIES HEALTH INSURANCE COVERAGE HEALTH INSURANCE DEFICITS HEALTH INSURANCE FUND HEALTH INSURANCE FUNDS HEALTH INSURANCE MARKET HEALTH INSURANCE MARKETS HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INSURER HEALTH INSURERS HEALTH OUTCOMES HEALTH PLAN HEALTH PROGRAMS HEALTH SERVICE HEALTH SERVICES HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS ILLNESS INCENTIVES FOR PROVIDERS INCOME INFORMATION SYSTEMS INSURANCE AGENCIES INSURANCE FUNCTION INSURANCE PLANS INSURANCE SYSTEMS LATIN AMERICAN LAWS LOW-INCOME COUNTRIES MARKET INSTITUTIONS MEDICAL ASSOCIATION MEDICAL BENEFITS MEDICAL CARE MEDICAL CARE COSTS MEDICAL CARE EXPENDITURES MEDICAL EXPENDITURES MEDICAL EXPENSES MEDICAL INSURANCE MEDICAL SERVICES MIGRANTS MORAL HAZARD MULTIPLE INSURERS NATIONAL HEALTH NATIONAL HEALTH INSURANCE NATIONAL HEALTH INSURANCE FUND NATIONAL HEALTH SERVICE NATIONAL HEALTH SERVICES NUTRITION PATIENTS PENSION FUNDS POCKET PAYMENT POCKET PAYMENTS POLITICAL DEBATES POLLUTION PRESCRIPTIONS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE HEALTH INSURANCE PRIVATE INSURANCE PRIVATE INSURERS PRIVATE SECTOR PROVIDER PAYMENT PROVISION OF CARE PROVISION OF HEALTH CARE PROVISION OF SERVICES PUBLIC ADMINISTRATION PUBLIC HEALTH PUBLIC HEALTH INSURANCE PUBLIC INSURERS PUBLIC PROVISION PUBLIC SECTOR QUALITY OF CARE RESEARCH PROGRAM SICKNESS FUNDS SOCIAL HEALTH INSURANCE SOCIAL INSURANCE SOCIAL INSURANCE SYSTEMS SOCIAL SECURITY SOCIAL SECURITY SCHEMES SOCIAL WELFARE SOLVENCY SUSTAINABILITY TREATMENTS TUBERCULOSIS UNEMPLOYMENT UNEMPLOYMENT INSURANCE WESTERN EUROPE WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2008/06/9850999/governing-mandatory-health-insurance-learning-experience http://hdl.handle.net/10986/6526

Description
Summary:	This book provides guidance to countries that want to reform or establish mandatory health insurance (MHI) by specifically addressing governance. It elucidates the role played by the social, political, and historical context in conditioning how MHI systems are governed and, in turn, how governance structures influence the health insurance systems' performance. The book describes the forms of governance that are associated with success, in particular, the regulatory institutions required to guide the system toward its social goals; the oversight mechanisms that monitor and correct the system; and the internal management of the health insurance institutions themselves. It highlights five governance dimensions: coherent decision making structures, stakeholder participation, transparency and information, supervision and regulation, and consistency and stability that influence the coverage, financial protection, and efficiency of MHI entities, and show how these operate in particular countries. Detailed analysis of governance arrangements in four countries: Chile, Costa Rica, Estonia, and the Netherlands, provide nuanced lessons for establishing health insurance systems that can truly serve the social goals of improved health, reduced financial insecurity, and greater equity.

Governing Mandatory Health Insurance : Learning from Experience

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