Financing Health Care in East Asia and the

The East Asia and Pacific (EAP) region is characterized by wide variations in the types of health financing systems. The continued high prevalence of communicable diseases coupled with the rapid population aging place EAP financing systems under pressure. The need to mobilize additional financial resources for health has highlighted variations in technical and allocative efficiency as well as large inequalities. This basic premise of this book is that health systems need to generate sustainable, adequate financing for health so as to ensure that health outcomes are optimized and financial protection is guaranteed. Many countries in the EAP region are searching for health financing best practices and options for their country. This book reviews best practices and remaining challenges with regard to each of the functions of health financing -- collecting and pooling of revenues, and purchasing of services -- across EAP countries

Acknowledgments	p. xv
About the Book	p. xvii
Abbreviations	p. xxi
Overview	p. 1
Key Messages	p. 2
Establishing the Baseline: Understanding the Current Situation	p. 5
Preparing for What Comes Next: The Changing Population and Emergent Disease Profile	p. 10
Improving the Performance of Health Care Financing	p. 11
Reforming Service Delivery and Organization of Care	p. 21
Notes	p. 25
Reference	p. 25
Understanding the Macroeconomic Context and the Health Sectors in East Asia and the Pacific	p. 27
Macroeconomic Context	p. 27
Effects on the Poor	p. 29
Health Status and Health Outcomes	p. 34
Demographic and Epidemiologic Trends	p. 37
Millennium Development Goals	p. 44
Health Financing Levels and Trends	p. 44
Linking Health Expenditures and Delivery of Services	p. 52
Notes	p. 64
References	p. 64
Importance of Investing in Health and a Framework for Managing and Using Funds	p. 67
Health and Its Effects on Economic Growth	p. 67
Health Care Financing Function and Goals	p. 69
References	p. 71
Mobilization of Revenues for Health	p. 73
Assessment of the Mix of Health Financing Revenues	p. 73
Analysis and Discussion	p. 97
Note	p. 114
References	p. 114
Pooling and Management of Funds	p. 117
Pooling: Is It Important?	p. 117
Pooling and Management of Funds in East Asia and the Pacific	p. 119
Notes	p. 134
References	p. 134
Resource Allocation and Purchasing	p. 137
A Resource Allocation and Purchasing Framework	p. 137
For Whom to Purchase Services: Reaching All in the Health Sector	p. 138
Resource Allocation, Targeting, and Decentralization	p. 140
What to Buy: Refining and Standardizing the Benefits Package	p. 146
From Whom to Buy: Contracting for Improved Cost and Quality	p. 163
How to Pay: Implementing New Incentive Payment Systems	p. 170
Demand-Side Financing (Purchasing)	p. 188
Notes	p. 193
References	p. 194
Connecting Financing and Delivery of Services: Institutional and Organizational Characteristics in East Asian and Pacific Countries	p. 199
Overview and Links to Health Care Financing	p. 199
Decentralization and Organizational Issues in the Delivery Systems	p. 200
Dimensions of Governance and Stewardship	p. 219
Medical Tourism	p. 231
Analysis and Discussion	p. 235
Note	p. 238
References	p. 238
Assessing Performance in East Asia and the Pacific: Efficiency and Equity of Health Financing	p. 243
Efficiency	p. 243
Equity	p. 246
Distribution of Public Subsidies for Health Care	p. 256
Note	p. 259
References	p. 260
National Health Account Activity in East Asia and the Pacific	p. 265
Medical Tourism in East Asia and the Pacific	p. 287
Health Financing in East Asia and the Pacific: Review of Project Appraisal Documents	p. 305
Index	p. 309
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Financing Health Care in East Asia and the Pacific Best Practices and Remaining Challenges

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