PHA-Exchange> Free Government Health Services

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> Free Government Health Services:
> Are They the Best Way to Reach the Poor?
> Davidson R. Gwatkin, March, 2003
> World Bank
>
> Available online as PDF file [13p.] at:
> http://poverty.worldbank.org/files/13999_gwatkin0303.pdf
>
> "..........Equity is a frequently stated justification for government
> involvement in the health care market. This is often taken to mean
directly
> providing all segments of the population with a wide range of
> government-operated health services at no cost: free universal care.
>
> Yet a look at the record suggests that this goal all too often remains
> elusive, especially in poor countries; that governments in fact serve only
a
> some of the population; and that the people served are disproportionately
> concentrated among the better-off. When this happens, government health
> services, far from promoting equity, work against it.
>
> The purpose of this chapter is to illustrate that there are many ways for
> governments to pursue the goal of ensuring that the poor receive adequate,
> affordable services through alternative approaches to resource allocation
> and purchasing. The first section summarizes the information known about
the
> distribution of benefits from government health services across social
> groups in order to document the regressive pattern that now frequently
> exists and the need for significant changes in approach if the poor are to
> benefit. The second and third sections illustrate the kinds of changes
that
> might be considered....."