Drechsler Denis, Jütting Johannes
J Health Polit Policy Law. 2007 Jun;32(3):497-534. doi: 10.1215/03616878-2007-012.
This article discusses the role of private health insurance (PHI) in developing countries. Three broad regional clusters are identified that share similar characteristics and policy challenges for the effective integration of private insurance into national health care systems: (1) Latin America and Eastern Europe, where there are already developed insurance industries facing important market and policy failures; (2) the Middle East/North Africa region and East Asia, where there is a projected strong growth of PHI that needs to be accompanied by efficient regulation; and finally, (3) South Asia and Sub-Saharan Africa, where PHI will only play a marginal role in the foreseeable future while the scaling up of small-scale, nonprofit insurance schemes appears to be of critical importance. Overall, this survey shows that the role of private insurance varies depending on the economic, social, and institutional settings in a country or region. Private health insurance schemes can be valuable tools to complement existing health-financing options only if they are carefully managed and adapted to local needs and preferences.
本文探讨了私人医疗保险(PHI)在发展中国家的作用。确定了三个广泛的区域集群,它们在将私人保险有效纳入国家医疗保健系统方面具有相似的特征和政策挑战:(1)拉丁美洲和东欧,那里已经有发达的保险业,但面临着重要的市场和政策失灵问题;(2)中东/北非地区和东亚,预计私人医疗保险将强劲增长,这需要有效的监管;最后,(3)南亚和撒哈拉以南非洲,在可预见的未来,私人医疗保险只会发挥边缘作用,而扩大小规模非营利保险计划似乎至关重要。总体而言,这项调查表明,私人保险的作用因国家或地区的经济、社会和制度环境而异。只有经过精心管理并适应当地需求和偏好,私人医疗保险计划才能成为补充现有卫生筹资选择的宝贵工具。