Improving Equity in Health Financing

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Improving Equityin Health Financing

• David de Ferranti
• April 14, 2007

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As we meet today

• 3 billion people live on less than 2/day
• For Millions
• no care or grossly inadequate care
• the cost of care worsens poverty
• vicious circle poverty, ill health, high costs
• Health financing a serious problem
• Not just need more money
• Also Who pays, how much, for what, how.
• Efficiency, equity

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Focus on one big idea The burden ofillness
and health costsshould be sharedamong the
healthy and the sick.

• The third great transition in health
• Use to get greater equity
• Female / male formal / informal sectors
• Marginalized / powerful groups
• Can it be done? Is the world ready?
• What the pessimists say
• But theres new evidence and a new opportunity now

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Source Gottret, P. and G. Schieber. 2006.
Health Financing Revisited. World Bank.
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Sources of health spending
Source WHO National Health Accounts, updated
2002.
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Uses of household out of pocket spending in India
(van Doorslaer et al 2002)
India is an extreme case approximately 80 of
total health expenditure is out of pocket by
households