cover image: The Prices in the Crises : What We Are Learning from Twenty Years of Health Insurance in Low- and Middle-Income Countries

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The Prices in the Crises : What We Are Learning from Twenty Years of Health Insurance in Low- and Middle-Income Countries

1 Feb 2023

Governments in many low- and middle-income countries are developing health insurance products as a complement to tax-funded, subsidized provision of health care through publicly operated facilities. This paper discusses two rationales for this transition. First, health insurance would boost fiscal revenues for health care, as post-treatment out-of-pocket payments to providers would be replaced by pre-treatment insurance premia to health ministries. Second, increased patient choice and carefully designed physician reimbursements would increase quality in the health care sector. This essay shows that, at best, these objectives have only been partially met. Despite evidence that health insurance has provided financial protection, consumers are not willing to pay for unsubsidized premia. Health outcomes have not improved despite an increase in utilization. The authors argue that this is not because there was no room to improve the quality of care but because behavioral responses among health care providers have systematically undermined the objectives of these insurance schemes.
health insurance moral hazard adverse selection health care quality health ministries health, nutrition and population :: health systems development & reform health, nutrition and population :: public health promotion health, nutrition and population :: health insurance health, nutrition and population :: health economics & finance health, nutrition and population :: health policy and management medical insurance premiums health insurance utilization health care provider behavior

Authors

Das, Jishnu, Do, Quy-Toan

Collection(s)
Policy Research Working Papers
DOI
http://dx.doi.org/10.1596/1813-9450-10313
Googlescholar linkpresent
yes
Identifier externaldocumentum
IDU-9939e014-545c-4049-b24d-db206215ee67
Identifier internaldocumentum
34007528
Published in
United States of America
RelationisPartofseries
Policy Research Working Papers;10313
Report
WPS10313
Rights
CC BY 3.0 IGO
Rights Holder
World Bank
Rights URI
http://creativecommons.org/licenses/by/3.0/igo
UNIT
DECRG: Poverty & Inequality (DECPI)
URI
http://hdl.handle.net/10986/39472
citation
“Das, Jishnu; Do, Quy-Toan. 2023. The Prices in the Crises : What We Are Learning from Twenty Years of Health Insurance in Low- and Middle-Income Countries . Policy Research Working Papers;10313. World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/39472 License: CC BY 3.0 IGO.”
date disclosure
2023-02-22

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