Jens Holst

It would be difficult to identify another issue that is comparably present in political debates as the future of social protection systems. In the industrialised world, the dispute stresses the potential insolvency of the traditional welfare state that requires an urgent "modernisation" and more "efficiency". Recommendation urge developing countries to concentrate on economic growth and search their destinies in opening their markets while investment in social protection is considered secondary or even tertiary.

Effective and sustainable social protection is increasingly accepted as a key element of economic and social development that is negatively affected by social exclusion and huge income gaps (1). From a socio-political, as well as from a macro-economic point of view, three criteria are of utmost importance for performance, quality, and sustainability of healthcare systems: the extension of demographic coverage, the degree of risk pooling among various population groups, and the fairness of financing.

Social Health Insurance (SHI) is a method for financing and managing healthcare by pooling the widest range of health risks possible, and, by pooling contributions of enterprises, households, and government. Broad-based risk pooling is an essential condition for the financial sustainability of any health insurance scheme. Risk pooling corresponds to the traditional insurance function of distributing the financial costs of an individual's healthcare to the group members as a whole. Its central purpose is to share the financial risk associated with the use of health services for which the need is uncertain, and it varies between individuals.

Download the whole July 2007 Federation Pages of the WFPHA: World Federation of Public Health Associations