Among the most nettlesome obstacles in the yearlong debate over increasing the accessibility and affordability of health insurance has been the question of what effect health care reform legislation would have on the incidence of abortion. The recent experience in Massachusetts suggests that universal health care coverage has been associated with a decrease in the number of abortions performed, despite public and private funding of abortion that is substantially more liberal than the provisions of the federal legislation currently under consideration by Congress. Parties on both sides of the national debate on this issue, including the U.S. Conference of Catholic Bishops, reached an in-formal consensus early last year that reform should maintain as nearly as possible the status quo, which mostly keeps the federal
Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme - a systems approach
Year
2014
Author
I. Agyepong, G. Aryeetey, J. Nonvignon, F. Asenso-Boadi, H. Dzikunu, E. Antwi, D. Ankrah, C. Adjei-Acquah, R. Esena, M. Aikins and D. Arhinful
In many African countries a considerable proportion of the population faces problems of financial access to essential health care services. This holds especially true for the informal sector and people living in rural area. This holds especially true for the informal sector and people living in rural areas. In order to enhance care coverage and provide financial protection against impoverishment due to the costs of catastrophic illness, the Government of Rwanda has implemented several financing mechanisms. Apart from social health insurance schemes covering employees in the formal public and private sector, a community-based health insurance was established to improve access and offer financial protection to the majority of the Rwanda population working in the informal sector. In addition to the Community-Based health Insurance Policy, the present policy has been elaborated to provide a comprehensive guiding framework for a National Health Insurance system in Rwanda. Among the measures proposed is the creation of an overarching health insurance council that will take on an advisory and coordination role for all insurance mechanisms as well as the strengthening of partnerships between public and private institutions. By looking at the wider social health protection perspective it is hoped to fill current gaps in coverage and link the existing mechanisms more effectively. The mutual health insurance (Mutuelle de Sante) system in Rwanda is one of the most extensive community based health insurance schemes operated in Sub-Saharan Africa covering over 90% of the population. Several studies, so far, have documented the success of the Mutuelle de Sante in addressing the two prime objectives of health insurance in a low-income setting, namely to increase access to health care and to reduce the burden of catastrophic health spending particularly for the poorer groups of society.
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