In this Book

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Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty.

Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly.

What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.

Table of Contents

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  1. Front Cover
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  1. Title Page, Copyright Information
  2. pp. i-iv
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  1. Table of Contents
  2. pp. v-viii
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  1. Foreword
  2. pp. ix-x
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  1. Acknowldgments
  2. pp. xi-xii
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  1. Preface
  2. pp. xiii-xiv
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  1. About This Book
  2. pp. xv-xx
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  1. The Health Benefits Package: Bringing Universal Health Coverage from Rhetoric to Reality
  2. Amanda Glassman
    Ursula Giedion
    Peter C. Smith
  3. pp. 1-18
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  1. Revisiting and Reformulating: How Explicit Benefit Packages Have Helped Mexico Move toward Universal Health Coverage
  2. Eduardo González-Pier
  3. pp. 19-22
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  1. Part I: Goverancne and Process: The Foundation of a Health Bene ts Package Policy
  2. Ursula Giedion
  3. pp. 23-29
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  1. Defining the Rules of the Game: Good Governance Principles for the Design and Revision of the Health Benefits Package
  2. Ursula Giedion
    Javier Guzmán
  3. pp. 30-60
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  1. Tracking the Benefits Package from Paper to Practice: Monitoring and Evaluation
  2. Ricardo Bitrán
  3. pp. 61-87
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  1. Managing the Money: Fiscal and Budgetary Consideration for the Benefits Package
  2. Amanda Glassman
  3. pp. 88-104
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  1. Aspiring to National Health Insurance, South Africa Considers Its Benefits Package
  2. Mark Blecher
    Yogan Pillay
  3. pp. 105-108
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  1. Part II: Putting Pen to Paper: Methods to Select a Bene ts Plan That Works
  2. Peter Smith
  3. pp. 109-114
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  1. How Much Health for the Money? Using Cost-Effectiveness Analysis to Support Benefits Plan Decisions
  2. Mark Sculpher
    Paul Revill
    Jessica M. Ochalek
    Karl Claxton
  3. pp. 115-140
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  1. Benefits beyond Health: Evaluating Financial Risk Protection and Equity through Extending Cost-Effectiveness Analysis
  2. Stéphane Verguet
    Dean T. Jamison
  3. pp. 141-153
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  1. Comparing Apples and Oranges: Strategies to Weigh Health against Other Social Values
  2. Alec Morton
    Jeremy A. Lauer
  3. pp. 154-174
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  1. Square Pegs, Round Holes: Addressing Health Sector Interventions with Non-Health Benefits
  2. Rachel Silverman
  3. pp. 175-184
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  1. At What Price? Costing the Health Benefits Package
  2. Cheryl Cashin
    Annette Özaltın
  3. pp. 185-200
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  1. Beyond Cost- Effectiveness: Health Systems Constraints to Delivery of a Health Benefits Package
  2. Katharina Hauck
    Ranjeeta Thomas
    Peter C. Smith
  3. pp. 201-213
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  1. See the Bigger Picture: Resources Optimization Tools to Inform HBP Design
  2. Marelize Görgens
    Janka Petravic
    David J. Wilson
    David P. Wilson
  3. pp. 214-234
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  1. Reliable Sources? Generating, Selecting, and Applying Evidence to Inform the Health Benefits Package
  2. Neil Hawkins
    Robert Heggie
    Olivia Wu
  3. pp. 235-246
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  1. Confronting Tight Fiscal, Human Resource, and Evidence Constraints, Malawi Revises Its Benefits Package
  2. Gerald Manthalu
    Dominic Nkhoma
    Jessica M. Ochalek
    Andrew Phillips
    Paul Revill
  3. pp. 247-252
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  1. More than a List: Reforming a Country's Health Benefits Package—A Rigorous Approach to Tackling Costly Overutilization
  2. Yot Teerawattananon
    Waranya Rattanavipapong
    Benjarin Santatiwongchai
    Thanaporn Bussabawalai
    Kittiphong Thiboonboon
    Saudamini Dabak
  3. pp. 253-267
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  1. Starting with the Essential Medicines List: How New Zealand's PHARMAC Prioritizes and Purchases Pharmaceutical Benefits
  2. Thomas Wilkinson
  3. pp. 268-272
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  1. Part III: Tough Choices: Considering Ethics, Rights, and Political Economy in Defi ing Bene ts
  2. Amanda Glassman
  3. pp. 273-276
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  1. Priority-Setting as Politics: A Political Economy Framework for Analyzing Health Benefits Package Decision
  2. Jesse B. Bump
    Angela Y. Chang
  3. pp. 277-289
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  1. A Matter of Morality: Embedding Ethics and Equity in the Health Beneftis Policy
  2. Carleigh Krubiner
    Ruth Faden
  3. pp. 290-326
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  1. The Right to Health and the Health Benefits Package: Accounting for a Legal Right to Health When Designing a HBP
  2. Rebecca Dittrich
    Leonardo Cubillos
    Lawrence O. Gostin
    Kalipso Chalkidou
    Ryan Li
  3. pp. 327-344
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  1. Chile's Guaranteed Package of Health Benefits Navigates Poiltical Challenges
  2. Antonio Infante
  3. pp. 345-354
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  1. Contributors
  2. pp. 355-362
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  1. Glossary
  2. pp. 363-366
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  1. Index
  2. pp. 367-376
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  1. Back Cover
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