Policy Options for Financing Health Services in Pakistan. Volume 4: Development of Private Health Insurance Based on Managed-Care Principles

摘要

This is one volume in a set of five reporting on work performed between 1991 and 1993 by the Federal Ministry of Health (FMOH) of Pakistan with the assistance of USAID's Health Financing and Sustainability Project (HFS). The purpose of this study was to design four financial and organizational reform initiatives to improve the delivery of health services in Pakistan. This report focuses on the potential for developing in Pakistan private health insurance programs based on managed-care principles. Fostering such programs would benefit the Government of Pakistan because encouraging private coverage of health care costs would reduce the burden that the government currently bears in financing health services. At the same time, promoting the development of a private-sector insurance industry with the managed-care approach would contain the costs of health services while improving the quality of care provided. This study surveys employees in Karachi and Islamabad to ascertain the market potential for private insurance programs and makes recommendations about developing these markets. It also presents the basic elements of a model managed-care health insurance program for Pakistan.