Theme: Healthcare Finance

In this paper, we document the experience of Germany’s SHI system with managed competition and the challenges faced by this sub-system in faithfully implementing the principles of managed competition as originally envisioned by Enthoven.

In this paper, we look at what made a transition to managed competition possible in the Netherlands, how managed competition has played out, and the challenges that the system currently faces.

The study is authored by Aarushi Gupta, senior research associate at Dvara Research. Bindu Ananth, co-founder and chair of Dvara Trust. Bindu Ananth and Hasna Ashraf are fellow, Lancet Citizen’s Commission on Reimagining India’s Health Systems.

India’s healthcare sector has made significant strides in the last couple of decades. Yet, progress in terms of access, affordability, and quality of healthcare remains variable across states.  There are many factors that affect the status of health in a national/sub-national geography, with the political economy of healthcare being a key driver of health outcomes. […]

Health systems are extremely complex, with multiple interacting components which can lead to varied outcomes depending on the context in which
they are placed. Building a systematic understanding is then essential for designing health systems and reforming existing ones.

In India, nearly 65% of the healthcare spending is out of pocket by individuals. The remaining 35% is highly fragmented and comes from a number of central and state government funds, and insurance companies. The unprecedented healthcare crisis caused by the pandemic has brought a number of concerns about the effectiveness and sustainability of the healthcare system to the forefront.

In this piece, we revisit Enthoven’s principles and propose a broader definition of the concept of managed competition in order that it may encompass other countries’ experiences that do not conform to a strict application of Enthoven’s concept.

Based on a study of the theoretical and empirical literature, we conclude with a set of hypotheses that looks at how demand for health insurance can be fostered by targeting both the components of demand (intention and action), through well-designed awareness measures and nudges to overcome the various behavioural biases involved.

In this blog post, we analyse Germany’s Statutory Health Insurance and its lessons for health systems design.

This case study analyse Thailand’s strategic purchasing and explain their health system financing