Health financing policy formulation in the Eastern Caribbean

✍ Scribed by Maggie Huff-Rousselle; Stanley Lalta; John L. Fiedler

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 146 KB
• Volume: 13
• Category: Article
• ISSN: 0749-6753
• DOI: 10.1002/(sici)1099-1751(199804/06)13:2<149::aid-hpm507>3.0.co;2-h

✦ Synopsis

Stakeholders formulating policies on national health insurance (NHI) in the Eastern Caribbean have circled the abstract concept called NHI like the proverbial blind men explaining the elephant. De®nitions of NHI have shifted depending on their perspectives and philosophical leanings, their understanding of the issues, and their degree of in¯uence on the process. Based on NHI feasibility studies, market research, and stakeholder analysis conducted in ®ve countries, this article analyses the policy formulation stage of NHI development in these tiny countries. Given the level of economic development and the existing administrative capacity of the governments, this `phase one' NHI could be a pragmatic ®rst step in introducing a health insurance component into the social security systems of the countries, and gradually reforming other aspects of the health sector. The article is structured around key questions which help to de®ne the positions and relationships of key stakeholders, and then evaluate NHI plans in terms of economic viability, equity, administrative feasibility and eciency, cost containment incentives, and political palatability. These are the elements thatÐin combination with economic and political contextÐwill determine the success or failure of NHI in the Eastern Caribbean.