Hospitals remain an important source of critical health care services in most countries, providing both basic and advanced care to their populations. They are often the provider 'of last resort' for the critically ill and poor. Yet hospitals also make up the largest expenditure category of the health system both in developed and developing countries. 'Innovations in Health Service Delivery' offers insights into recent trends in the reform of public hospitals, with a focus on organizational changes such as increased management autonomy, corporatization, and privatization. This book also...

With the decline of ideology, politicians have grown increasingly fond of the dictum 'What's best is what works.' This book is an excellent lesson on what works in health care -- or more precisely, on how to make what works work better, especially with respect to the involvement of the private sector. It should be on every health policy maker's desk.

Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in the financing of health care provides a critical albeit insufficient first step in the long march towards improved access to health care by the poor and social protection against the cost of...

With a special focus on strategic purchasing and contracting of services from nongovernmental providers, 'Spending Wisely' reviews ways to make public spending on health care more efficient and equitable in developing countries. The underlying premise is that it is necessary to separate the function of financing from service delivery to improve public sector performance and accountability. In moving from passive budgeting to active purchasing of health care, the authors recommend policymakers ask five fundamental questions: for whom to buy, what to buy, from whom to buy, how to pay and at...

Private voluntary health insurance already plays an important role in the health sector of many low and middle income countries. The book reviews the context under which private insurance could contribute to an improvement in the financial sustainability of the health sector, financial protection against the costs of illness, household income smoothing, access to care, and market productivity. This volume is the third in a series of in-depth reviews of the role of health care financing in providing access for low-income populations to needed health care, protecting them from the impoverishing...

Financial protection against the cost of illness and inclusion of vulnerable groups will require better mobilization and use of private means. Private voluntary health insurance already plays an important role in mobilizing additional resources to the health sector and protecting against the catastrophic cost of illness in some countries. This review explores the context under which private voluntary health insurance could contribute to an improvement in the sustainability of the health sector and financial protection in other countries."

Health insurance can offer protection against catastrophic medical expenses and improve access to health care. There are, however, imperfections in the insurance market that require intervention such as asymmetry of information between the policy holder and the insurance company, moral hazard that can occur on the side of the insured or the provider of health services, risk selection that may lead to cream skim a particular market, and others. To encourage the effective development of Voluntary Private Health Insurance, it will be necessary for policymakers to establish and enforce regulatory...