Managing the process
As important as it is to bring different stakeholders together to listen, consult,
negotiate and compromise, it is essential that the leaders of the reform have
the power to resolve conflicts and to drive through the necessary changes.
Otherwise countries risk getting stuck in the design stage, stalled by interest groups
that feel threatened and are resisting change. Countries need a concrete plan
to manage the reform process. It is also important to build capacity, not just to
design a universal coverage scheme, but also to manage its implementation,
including capacity for learning from the experience and tweaking the scheme
as it is implemented.
Designing the system
Three design elements are essential to achieve universal coverage: extension
of access to services, cost containment and strategic purchasing. Financing
reform must go hand in hand with ensuring physical access to services. There is
no point giving people a theoretical entitlement to financial protection if they
have no access to local services or if it is too costly to access services outside
the community in which they live. Thailand was in a good position to implement
the UCS policy because for decades the government had invested in building
local health infrastructure.
Managing the processAs important as it is to bring different stakeholders together to listen, consult,negotiate and compromise, it is essential that the leaders of the reform havethe power to resolve conflicts and to drive through the necessary changes.Otherwise countries risk getting stuck in the design stage, stalled by interest groupsthat feel threatened and are resisting change. Countries need a concrete planto manage the reform process. It is also important to build capacity, not just todesign a universal coverage scheme, but also to manage its implementation,including capacity for learning from the experience and tweaking the schemeas it is implemented.Designing the systemThree design elements are essential to achieve universal coverage: extensionof access to services, cost containment and strategic purchasing. Financingreform must go hand in hand with ensuring physical access to services. There isno point giving people a theoretical entitlement to financial protection if theyhave no access to local services or if it is too costly to access services outsidethe community in which they live. Thailand was in a good position to implementthe UCS policy because for decades the government had invested in buildinglocal health infrastructure.
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