Health Insurance In Developing Countries The Social Security Approach
İÇİNDEKİLERCONTENTSForeword Part 1. Introduction to compulsory health insurance 1. Health insurance as a social security undertaking Social security: A fundamental concept The pressures for establishing health insurance The historical evolution of health insurance: A brief review Highlights in industrialised countries The evolution in developing countries 2. Compulsory health insurance as a social programme and a health sub-system Government and health insurance Sources of revenue Social security as a health sub-system Role of the participants 3. Health insurance benefits Classification of benefits Benefit characteristics Indirect method of providing health care benefits The direct method Development of hospital care Development of primary health care Combined systems Cost-sharing 4. Paying doctors and hospitals under health insurance General considerations Lower charges Standardised paymentsHealth insurance in developing countries Paying the doctor Fee-for-service Salary Capitation Conclusion on doctor payment Paying the hospital Payment per itemised bill Payment per-inclusive day Payment by diagnosis Payment by budget 5. Organisation and administration of health insurance The health insurance system as an organisation . Social and economic factors in administration Centralisation and decentralisation Administration Control tasks Control of membership coverage Financial control Quality assurance Part II: Experiences in the developing countries of Asia Introduction to the country profiles Bangladesh China Fiji India Indonesia Jordan Republic of Korea Kuwait Malaysia Myanmar Nepal Pakistan Papua New Guinea Philippines Sri Lanka Thailand Annexes Annex I: Glossary: Health insurance and health care terms Annex II: Medical care: Extract from provisions of lLO Conventions and Recommendations Annex IIl: Suggestions for further reading  |
