子模块6.5：其他医疗融资方案

Module 6:The financing dimension Other health care financing schemes6.5:Submodule Content •Other health care financing schemes•Characteristics of NPISH financing schemes and their flows [HF.2.2]•Revenue of NPISH financing schemes and their financing agents•Characteristics of enterprise financing schemes [HF.2.3]•Revenue of enterprise financing schemes and their financing agents•Characteristics of compulsory medical saving accounts financing schemes (CMSA)•Revenue of CMSA financing schemes and their financing agents•Characteristics of Rest of the World (ROW) financing schemes [HF.4]•Revenue of ROW financing schemes and their financing agents•Frequent data sources related to other financing schemes•Accounting notes for other financing schemes•Challenges Additional Content: •Questions and Answers•Suggested reading Other health care financing schemes In this submodule, we present the remainingcategories of SHA 2011 health care financingschemes. These are less frequent, not alwaysfully documented, and/or usually represent lowexpenditure shares in current healthexpenditure (CHE). Characteristics of NPISH financingschemes [HF.2.2] Mode of participation Voluntary:Coverage of individuals or groups is at the discretion of the Non-Profit institution managing the scheme. SHA 2011 distinguishestwo typesof financing schemes of Non-ProfitInstitutions Serving Households (NPISH): Benefit entitlement a.Resident foreign agencies schemes [HF.2.2.2], for example, developmentpartners with a representative acting within the country. They oftenprovide funding, in kind donations, and technical assistance. Examplesinclude UN agencies such as UNICEF, which has more than 200 countryoffices operating schemes related to children’s health. Non-contributory, discretionary. Basic method for revenue collection b.NPISH schemes [excluding resident foreign agencies] [HF.2.2.1]refer to allother domestic NPISH schemes financing and performing health careactivities. Their income primarily comes from grants and donations fromhouseholds, enterprises, donors, and government transfers. In Ethiopia, NPISH schemes include, among others, the EthiopianKidney Association, a scheme dedicated to kidney-related healthproblems. Pooling Varies across programmes, but pooling is typically at the programme level. Example of financial flows related to NPISH financing schemes These are the typicalfinancing flows of NPISHschemes. The chart provides asimplified view; additionalflows may exist. Revenue of NPISH financing schemes and their financing agents NPISH often complement government preventive schemes.Governments can contribute throughspecific transfers [FS.1.4]tonon-profit institutions. Households and corporations may providedonations [FS.6.1andFS.6.2respectively].Other domestic revenuesof NPISH [FS.6.3]can correspond to own income of the NPISHgenerated through their activities, rent of buildings, etc. In somecases, revenue comes fromexternal aid [FS.7]. CodeName FS.1.4Other transfers from government domestic revenue FS.6.1Other revenues from households n.e.c.FS.6.2Other revenues from corporations n.e.c.FS.6.3Other revenues from NPISH n.e.c. Allinstitutional unitscan provide resources to NPISH schemes. Direct foreign transfersFS.7 The NPISH financing schemes are operated byNPISH financing agents[FA.4]. These are non-governmental, and they offer financing and/orhealth care for free, or at non-significant prices [below market value]. CodeName Institutional units providing revenues to financingschemesFS.RI.1 FS.RI.1.4FS.RI.1.5GovernmentCorporationsHouseholdsNPISHRest of the worldFS.RI.1.1FS.RI.1.3FS.RI.1.2 Characteristics of enterprisefinancing schemes [HF.2.3] Mode of participation Voluntary choice of a particular corporation, with coveragebased on employment at such a firm [e.g. compulsoryoccupational health care]. Enterprise schemes includearrangements to directly provide or finance health services for their employees[such as occupational health services]. By convention, HF.2.3 also includes health care providers' ownfinancing modalities. Please note that enterprise schemes do not include employer-based insuranceschemes. Benefit entitlement Non-contributory, discretionary with regard to the type ofservices, though may sometimes be specified by law. SHA 2011 distinguishestwo different typesof enterprise scheme: a.Enterprise financing schemes, except health care providers [HF. 2.3.1]. Enterprises may provide on-site services or fund them. In some cases, they have a health department, ranging from a small officeto an entire hospital. Saudi Aramco, the oil company in Saudi Arabia, operates a network of clinics in each drillingsite, including ambulances and its own hospital. Basic method for revenue collection Large enterprises and those with high accident rates, provide health care services, such as in thechemical, construction, or mining sectors. Voluntary: choice of the firm to use its revenues for thispurpose. b.Hea