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Ms. Evridiki Tsounta
Despite the increasing interest in universal health care, little is known about the optimal way to finance, design, and implement it. This paper attempts to fill this gap by providing some general policy recommendations on this important issue. While most of the paper addresses the Eastern Caribbean Currency Union (ECCU) countries, its policy implications are applicable to any country. The paper finds that the best financing option is country-specific depending on a country’s economic, cultural, institutional, demographic and epidemiological characteristics, as well as political economy considerations. However, taxation should be the primary financing source. It also concludes that an appropriate and realistic benefit package would need to be designed to ensure the system’s financial viability. Regarding the optimal way to implement universal health care, certain preconditions are needed, including sound public administration, a small informal economy, and a transparent health financing system that builds social consensus.
International Monetary Fund

. An electronic “health card” has been introduced with the intent of monitoring individuals' expenditures and preventing fraud and waste. The role of the Pharmaceutical Agency has been expanded to monitor spending on drugs and to contain related prices. Court of Auditors In line with staff recommendations, the role and capabilities of the Court of Auditors (Corte dei Conti) has been strengthened. Moreover, its mandate has been extended to monitor the finances of local governments and healthcare agencies. 6. Ageing-related costs and fiscal

Ahsan S. Mansur

3.5 percent of the population (who were below the absolute poverty line) close to the poverty line. The food coupon system served the majority of the population, although individual benefits were relatively low (totaling JD 6.5 a year). It is believed that the low- and middle-income households—who either do not qualify or avoid means-tested transfer programs—receive benefit transfers only through food coupons and the generalized subsidies. The health card system provides fairly comprehensive health care coverage to more than 8 percent of the population, at a

International Monetary Fund. Middle East and Central Asia Dept.

Welfare Fund. 12 Recently, the new Prime Minister’s Health Card Program has been launched to provide free health care services to the poor. In addition to these social safety net programs, electricity and food subsidies and subsidies to foster the development of the agricultural sector are in place. Overall, expenditures on social safety nets, excluding subsidies and provincial programs, represent 0.54 percent of GDP, well below South Asia average and emerging markets’ average. Pakistan: Social Safety Nets are Relatively Small (Expenditures on social safety nets

Mr. Paul R Masson, Mr. Timothy D. Lane, and Ms. Padma Gotur

and municipalities, through protection of allocations for the Public Assistance Scheme and the Voluntary Health Card System; and by redeploying health staff to rural areas. These programs are to be supported by an AsDB Social Sector loan amounting to B 15–25 billion over three years. A subsidy for urban bus and rail fares will be maintained to protect urban low-income workers. VI. Further Options The various social safety net initiatives contained in the Fund-supported programs for the three countries should help in mitigating the adverse social impact

Marijn Verhoeven, Mr. Sanjeev Gupta, Mr. Gerd Schwartz, Mr. Calvin A McDonald, Željko Bogetic, and Mr. Christian Schiller
This paper presents a preliminary analysis of the likely social impact of the economic crisis and the reform programs in three Asian countries—Indonesia, Korea, and Thailand. The focus is on likely changes in real consumption expenditures arising from higher inflation and increases in unemployment. The current social policy measures adopted in the reform programs should provide significant social safety nets for the poor. However, if the social impact turns out to be larger than projected, it would be worthwhile to assess cost-effective and efficient alternatives for expanding social safety nets. The paper presents some options that could be considered.
Marijn Verhoeven, Mr. Sanjeev Gupta, Mr. Gerd Schwartz, Mr. Calvin A McDonald, Željko Bogetic, and Mr. Christian Schiller

Voluntary Health Card System; and by redeploying health staff to rural areas. These programs are to be supported by an AsDB Social Sector loan amounting to B 15-25 billion over three years. A subsidy for urban bus and rail fares will be maintained to protect urban low-income workers. VI. F urther O ptions The various social safety net initiatives contained in the Fund-supported programs for the three countries should help in mitigating the adverse social impact of the economic crisis. The social impact may even turn out to be larger than currently projected

Mr. David Coady, Mr. Benedict J. Clements, and Mr. Sanjeev Gupta

Achievement (Percent) Scheme 1991 1996 2001 Social welfare for the poor, the elderly, and socially disadvantaged groups 12.7 12.6 32.4 Civil Servant Medical Benefit Scheme 15.3 10.2 8.5 Social health insurance — 5.6 7.2 Voluntary health card 1.4 15.3 20.8 Private health insurance 4.0 1.8 2.1 Total insured 33.4 45.5 71.0 Total uninsured 66.6 54.5 29.0 Sources: National Statistical Office, Health and Welfare Surveys (various years). By 2002, the entire