Social health insurance is a financing mechanism for health care in which coverage is organised around pooled, usually compulsory, contributions, often shared among employees, employers, and government, to provide members with access to a defined range of health services. Its central aim is to promote equitable and …
Social health insurance is a financing mechanism for health care in which coverage is organised around pooled, usually compulsory, contributions, often shared among employees, employers, and government, to provide members with access to a defined range of health services. Its central aim is to promote equitable and affordable access and to protect households from the financial burden of illness by reducing out-of-pocket spending at the point of care. As a model of health financing, it spreads risk across a broad population so that the healthy and the sick, and those with higher and lower incomes, jointly support the cost of care, and it is a principal route through which countries pursue universal health coverage. Schemes vary in structure, including government-sponsored and contributory arrangements, and in the benefits and population groups they cover. Research in this area examines coverage and enrolment, the effect of insurance on out-of-pocket expenditure and on access to and use of services, and the experience of particular populations such as older adults, for whom financial protection and access to care are especially important. It also considers the barriers and facilitators that influence whether coverage translates into effective care. Social health insurance is therefore a key instrument in health policy and in efforts to improve access, equity, and financial protection.
6 peer-reviewed articles, ranked by relevance. Each links to its DOI.
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