Aligning priorities in Ethiopian health finance: How do the essential health services package and health benefit plans compare?

2021 ◽  
Author(s):  
Adam D. Koon ◽  
Jenna Wright ◽  
Leulseged Ageze ◽  
Jodi Charles ◽  
Jeanna Holtz
Keyword(s):  
Health Services ◽  
Health Benefit ◽  
Health Benefit Plans ◽  
Health Finance

Part of the Yellow Dog: U.S. Coal Miners' Opposition to the Company Doctor System, 1936–1946

1989 ◽  
Vol 19 (4) ◽  
pp. 709-720 ◽  
Author(s):  
Alan Derickson
Keyword(s):  
Health Services ◽  
Health Benefit ◽  
Extensive Investigation ◽  
Health Benefit Plans ◽  
Coal Miners ◽  
Retirement Fund ◽  
United Mine Workers ◽  
Company Doctor ◽  
Medical Examinations ◽  
United Mine

By the mid-1930s, U.S. coal miners could no longer tolerate company doctors. They objected to the misuse of preemployment and periodic medical examinations and to many other facets of employer-controlled health benefit plans. The rank-and-file movement for reform received critical assistance from the Bureau of Cooperative Medicine, which conducted an extensive investigation of health services in 157 Appalachian communities. This study not only substantiated the workers' indictment of prevailing conditions but illuminated new deficiencies in the quality and availability of hospital and medical care as well. The miners' union curtailed the undemocratic, exploitative system of company doctors and proprietary hospitals by establishing the United Mine Workers of America Welfare and Retirement Fund in 1946.

The Politics of Health Finance Reform in Hong Kong

2013 ◽  
pp. 69-77 ◽  
Author(s):  
Raymond K. H. Chan
Keyword(s):  
Hong Kong ◽  
Health Services ◽  
Health Financing ◽  
User Fees ◽  
Alternative Methods ◽  
Public Health Services ◽  
Finance Reform ◽  
Health Finance ◽  
The Government ◽  
Welfare Politics

Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.

Politics Matters

2021 ◽  
pp. 565-575
Author(s):  
Raymond K. H. Chan
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Financing ◽  
User Fees ◽  
Alternative Methods ◽  
Public Health Services ◽  
Health Finance ◽  
Rational Planning ◽  
The Government ◽  
Welfare Politics

Hong Kong's public health services gradually developed since the 1950s. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests; and eventually can only end up with a limited voluntary health insurance scheme. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.

Politics Matters

2020 ◽  
pp. 188-198
Author(s):  
Raymond K. H. Chan
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Financing ◽  
User Fees ◽  
Alternative Methods ◽  
Public Health Services ◽  
Health Finance ◽  
Rational Planning ◽  
The Government ◽  
Welfare Politics

Hong Kong's public health services gradually developed since the 1950s. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests; and eventually can only end up with a limited voluntary health insurance scheme. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.

Measuring consumer perceptions of quality differences among competing health benefit plans

2002 ◽  
Vol 21 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Katherine Harris ◽  
Jennifer Schultz ◽  
Roger Feldman
Keyword(s):  
Health Benefit ◽  
Consumer Perceptions ◽  
Health Benefit Plans

scholarly journals Equity in Health Benefit Utilization and Financial Risk Protection in Outpatient and Inpatient Care: Baseline Survey of Two Socioeconomic Groups of a Pilot Primary Care Benefits Scheme in the Catchment Areas of a University-Based Health Facility

2020 ◽  
Vol 53 (1) ◽  
Author(s):  
Jose Rafael A. Marfori ◽  
Antonio Miguel L. Dans ◽  
Mica Olivine C. Bastillo ◽  
Ramon Pedro P. Paterno ◽  
Mia P. Rey ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Facility ◽  
Financial Risk ◽  
Health Benefit ◽  
Income Group ◽  
The Philippines ◽  
Financial Risk Protection ◽  
Risk Protection

Background. Health inequities in the Philippines are driven by health workforce maldistribution and health system fragmentation. These can be addressed by strengthening primary care through central social health insurance (PhilHealth) coverage. However, high reported PhilHealth population coverage and health provider accreditation have not necessarily increased health benefit utilization or financial risk protection. Objective. This study aims to examine the impact of an enhanced, comprehensive primary care benefits package at a university-based health facility. This paper reports baseline utilization of health services and health benefits, and out-of-pocket health spending in two socioeconomic strata of the catchment population, for outpatient and inpatient services. Methods. A questionnaire-guided survey was done among randomly selected faculty (higher income group) and non-faculty (lower income group) employees to determine the frequencies and costs of using outpatient and inpatient health services, and amounts paid out-of-pocket. Results. Annually, both groups had approximately 1 consultation/patient and about 15 hospitalizations per 100 families annually. For hospitalizations, non-faculty inpatients utilized health insurance more frequently than faculty inpatients (75.7% vs. 66.7%), but paid higher out-of-pocket proportions (73.3% or Php 92,479/hospitalization vs. 57.4% or Php 16,273/hospitalization). For outpatient care, health benefit utilization rates were higher among non-faculty (12.4% vs 2.1% of consultations) although low overall, with similar total (Php 2,319 vs Php 1,741) and out-of-pocket expenses (100%). Conclusion. These findings confirm inequities in accessing outpatient and inpatient health services and utilizing health insurance benefits in the target population.

scholarly journals The cost-effectiveness of using performance-based financing to deliver the basic package of health services in Afghanistan

2020 ◽  
Vol 5 (9) ◽  
pp. e002381
Author(s):  
Ahmad S Salehi ◽  
Josephine Borghi ◽  
Karl Blanchet ◽  
Anna Vassall
Keyword(s):  
Cost Effectiveness ◽  
Health Services ◽  
Unit Cost ◽  
Health Benefit ◽  
Standard Of Care ◽  
Child Health Services ◽  
Randomised Control Trial ◽  
Economic Evaluations ◽  
Performance Based Financing ◽  
The Cost

Performance-based financing (PBF) is a mechanism to improve the quality and the utilisation of health benefit packages. There is a dearth of economic evaluations of PBF in the ‘real world’. Afghanistan implemented PBF between 2010 and 2015 and evaluated the programme using a pragmatic cluster-randomised control trial. We conducted a cost-effectiveness analysis of the PBF programme in Afghanistan, compared with the standard of care, from the provider payer’s perspective. The incremental cost-effectiveness ratio of PBF compared with the standard of care was US$1242 per disability-adjusted life year averted; not cost-effective when compared with an opportunity cost threshold of US$349. Incentive payments were the main contributor to PBF financial cost (70%) followed by data verification (23%), staff time (5%) and administration (2%). The unit cost per case of antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC) services in the standard of care was US$0.96 (95% CI 0.92–1.0), US$4.8 (95% CI 4.1–6.3) and US$1.3 (95% CI 1.2–1.4), respectively, whereas the cost of ANC, SBA and PNC services per case in PBF areas were US$4.72 (95% CI 4.68–5.7), US$48.5 (95% CI 48.0–52.5) and US$5.4 (95% CI 5.1–5.9), respectively. To conclude, our study found that PBF, as implemented in the Afghan context, was not the best use of funds to strengthen the delivery of maternal and child health services. The cost-effectiveness of alternative PBF designs needs to be appraised before using PBF at scale to support health benefit packages. PBF needs to be considered in the context of funding the range of constraints that inhibit health service performance improvement.

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