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Governing Mandatory Health Insurance : Learning from Experience

Author

Listed:
  • William D. Savedoff
  • Pablo Gottret

Abstract

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.

Suggested Citation

  • William D. Savedoff & Pablo Gottret, 2008. "Governing Mandatory Health Insurance : Learning from Experience," World Bank Publications - Books, The World Bank Group, number 6526.
  • Handle: RePEc:wbk:wbpubs:6526
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    File URL: https://openknowledge.worldbank.org/bitstream/handle/10986/6526/454070PUB0Box310ONLY10june012102008.pdf?sequence=1
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    Citations

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    Cited by:

    1. Martinez-Gutierrez, María Soledad & Cuadrado, Cristóbal, 2017. "Health policy in the concertación era (1990–2010): Reforms the chilean way," Social Science & Medicine, Elsevier, vol. 182(C), pages 117-126.
    2. Ramiro Guerrero & Sergio I. Prada & Dov Chernichovsky, 2014. "La doble descentralización en el sector salud: evaluación y alternativas de política pública," Cuadernos de Fedesarrollo 12019, Fedesarrollo.
    3. George Schieber & Cheryl Cashin & Karima Saleh & Rouselle Lavado, 2012. "Health Financing in Ghana," World Bank Publications - Books, The World Bank Group, number 11977.
    4. Greg Brunner & Pablo Gottret & Birgit Hansl & Vijayasekar Kalavakonda & Somil Nagpal & Nicole Tapay, 2012. "Private Voluntary Health Insurance : Consumer Protection and Prudential Regulation," World Bank Publications - Books, The World Bank Group, number 13093.
    5. World Bank, 2015. "Bulgaria Health Financing," World Bank Publications - Reports 22964, The World Bank Group.
    6. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.
    7. Mathauer, Inke & Nicolle, Emmanuelle, 2011. "A global overview of health insurance administrative costs: what are the reasons for variations found?," Health Policy, Elsevier, vol. 102(2), pages 235-246.
    8. Matthias Pelster & Vera Hagemann & Franziska Laporte Uribe, 2016. "Key Aspects of a Sustainable Health Insurance System in Germany," Applied Health Economics and Health Policy, Springer, vol. 14(3), pages 293-312, June.
    9. Changwoo Shon & Myoungsoon You, 2020. "Evaluation of Health Policy Governance in the Introduction of the New DRG-Based Hospital Payment System from Interviews with Policy Elites in South Korea," IJERPH, MDPI, vol. 17(11), pages 1-18, May.

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