Financing Health System Assignment: Out-of-Pocket-Payments

Financing Health System Assignment

Out-of-Pocket-Payments

The above image is the WHO health financing framework for Universal Health coverage. This framework is essential for understanding how different countries manage and allocate resources to ensure equitable access to healthcare services.

WHO’s approach to health financing focuses on core functions: revenue raising (sources of funds, including government budgets, compulsory or voluntary prepaid insurance schemes, direct out-of-pocket payments by users, and external aid). These functions are critical in determining how effectively a health system can provide services to its population.

Pooling of funds (the accumulation of prepaid funds on behalf of some or all of the population) is another vital component. This process helps in risk-sharing and ensures that financial resources are available to cover health services when needed.

Purchasing of services (the payment or allocation of resources to health service providers) is the third core function. Efficient purchasing strategies can lead to better health outcomes and more sustainable health systems.

In addition, all countries have policies on which services the population is entitled to, even if not explicitly stated by the government; by extension, those services not covered are usually paid for by patients (sometimes called co-payments). This often leads to disparities in access to healthcare, particularly for low-income individuals. (Ref: WHO, 2019)

Several indicators form part of revenue-raising for a country’s health expenditures. These indicators help in assessing the financial health and sustainability of a country’s healthcare system. Low-and-middle-income countries are largely dependent on either external funding or Out-Of-Pocket Payments (OOPS) by users (patients). This reliance can lead to financial strain on households and limit access to necessary healthcare services.

OOPS is a reliable indicator for tracking efficiencies/deficiencies in a health system. It provides insights into how well a health system is functioning and where improvements are needed. Higher OOPS indicates higher household expenses to cover their healthcare expenses. This can result in financial hardship and deter individuals from seeking necessary medical care.

Millions of people don’t access healthcare due to higher OOPS. This barrier to access is a significant concern for global health equity. Countries should structure policies to reduce OOPS. Implementing universal health coverage and increasing government funding for healthcare are potential strategies to address this issue.

References:

Xu, K., Soucat, A., & Kutzin, J. (2022). Public financing for health in the context of COVID-19. The Lancet Global Health, 10(5), e566-e567. https://doi.org/10.1016/S2214-109X(22)00001-2

Wagstaff, A., & Neelsen, S. (2023). Reducing financial barriers to health care: The role of health insurance in low- and middle-income countries. Health Economics, 32(3), 345-356. https://doi.org/10.1002/hec.4501

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Financing Health System Assignment

Out-of-Pocket-Payments

The above image is the WHO health financing framework for Universal Health coverage.

WHO’s approach to health financing focuses on core functions:

revenue raising (sources of funds, including government budgets, compulsory or voluntary prepaid insurance schemes, direct out-of-pocket payments by users, and external aid)

pooling of funds (the accumulation of prepaid funds on behalf of some or all of the population)

purchasing of services (the payment or allocation of resources to health service providers)

In addition, all countries have policies on which services the population is entitled to, even if not explicitly stated by the government; by extension, those services not covered are usually paid for by patients (sometimes called co-payments). (Ref: WHO, 2019)

Several indicators form part of revenue-raising for a country’s health expenditures. Low-and-middle-income countries are largely dependant on either external funding or Out-Of-Pocket Payments (OOPS) by users (patients). OOPS is a reliable indicator for tracking efficiencies/deficiencies in a health system. Higher OOPS indicates higher household expenses to cover their healthcare expenses. Millions of people don’t access healthcare due to higher OOPS. Countries should structure policies to reduce OOPS.

Your task is :

Go to this website: https://apps.who.int/nha/database/Select/Indicators/enLinks to an external site.

Search OOPS and select ‘Out-Of-Pocket-Payments as % of Current Health Expenditure CHE’ indicator

Click Next and select atleast 4 countries (including your own country)

Click Next and select the latest year

Click Next and select ‘% of Current Health Expenditure CHE’

On the left hand side, click on ‘View data and build report’

A Table will be generated.

Save the table in Excel format and copy-paste the table here

Reflect on what you have observed

List few methods to reduce Out-Of-Pocket-Payments and explain them in a couple of sentences

This answer doesn’t need referencing unless you are using references from external source

( Max: 400 words ) – Write Style: APA7 Style