An appropriate health
care financing scheme can improve the efficient, equitable, and effective use
of health care resources; however, each popular health care financing scheme
has some advantages and disadvantages. The designing of health care financing
strategy to fit with the country specific features is not straightforward. In resource poor country, allocation of resources for health care services are always critical and frequently unstable due to
nuances annual budget process, small fiscal space, uncertainties in
contributions of external development partners. Considerable quantities of
country specific researches require for the choice of an appropriate health
care financing scheme. The paper illustrates possible better options for the government to pursue the goal of ensuring that the poor receive more benefits. The
paper compares the benefit incidences and cost of services with different
options purposed for primary health care services by utilizing recently
collected data from different hospitals in Nepal. The paper offers an
alternative policy such as a universal free care below the district level services;
but in the district level which is top level of primary care, “extended
targeted free health care” may be an efficient, fair, and relatively simple approach.
Xu, K., Evans, D.B., Kadama, P., Nabyonga, J., Ogwal, P.O., Nabukhonzo, P. and Aguilar, A.M. (2006) Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda. Social Science & Medicine, 62, 866-876.
Lagarde, M. and Palmer, N. (2008) The impact of user fees on health service utilization in low-and middle-income countries: How strong is the evidence? Bulletin of the World Health Organization, 86, 839-848.
Laterveer, L., Munga, M. and Schwerzel, P. (2004) Equity implications of health sector user fees in Tanzania. Do we retain the user fee or do we set the user f(r)ee? Analysis of literature and stakeholder views. Research for Poverty Alleviation (REPOA), ETC Crystal Leusden.
Adhikari, S.R. and Maskay N.M. (2004) Health sector policy in the first decade of Nepal’s multiparty democracy: Does clear enunciation of health priorities matter? Health Policy, 68, 103-112.
O’Donnell O., van Doorslaer, E., Rannan-Eliya, R.P., Somanathan, A., Adhikari, S.R., Harbianto, D., Garg, C.C., et al. (2007) The incidence of public spending on healthcare: Comparative evidence from Asia. The World Bank Economic Review, 21, 93-123. doi:10.1093/wber/lhl009
WHO (2009) South East Asian region and western pacific region health financing strategies for the Asia Pacific region 2010-2015. South East Asian Region and Western Pacific Region, World Health Organization.