Desafios del aseguramiento universal
Páginas: 8 (1900 palabras)
Publicado: 11 de mayo de 2011
17/04/2008
Macroeconomia y Salud
El Desafio del Aseguramiento Universal
Cristian Baeza Asesor Principal en Politica de Salud Region de America Latina y el Caribe Banco Mundial
Presentacion
• Aspectos Generales de la relacion economia y salud • Contribucion de los Sistemas de Salud y sus determinantes • Aseguramiento en Salud y Proteccion Financiera • Que es Aseguramiento Universal? •Aspectos criticos de la universalidad y los desafios para su implementacion
17/04/2008
Circulo Virtuoso Economia y Salud
•Incremento Ingresos y I Consumo
Mercado del Trabajo T b j
•Producto Agregado •Competitividad Pais •Innovacion
•Incremento Productividad
Hogar / Trabador Saludable
Crecimiento y Desarrollo Socio-Economico
Desarrollo Humano
•Servicios de Salud•Proteccion Social •Seguridad y Justicia •Educacion •Vivienda •Inclusion Social
Health Systems as contributors to Human Development: today Income Housing
Citizens
Producers
Financial Protection Providers
Health interventions
Utilization
Health
Country Competitiveness C titi
Human Development
Household Human Capital Production Function
Poverty Reduction
Consumers ContributorsDignity
Food
Social Integration
Education
17/04/2008
Oversight
(Stewardship)(d)
Financing (a)
Funding (Public, Oops and DAH), Contribution, Pooling and Payment Mechanisms
Resource Generation
HR, Pharma, M d HR Ph Med. Equipment, (f)
Patients And Population Health service/status Financial Protection Country fiscal & Competitiveness Dignity
Public and Private Providers(e)
Health, Nutrition and Population interventions (g)
Demand (c)
Preferences, believes and behaviors
System Governance,
including fiduciary arrangements and other systems (b)
Cristian C. Baeza The World Bank
17/04/2008
El costo de tratar una enfermedad es la segunda causa mas frecuente de shock al ingreso reportada por el hogar
(Responses to the question “In the past threeyears, has your household experienced an event that has caused a significant loss in income?”, PRIESO surveys, Santiago Chile, 2000, and Lima, Peru, 2002)
45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0
42.6
Peru
Percenta (%) of Total Reported Shocks age
18.6 16.9 12.3 12 3
6.1 5.0 1.2 0.0 Recession, Policy/political usually loss of change job Natural disaster & crime Other disasterDisability of Death of Sickness Other sudden family member family member costly to treat increase in HH costs 1.2 1.0
El costo de tratar una enfermedad es la segunda causa mas frecuente de shock al ingreso reportada por el hogar
(Responses to the question “In the past three years, has your household experienced an event that has caused a significant loss in income?”, PRIESO surveys, Santiago Chile,2000, and Lima, Peru, 2002)
35.0
Chile
29.4
30.0
Perc centage (%) of Total Reported Shocks
25.0 20.2 20.0
15.0
10.0
5.0 2.2 0.0 Recession, usually loss of job Policy /political change
4.1 2.5
4.6 2.5 0.9
Natural disaster & crime
Disability of family member
Death of family member
Sickness costly to treat
Other sudden increase in HH costs
Help to F&Foutside HH
17/04/2008
Causes for Impoverishing Effects of Health Events (shocks)
• Loss of income
– Unemployment – Reduced returns from labor market participation
• Excess Expenditures
– Out-of-Pocket – Insurance Premiums – Taxation
Inequality in out-of-pocket expenditures
Mexico 2000
Mean Total OOPs % HH Exp
14%
Colombia 2000
Mean Total OOPs % HH Exp
12%
Adjusted MeanTotal OOPs % HH Exp
Adjusted Mean Total OOPs % HH Exp
12%
10%
10%
8%
8%
6%
6% 4% 4%
2%
2%
0% Q1 (poorest) Q2 Q3 Q4 Q5 (richest)
0% Q1 (poorest) Q2 Q3 Q4 Q5 (richest)
17/04/2008
Income Effects of Health Expenditures
Honduras: Household Income, Poverty and Health Expenditures
Graph VII-1: Average Previsional Household Monthly Per Capita Income Pre- and...
Macroeconomia y Salud
El Desafio del Aseguramiento Universal
Cristian Baeza Asesor Principal en Politica de Salud Region de America Latina y el Caribe Banco Mundial
Presentacion
• Aspectos Generales de la relacion economia y salud • Contribucion de los Sistemas de Salud y sus determinantes • Aseguramiento en Salud y Proteccion Financiera • Que es Aseguramiento Universal? •Aspectos criticos de la universalidad y los desafios para su implementacion
17/04/2008
Circulo Virtuoso Economia y Salud
•Incremento Ingresos y I Consumo
Mercado del Trabajo T b j
•Producto Agregado •Competitividad Pais •Innovacion
•Incremento Productividad
Hogar / Trabador Saludable
Crecimiento y Desarrollo Socio-Economico
Desarrollo Humano
•Servicios de Salud•Proteccion Social •Seguridad y Justicia •Educacion •Vivienda •Inclusion Social
Health Systems as contributors to Human Development: today Income Housing
Citizens
Producers
Financial Protection Providers
Health interventions
Utilization
Health
Country Competitiveness C titi
Human Development
Household Human Capital Production Function
Poverty Reduction
Consumers ContributorsDignity
Food
Social Integration
Education
17/04/2008
Oversight
(Stewardship)(d)
Financing (a)
Funding (Public, Oops and DAH), Contribution, Pooling and Payment Mechanisms
Resource Generation
HR, Pharma, M d HR Ph Med. Equipment, (f)
Patients And Population Health service/status Financial Protection Country fiscal & Competitiveness Dignity
Public and Private Providers(e)
Health, Nutrition and Population interventions (g)
Demand (c)
Preferences, believes and behaviors
System Governance,
including fiduciary arrangements and other systems (b)
Cristian C. Baeza The World Bank
17/04/2008
El costo de tratar una enfermedad es la segunda causa mas frecuente de shock al ingreso reportada por el hogar
(Responses to the question “In the past threeyears, has your household experienced an event that has caused a significant loss in income?”, PRIESO surveys, Santiago Chile, 2000, and Lima, Peru, 2002)
45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0
42.6
Peru
Percenta (%) of Total Reported Shocks age
18.6 16.9 12.3 12 3
6.1 5.0 1.2 0.0 Recession, Policy/political usually loss of change job Natural disaster & crime Other disasterDisability of Death of Sickness Other sudden family member family member costly to treat increase in HH costs 1.2 1.0
El costo de tratar una enfermedad es la segunda causa mas frecuente de shock al ingreso reportada por el hogar
(Responses to the question “In the past three years, has your household experienced an event that has caused a significant loss in income?”, PRIESO surveys, Santiago Chile,2000, and Lima, Peru, 2002)
35.0
Chile
29.4
30.0
Perc centage (%) of Total Reported Shocks
25.0 20.2 20.0
15.0
10.0
5.0 2.2 0.0 Recession, usually loss of job Policy /political change
4.1 2.5
4.6 2.5 0.9
Natural disaster & crime
Disability of family member
Death of family member
Sickness costly to treat
Other sudden increase in HH costs
Help to F&Foutside HH
17/04/2008
Causes for Impoverishing Effects of Health Events (shocks)
• Loss of income
– Unemployment – Reduced returns from labor market participation
• Excess Expenditures
– Out-of-Pocket – Insurance Premiums – Taxation
Inequality in out-of-pocket expenditures
Mexico 2000
Mean Total OOPs % HH Exp
14%
Colombia 2000
Mean Total OOPs % HH Exp
12%
Adjusted MeanTotal OOPs % HH Exp
Adjusted Mean Total OOPs % HH Exp
12%
10%
10%
8%
8%
6%
6% 4% 4%
2%
2%
0% Q1 (poorest) Q2 Q3 Q4 Q5 (richest)
0% Q1 (poorest) Q2 Q3 Q4 Q5 (richest)
17/04/2008
Income Effects of Health Expenditures
Honduras: Household Income, Poverty and Health Expenditures
Graph VII-1: Average Previsional Household Monthly Per Capita Income Pre- and...
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