Foreword vii Acknowledgments ix Abbreviations xi 1.Introduction, Context, and Theory1 William C. Hsiao and R. Paul Shaw Context 4 Theory and Principles11 References18 2.Design and Implementation of Social Health Insurance 21 William C. Hsiao Design 21 Implementation33 Summary 39 References 40 3.Kenya: Designing Social Health Insurance 43 Andrew Fraker and William C. Hsiao Background43 Design of the NSHIF47 Implementation Issues 52 Conclusion59 References 59 4.Ghana: Initiating Social Health Insurance61 Sreekanth Ramachandra and William C. Hsiao Background61 Evolution of Health Financing Mechanisms65 Design Issues71 Implementation Issues75 Successes and Challenges77 References79 5.The Philippines: Extending Coverage beyond the Formal Sector81 Matthew Jowett and William C. Hsiao Background81 Delivery of Health Services86 Design and Implementation Issues90 Impact of SHI103 References104 6.Colombia: Social Health Insurance with Managed Competition to Improve Health Care Delivery105 Diana Pinto and William C. Hsiao Background 105 Health Care Reform108 Design110 Implementation113 Achievements124 Challenges 124 References131 7.Thailand: Achieving Universal Coverage with Social Health Insurance 133 Piya Hanvoravongchai and William C. Hsiao Background133 Health Insurance Development before Universal Coverage140 Achieving Universal Coverage146 Lessons Learned from Universal Coverage151 Challenges153 Conclusion154 References154 8.Lessons Learned and Policy Implications155 William C. Hsiao and R. Paul Shaw The Development Context Matters158 The Five Country Case Studies159 Positive Changes Attributable to SHI159 Major Challenges Inherent in Implementation162 Policy Implications165 Conclusions170 References171