Flessa S
Forschungsgruppe Medizinökonomie, Universität Erlangen-Nürnberg.
Gesundheitswesen. 1998 Jan;60(1):52-7.
Health Care Systems Clutch at a Straw: The health care systems of sub-Saharan Africa are facing a global crisis which is severely challenging their survival. Currently, alternatives to the traditional financing of health care by government grants and/or "fee for service" are sought. Otherwise the vast majority of poor rural inhabitants of these countries will lose access to Western medicine at the end of this century, making appropriate medical care a privilege of a small number of rich urbans. One approach to solving this crisis is the introduction of a health insurance system. However, the culture of African people must also be considered if one attempts to design and implement an insurance scheme. This paper reflects some of the problems of health insurance in an African context. Since the author contributed to the design of a "Community Based Health Insurance" of the Evangelical Lutheran Church in Tansania, this scheme is used here as an example.
撒哈拉以南非洲的医疗保健系统正面临一场全球危机，这场危机正严重挑战着它们的生存。目前，人们正在寻求政府拨款和/或“服务收费”以外的传统医疗保健融资方式。否则，这些国家绝大多数贫困农村居民将在本世纪末失去获得西医治疗的机会，使适当的医疗保健成为少数富裕城市居民的特权。解决这一危机的一种方法是引入医疗保险制度。然而，如果有人试图设计和实施一项保险计划，非洲人民的文化也必须加以考虑。本文反映了非洲背景下医疗保险的一些问题。由于作者参与了坦桑尼亚福音路德教会“社区医疗保险”的设计，这里将该计划作为一个例子。
