Cover -- Title Page -- Contents -- Latin American Development Forum Series -- Foreword -- Acknowledgments -- About the Authors -- Abbreviations -- Executive Summary -- Introduction -- Health Care Systems in LAC: Functions and Organization -- Health Shocks, Household Welfare, and the Risk of Poverty -- Public Policy's Role in Household Protection against Health Shocks -- The Role of Alternative Risk-Pooling Arrangements -- Risk Pooling for Everyone: The Challenge of a Growing Informal Economy -- The Quest for Efficiency and Universal Coverage: Health Sector Reform in LAC -- Lessons -- Fiscal sustainability is all important -- For efficiency gains, it is essential to strengthen the purchasing-provider compact and increase provider autonomy in health personnel management to ensure improvement in the public provider incentive-performance framework and civil service reform -- Private sector participation needs to be expanded in the delivery of publicly financed health services as well as contributory risk pooling -- Challenges -- 1 Health Care Systems in Latin America and the Caribbean: Functions and Organization -- Introduction -- Health System Functions -- Sources of Financing for an Equity Subsidy -- Alternative Organizational Arrangements for Risk Pooling -- Health Systems in Latin America and the Caribbean -- Note -- 2 Health Shocks, Household Welfare, and the Risk of Poverty -- Introduction -- Country and Household Spending on Health -- Evidence of the Impact of Health on Household Income -- The Impact of Health and Nutrition on Earning Ability -- Income Losses from Forgone Work due to Sickness or Injury -- Policy Mechanisms to Address Household Losses of Income Due to Health Shocks -- Cost of Health Care and Its Impact on Consumption -- The Impact of Health Spending Shocks on Household Welfare in Six Latin American and Caribbean Countries.

Adverse Health Events and Shocks to Household Income -- Distribution of Household Expenditure and Impoverishing Out-of-Pocket Spending on Health -- Impoverishing Out-of-Pocket Expenditure on Health -- Notes -- 3 Public Policy's Role in Household Perception, Preparation, and Protection against Health Shocks -- Introduction -- Household Strategies for Managing and Coping with Shocks -- The Importance of Information on Household Choices to Cover Health Shocks -- Information Problems that Plague Provision of Insurance Instruments -- The Role of Public Policy in Protecting Households from the Impoverishing Effects of Health Shocks -- The Government's Role in Augmenting Household Risk Management, Financial Protection, and Health Outcomes -- Household Coping Strategies -- Policy Lessons from Earlier Applications of the Comprehensive Insurance Framework to Other Losses -- Notes -- 4 The Role of Alternative Risk-Pooling Arrangements -- Introduction -- Society's Need for Financial Protection -- The Importance of a Mandatory Benefits Package -- Risk Pooling in Latin America and the Caribbean -- What Arrangement Gives the Best Financial Protection? -- What Makes the Difference? -- Determinants of Performance -- Characteristics of Risk-Pooling Systems -- Benefits package -- Strategic purchasing -- Equity subsidies -- Insights from Colombia and Chile -- 5 Risk Pooling for Everyone: The Challenges Posed by a Growing Informal Economy -- Introduction -- The Challenge of Extending Risk Pooling -- Policy Options for Extending Risk Pooling -- What Explains the Low Participation of the Informal Nonpoor in Contributory Risk-Pooling Schemes? -- Barriers to Participation -- Holes in the Incentives Framework -- Incentives set by access to free, quality health services -- The contribution-benefits gap -- Cost of labor formalization.

Policy Options for Extending Contributory Risk Pooling among the Informal and the Self-Employed Nonpoor -- Delinking Risk-Pool Financing from Labor Status -- Delinking with a shift toward general taxation financing -- Shifting Toward Risk-Rated Premiums during the Transition -- Improving Incentives for Participation of the Nonpoor in Contributory Risk Pooling without Delinking -- Notes -- 6 The Quest for Efficiency and Universal Coverage: Health Sector Reform in Latin America and the Caribbean -- Introduction -- Achieving Universal Coverage -- Coverage as Breadth and Depth -- Reshaping Health Benefits Packages as Explicit Entitlements -- Bismarck versus Beveridge: Does It Matter? -- Improving Health Sector Efficiency in Latin America and the Caribbean -- Reducing Fragmentation: Single versus Virtual Single Risk-Pool -- Creating the Right Incentive Framework for Insurers and Service Providers -- Strengthening the Purchaser-Provider Compact -- Reconverting Public and Social Security Providers -- Introducing Competition for Mandatory Health Insurance and Service Delivery -- Lessons and Challenges -- The Lessons -- The Challenges -- Notes -- References -- Index -- Back Cover.