Health Insurance in Practice: Fifteen Case Studies from Developing Countries

摘要

As a companion piece to HFS Major Applied Research Report No. 3, this document details organizational and economic factors for 15 case studies of insurance programs in developing countries. It provides insight into the structure of the insurance schemes, their framework, how they work, what they cost, and the conditions under which they are effected. The 15 approaches are grouped into five categories: Community-Based Risk Sharing/Rural Health Insurance (Zaire, Thailand, Guinea Bissau); Social Security Coverage Extension (Panama, Costa Rica, Ecuador, Mexico); National Insurance Systems (Korea, Chile, China); Limited Catastrophic Coverage (Philippines, Kenya); and Pre-Payment Plans (Uruguay, Dominican Republic, Philippines). Each case study addresses three objectives: (1) the scheme's organization and how it pertains to insurers, consumers, providers, and employers; (2) the scheme's economic considerations, such as cost control and moral hazard; and (3) a summary of each scheme's advantages and weaknesses, and its probability for use as an effective health insurance model for other developing countries.