Jooma Rashid, Jalal Sabeena
Department of Neuro Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
J Pak Med Assoc. 2012 Jan;62(1):56-8.
Several developing countries lack a medical insurance system with universal coverage, so access to medical services is not easy, principally for people living in poverty. One of the biggest issues for designing healthcare systems in developing countries is how to include those not formally employed. Therefore, it is important to implement targeted interventions so that the most in need are not left out. The World Health Report 2000 distinguishes four functions for the health system to fulfill: (i) the provision of health services; (ii) the creation of the necessary investment and training resources for health; (iii) health financing; and (iv) government stewardship. The need for Health insurance in the developing world is again relevant because there is no compulsory health insurance in Pakistan. This special communication is a discussion of how we in Pakistan have proposed a design for the first ever indigenous health insurance system for the poor. What various other developing countries have done and the policies adopted to provide health coverage to their people have also been reviewed.
几个发展中国家缺乏全民覆盖的医疗保险体系，因此，获得医疗服务并不容易，对生活在贫困中的人们来说尤其如此。发展中国家设计医疗体系面临的最大问题之一是如何将非正规就业人员纳入其中。因此，实施有针对性的干预措施很重要，这样最需要帮助的人就不会被遗漏。《2000年世界卫生报告》区分了卫生系统要履行的四项职能：（一）提供卫生服务；（二）为卫生事业创造必要的投资和培训资源；（三）卫生筹资；（四）政府管理。由于巴基斯坦没有强制医疗保险，发展中国家对医疗保险的需求再次凸显。这篇特别通讯讨论了我们巴基斯坦人如何为有史以来首个针对穷人的本土医疗保险体系提出了一个设计方案。还回顾了其他各个发展中国家为其人民提供医疗保险所采取的措施和政策。
