CONTENTS Foreword Preface Acknowledgments xxxi Abbreviations and Acronyms xxxiii 1. Introduction: Strength in Numbers 1 Alexander S. Preker, Onno P. Schellekens, and Marianne Lindner Introduction 1 Policy Design 4 A New Paradigm for Financing Health Care 12 Implementation Challenges 20 References 23 PART 1EMPIRICAL AND ECONOMIC UNDERPINNINGS 27 2. Six Regions, One Story 29 Denis Drechsler and Johannes P. Jutting Introduction 29 Typology of Health Care Financing 33 Evidence of PHI In Low- and Middle-Income Countries 38 Outlook 85 Annex 2A WHO Data on Health Care Expenditure between 1998 and 2002 88 Annex 2B Country Groups according to 2005 World Bank Classification 92 Annex 2C PHI Spending, by Country Group 94 Annex 2D Non-Life and Life Insurance around the World 95 Notes 98 References 99 3. From Theory to Practice 107 Peter Zweifel Introduction 107 Review of the Theoretical Predictions 108 Evidence from the Country Studies 121 Conclusions and Outlook 131 Annex 3A Overview of Hypotheses and Results of Tests 133 Notes 139 References 139 PART 2EVIDENCE FROM THE PAST 141 4. Chile 143 Ricardo A. Bitrdn and Rodrigo Munoz Introduction 143 Objectives and Methodology 146 Results 149 Conclusions 153 Annex 4A Statistical Tables 155 Notes 162 References 162 5. Egypt 163 Heba Nassar and Sameh El-Saharty Introduction 163 Health Financing in Egypt 165 Status of Health Insurance in Egypt 166 Key Issues and Major Constraints related to 172 Health Care Financing in Egypt Assessing the Potential for VHI 173 Conclusions and Recommendations 179 Annex 5A Statistical Tables 184 Notes 187 References 188 6. South Africa 189 Michael Thiede and Vimbayi Mutyambizi Introduction 189 Situational Analysis of Health Financing in South Africa 190 The Private Sector 193 Financial Protection and Financial Vulnerability 199 Determinants of Utilization 202 Health Reform in South Africa 206 Challenges 207 Notes 207 References 207 7. Thailand 211 Siripen Supakankunti Introduction 211 On Private Health Insurance 212 System, Mechanism, and Regulation 216 Business Environment 218 Problems and Constraints in Health Care Financing 219 Quantitative Analyses 221 Interpretation of the Results and Conclusions 230 Limitations and Suggestions 230 Notes 231 References 231 8. Turkey 233 Anna Cederberg Heard and Ajay Mahal Introduction 233 Data and Methodology 238 Results 243 Conclusions and Policy Implications 250 Note 251 References 251 9. United States 253 M. Kate Bundorfand Mark V. Pauly Introduction 253 Methods 254 Results 255 Conclusions 259 Notes 260 References 260 PART 3OPPORTUNITIES FOR THE FUTURE 261 10. China 263 Teh-wei Hu and Xiao-hua Ying Introduction 263 Background of China's Health Care Financing System 266 Private Health Insurance in China Today 268 Key Issues of Health Care Financing in China 271 Determinants of Private Health Insurance Enrolment 272 Demand for Private Health Insurance: 278 Willingness to Pay and Ability to Pay Potential Private Health Insurance Market 284 Policy Options and Conclusions 288 Notes 290 References 290 11. Brazil 293 Bernard F. Couttolenc and Alexandre C. Nicolella Introduction 293 The Brazilian Context 293 Key Issues Related to Health Care Financing 304 Policy Options 308 Conclusions 319 Annex 11A Financial Flows in the Brazilian Health Sector 321 Annex 11B Regression Results 322 Notes 323 References 324 12. India 327 Peter A. Berman, Rajeev Ahuja, and Vijaysekar Kalavakonda Introduction 327 Owrview 328 Financial Feasibility of PVHI 335 Some Policy Issues and Concerns 342 Conclusions 343 Notes 344 References 347 13. Nigeria 349 Obinna Onwujekwe and Edit V. Velenyi Introduction 349 Research Methodology 351 Results 355 Discussion 364 Note 365 References 365 14. Slovenia 369 Maks Ta/nikar and Petra Dosenovic Bonca Introduction 369 The Slovenian Context 370 Health Insurance in Slovenia and the Advent of VHI 377 Issues Raised in the Development of VHI in Slovenia 380 Impact of VHI on the Efficiency of Primary Care Providers 392 Conclusions: The Future and the Reforms Needed in Slovenia's Voluntary Health Insurance 395 Note 398 References 399 15. Republic of Korea 401 Kee Taig Jung Introduction 401 The Korean Health Care System 402 NHI Financial Distress 405 Expansion of the Private Health Insurance Market 408 The Evaluation Study 411 Feasibility Study 419 Conclusions 422 Notes 423 References 423 Appendixes A. Methodology for Reviewing Private Voluntary Health Insurance 427 Alexander S. Preker, Richard M. Scheffler, and Mark C. Bassett Objectives of the Reviews 427 Methodology Used in Companion Volume, Friend or Foe 427 Methodology Used in Global Marketplace for Private Health Insurance: Strength in Numbers 433 Notes 440 References 440 B. Glossary of Terms 443 Note 459 About the Coeditors and Contributors 461 Coeditors 461 Other Contributing Authors 462 Index 471