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Deciding fairly: examining health financing decisions for universal health coverage in four different country contexts
Policy makers, interest groups, and the public can have serious disagreements about what the fair choices are when determining the financing of health care systems. In this situation, a fair decision-making process becomes crucial for increasing the trust and legitimacy of governments and their policies. Despite this essential role of process, what criteria decision-making processes in health financing should meet to produce trusted and legitimate decisions has been a neglected area theoretically and practically.
Aim of the session
The aim of the session is to critically discuss novel theoretical and empirical contributions to this neglected area of financing for UHC. The session will:
- present guiding principles and practical criteria, based on ongoing expert consultations and a comprehensive literature review, that can be used to examine, reform and build fairer processes for decision-making in health financing.
- present four case studies—from India, Mexico, Tanzania and Thailand—that have applied these criteria to health financing decisions in their settings. These presentations will especially pay attention to the opportunities and constraints to giving voice to the public and to diverse perspectives during the decision-making process, a critical feature of producing fairer processes in health financing.
The session will be organised in the following way:
1. Presentation of the proposed framework for thinking about fair processes in health financing (total: 8 minutes)
- Unni Gopinathan, Senior scientist, Norwegian Institute of Public Health
- Elina Dale, Senior advisor, Norwegian Institute of Public Health
2. Giving voice to the public during decision-making about health financing: experiences from four country contexts (total: 32 minutes)
- Ravi Prasad Varma, Associate Professor, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Procedural fairness in decisions on re-engineering primary health care services: a case study of the Aardram Mission in Kerala, India
- Mariana Barraza Lloréns, Health Economist and Founding Partner, Blutitude, Mexico
- Adoption of taxes on sugary drinks and on processed foods with high caloric density in Mexico: how fair was the process?
- Peter Binyaruka, Health Economist, Ifakara Health Institute, Tanzania
- Reducing fragmentation in Tanzania: the decision process on Improved Community Health Fund (iCHF)
- Saranya Sachdev, International Health Policy Program, Ministry of Public Health, Thailand
- Leaving no one behind: the decision introducing treatment for 24 rare diseases into the Universal Coverage Scheme (UCS)’s benefits package in Thailand
3. Questions and discussion moderated by David Evans, World Bank Consultant on Health Financing (total: 15 minutes)