By William Savedoff, Pablo Gottret
Needed medical health insurance schemes are being proposed or improved in lots of constructing international locations, yet with fairly little recognition to how they need to be ruled. This ebook considers how 5 dimensions of governance-coherent decision-making constructions, stakeholder participation, transparency and knowledge, supervision and rules, and consistency and stability-influence the assurance, monetary security, and potency of essential medical health insurance entities. It additionally seems on the institutional and political forces that impact the habit of such entities inside of their social and ancient context. It addresses those matters through reading reports from 4 countries--Chile, Costa Rica, Estonia, and the Netherlands-and develops classes for constructing international locations relating to those vital dimensions of governance, paying detailed recognition to questions of assuring solvency, monetary safety, and caliber overall healthiness care prone.
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Additional resources for Governing Mandatory Health Insurance: Learning from Experience
As with SHI, the meaning of “governance” varies substantially across contexts and researchers. Broad definitions of governance attempt to encompass all the relevant factors that influence the behavior of an organization. For MHI entities, these factors would include its relationship to the government, its members, any other payers (employers, for example), health care providers, and other insurers (competitors). Narrower definitions of governance look specifically at the “control” mechanisms that are used to hold the entity accountable.
Given the origins of SHI in Western Europe and its link with broader corporatist forms of social organization, this is understandable. These different perspectives are implicit in the characteristics ascribed to SHI. For example, the more instrumental version can view the form of affiliation, the basis for contributions, and the separation of providers and payers as policy choices rather than defining characteristics. On the other hand, a socially embedded view may see affiliation by employment (and consequently a role for intermediating labor representatives), incomebased contributions, and separation of providers and payers as core defining features.
It can be the responsibility of a specific government office, a quasigovernment independent agency, or through delegation to a privately constituted entity. The supervisory agent’s funding can come directly from government budgets, from taxes on premiums, or as a payment directly from the regulated insurers. Finally, the fifth dimension of governance is related to the Consistency and stability of the system. Mandatory health insurance involves a range of long-term investments and inter-temporal commitments that condition today’s decisions on tomorrow’s prospects.