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Tax-financed Health Care (conclusions for Peru (SIS) (basic health care…
Tax-financed Health Care
measuring coverage extension
Peru, Indonesia, Thailand
estimating causality
compare OOP and levels of utilization and individuals with coverage
how to measure
D-i-D
conclusions for Peru (SIS)
basic health care package strongly increased utilization
OOP did not drop
package reduces and eliminates payments for basic care, but OOP still needed beyond that
Seguro integral de Salud (SiS)
conclusions for Indonesia
Askeskin mixed impact
entitlement not fully delivered
conclusions on Thailand
Universal Coverage Scheme (UCS)
achieved good coverage
generous demand side
comprehensive benefit package
no fee, premiums
aggressive campaigning
strong entitlement feeling in pop.
supply side
established public provider system
primary care provider networks
central regulation / budget autonomy
gradual increase in resources
efficiency
single payer
payer-provider split
mix of capitation and DRGs for provuider reimbursement
primary care is gatekeeper
non-profit public providers
Evaluation problems
nationwide reforms don't have control group
conclusions
not just money
supply side policies can increase efficiency
limited causal evidence on supply-side requirements
entitlements need to be followed up by supply side intervention