1 / 10

CDD and Health Georgia Community-Based Health Insurance

CDD and Health Georgia Community-Based Health Insurance. Sarbani Chakraborty, ECSHD October 31, 2002. CDD and Health – A Framework. Level of community involvement can vary (low to high intensity) Government failure and market failure Evolutionary process

leroy
Télécharger la présentation

CDD and Health Georgia Community-Based Health Insurance

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CDD and Health Georgia Community-Based Health Insurance Sarbani Chakraborty, ECSHD October 31, 2002

  2. CDD and Health – A Framework • Level of community involvement can vary (low to high intensity) • Government failure and market failure • Evolutionary process • Ultimately need to strengthen relationships between policy-makers, providers and community/households.

  3. Georgia – Background and Context • Economically hard hit by the transition and civil war following independence • Large-scale collapse in the delivery of basic health services, deterioration in infrastructure • Currently 80% of health expenditures are on an out-of-pocket basis, growing prevalence of diseases

  4. The CDD Context • Serious institutional and governance challenges • Wide-spread skepticism among the public about the ability of the government to deliver on their promises • Distortions in the economic environment has limited the growth of a formal private sector • Community bonds and relationships have increasingly strengthened in this environment

  5. Community-based Health Insurance: Rationale • Communities are paying on an out-of-pocket basis which affects timely access to health services, increases uncertainty and some evidence of payments being catastrophic • Improving certainty, risk pooling, especially for hospital care • Social insurance system is still weak, very small private insurance market, community distrust of government and private sector

  6. Pilot Schemes • Implemented by international NGO (International Medical Corps) • Seven schemes implemented over less than two years • Collect resources on pre-paid basis and provide a comprehensive package of services based on community demands

  7. Early Results • Schemes were up and running in less than 6 months indicating strong community demand • Utilization of primary care increased • Changes in government financing patters affected community contributions • Concerns with management arrangements

  8. Next Steps • Expanding pilot from 7 to 36 in three years • Combine government funding with community contributions to provide a comprehensive package of services • Create a network among the schemes to increase the size of the risk pool, create economies of scale in management

  9. Challenges • The process in time and resource intensive • Ultimately not a solution to the problems in health financing in Georgia • Attention of donors and other partners needs to be on correcting Government failure • There is a need to combine public and private sources of financing but probably should happen through the development of private insurance

  10. Final Comments • CBHI may generate other spin-off affects (greater provider accountability to community, community empowerment) which might create reasons for scale-up • Need to closely monitor and evaluate (almost a three year research project).

More Related