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What is Enough?Sufficiency, Justice, and Health$
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Carina Fourie and Annette Rid

Print publication date: 2016

Print ISBN-13: 9780199385263

Published to Oxford Scholarship Online: November 2016

DOI: 10.1093/acprof:oso/9780199385263.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 05 December 2021

Defining Health Care Benefit Packages

Defining Health Care Benefit Packages

How Sufficientarian Is Current Practice?

Chapter:
(p.247) Chapter 13 Defining Health Care Benefit Packages
Source:
What is Enough?
Author(s):

Dimitra Panteli

Ewout van Ginneken

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199385263.003.0014

This chapter examines a number of country case studies to explore whether principles underlying the definition of benefit packages correspond to notions of sufficiency. Furthermore, assuming that two-tiered systems of health coverage—with a mandatory social and a voluntary private component—fundamentally embody the idea of sufficiency, it investigates if and how sufficiency is implemented in practice. Each country’s approach and trade-offs across the three dimensions of coverage (share of the population covered, range of services covered, and height of cost-sharing) depend on the country’s economic, political, and cultural context. Decisions regarding any of the three dimensions could impact the level of sufficiency for coverage; thus, the range of services covered alone is not an adequate indicator. Past and current experience with prioritization in a number of countries demonstrates that the notion of sufficiency can be difficult to conceptualize and implement in practice.

Keywords:   benefit package, coverage dimensions, international country comparison, priority-setting

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