History[ edit ] The first move towards a national health insurance system was launched in Germany inwith the Sickness Insurance Law.
I wish to thank my supervisor for her constant support and encouragement. I am also grateful to two external reviewers for helpful comments and suggestions.
Received Jul 3; Accepted Sep This article has been cited by other articles in PMC. Abstract This article proposes a critical but non-systematic review of recent health care system reforms in developing countries.
The literature reports mixed results as to whether reforms improve the financial protection of the poor or not. We discuss the reasons for these differences by comparing three representative countries: Mexico, Vietnam, and China.
First, the design of the Healthcare 3rd world country care system reform, as well as the summary of its evaluation, is briefly described for each country.
Then, the discussion is developed along two lines: The review suggests that i background differences, such as social development, poverty level, and population health should be considered when taking other countries as a model; ii although demand-side reforms can be improved, more attention should be paid to supply-side reforms; and iii the findings of empirical evaluation might be biased due to the evaluation design, the choice of outcome, data quality, and evaluation methodology, which should be borne in mind when designing health care system reforms.
In the Healthcare 3rd world country 10 years, health care system reform has been under way in a number of developing countries with a special focus on the poor or disadvantaged groups, who face financial barriers to have access to health care services and are exposed to financial risk due to illness.
Both of these can result in the medical poverty trap. In this article we sum up relevant empirical evidence and learn from past experience in order to improve future health policy-making. Most of the reforms appeal to social health insurance as the main approach to improve health care systems so as to protect the poor.
Empirical results have shown that some of these health reforms do provide financial protection to the poor but some do not. Mexico, Vietnam, and China are chosen here as representatives of health care system reforms to allow for discussion and comparison.
Mexico has been regarded as one of the most successful cases of health care system reform in developing countries. In contrast, empirical evidence criticises the effort of the Chinese government, which has poured a sum of public finance into reforms and has planned to budget more.
Vietnam, besides its similarities with China as for social and demographic background, has been implementing the compulsory social health insurance programme to the identified poor, which provides an opportunity to compare the effectiveness of public finance allocation.
The paper is organised as follows. The following section describes the health care system reforms in Mexico, Vietnam, and China, and summarises their evaluation results.
Then, we compare the three reforms in order to discuss the reasons why they differ one another. These are described along two lines: Policy design is further elaborated from background differences, the design of health care system reform, the eligibility of social health insurance for the poor, the benefit package of social health insurance, and the effects of insurance on health-seeking behaviour.
Evaluation methodology covers the choice of outcome variables, data quality, and evaluation methodology. The last section draws conclusions.
An overview of health care system reforms Mexico The World Health Report stated that catastrophic health expenditure in Mexico is one of the major problems in the country. This was done according to the idea that health care is a social right rather than a commodity or a privilege.
SP is a subsidised voluntary insurance that offers free access to an explicit set of health care services at the delivery point. The three sources of contribution are: Families are supposed to contribute by paying a certain premium determined by family income.
However, almost no family has virtually made premium contributions. The issues related to the provider payment system are not relevant since all the health interventions and drugs defined in the benefit package are access-free.
As an example, inunique health interventions and medicines were access-free. It is worth noting that, before the reform, the uninsured population did have access to health facilities run by the states on payment of a user fee, which brought about the high proportion of out-of-pocket expenditure.
Moreover, the uninsured may have suffered extra out-of-pocket expenditures due to the shortages of drugs resulting from budgetary limitations. A study on a year trend regarding the evolution of catastrophic and impoverishing health expenditure suggests that the reduction in out-of-pocket health expenditure and catastrophic health expenditure by households is related to the expansion of SP, although no causality conclusion can be drawn given the available data.
Moreover, the study found that some key components of SP - insuring the poorest quintiles, covering medications and ambulatory care, and including a package of catastrophic expenditures - are effective strategies to reduce catastrophic and impoverishing health expenditure. However, the effect on catastrophic health expenditure differs from data resources.
Contrary to other observational studies, there was no favourable evidence on medication spending, health outcomes, and health care utilisation, which may be attributed to the relatively short duration of treatment 10 months.
Vietnam Like other developing countries in Asia, out-of-pocket expenditure is the dominant source of health financing in Vietnam. By the end ofa compulsory social health insurance programme targeting all poor households and selected disadvantaged groups called HCFP, had been formally set up.
Specifically, the central and provincial governments were to contribute 2. The insured can benefit from a relatively broad - covering outpatient as well as inpatient services at all health care levels, laboratory exams, x-ray, and so on - but unspecified benefit package.Healthcare Consultancy Group (HCG), part of the Omnicom Health Group, is a global family of scientifically rigorous healthcare communications agencies.
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CONNECT with Global Speakers from all over the World at 22nd World Congress on Nutrition & Food Sciences during June , in Brisbane, Australia. In modern usage, the term Third World is commonly used to refer to the developing countries of Asia, He claimed that the attachment of Third World status to a particular country was not based on any stable economic or political criteria, and was a mostly arbitrary process.
Staff training is crucial for Third World health; News from Brown. Main menu. News; For Journalists; Staff training is crucial for Third World health The goal is to increase the overall numbers of healthcare providers in the country as well as their average level of knowledge and skills, all the while improving the effectiveness.