Prof Elias Mossialos COW.4.08

This course is compulsory on the MSc in Global Health. This course is not available as an outside option.

This course aims to introduce students to a comparative approach to analysing the development of health care financing, both in theory and in practice, with an emphasis on critical assessment of current and future policy options and issues. It focuses on the health financing functions of collecting revenue, pooling funds and purchasing services, as well as on policy choices concerning coverage, resource allocation and market structure. The course mainly draws on examples from health financing policy in both developed and low and middle income countries.

By the end of this course, students will have:

• a grasp of the economic, political and philosophical concepts relevant to any discussion of health financing policy;
• a good understanding of how financing arrangements affect the achievement of key health financing policy goals such as financial protection, equity in financing and equity of access to health care, incentives for efficiency and quality in the organisation and delivery of health services, administrative efficiency, transparency and accountability;
• the skills to critically assess current health financing arrangements and options for reform;
• an overview of key health financing policy issues, including the advantages and disadvantages of different ways of raising revenue for health; the role of private financing mechanisms; the importance of pooling; decisions about whom to cover, what services to cover, and how much of service cost to cover; allocating resources to purchasers, purchasing market structure and the principles of strategic purchasing; the incentives associated with different methods of paying providers; and the issue of financial sustainability.

10 hours of lectures and 10 hours of seminars in the MT. 3 hours of help sessions in the ST.

Ten one hour lectures and five two hour seminars, plus a three-hour revision seminar in the ST.

Students will be expected to produce 1 essay in the MT.

One non-assessed essay (2,000 words) in week 6.

WHO, World Health Report 2010 - Health systems financing: the path to universal coverage (2010).

R. Smith, R, K Hanson, Health systems in low- and middle-income countries: an economic and policy perspective, Oxford University Press (Oxford) 2011.

P Mladovsky, E Mossialos, (2008) A conceptual framework for community-based health insurance in low-income countries: social capital and economic development. World Development. 2008; 36(4):590-607.

E Mossialos, A Dixon, J Figueras & J Kutzin (eds), Funding health care: options for Europe, Open University Press (2002).

T Rice, The economics of health reconsidered, Health Administration Press (3nd edn, 2009).

Exam (75%, duration: 2 hours) in the main exam period.
Essay (25%, 3000 words) in the MT.