Health financing for universal coverage

Pooling

Philhealth

Pooling is a core function of health financing policy. The purpose of pooling is to spread financial risk across the population so that no individual carries the full burden of paying for health care.

To make progress towards universal health coverage, countries should increase the share of prepaid revenues in the health system, and minimise fragmentation in risk-sharing mechanisms. Establishing separate schemes for civil servants, private sector workers, and poor people are examples of fragmented risk-sharing.

Coverage can be improved by consolidating fragmented pools regardless of sources of funds.


Pooling in more detail

Key policy messages

Compulsory or automatic participation in a health coverage scheme ensures the creation of a large, diverse risk-pool; this allows health systems to make the most of limited resources in terms of cross-subsidy from the healthy to the sick.

Risk pooling for universal health coverage

Prepaid revenues can come from a range of sources, such as general or earmarked taxes, but ideally are pooled together rather than kept in separate funds targeting specific diseases or population groups.

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References