Table 3 Evaluation of PHI performance in Zimbabwe
From: Inequality and private health insurance in Zimbabwe: history, politics and performance
Evaluative criteria | Performance |
|---|---|
Can PHI fill gaps in publicly financed coverage? | • Deficient population coverage • Coverage in favor of urban-based and formally employed individuals • Coverage according to wealth index • Individualized expenditures similar to medical savings accounts as citizens opt out of PHI |
Does it enhance access to health care or improve efficiency in health service delivery? | • Financial barriers to care as insured individuals incur OOP expenditures • Geographical barriers to care for rural-based enrollees • Financial protection for insured individuals with generous coverage benefits • The dominance of fee-for-service payment mechanisms predisposes the system to inefficiencies driven by a moral hazard such as supplier-induced demand • High administrative costs as a share of total expenditures • Disproportionately high expenditures relative to the proportion of the population with coverage |
Does it provide financial relief for the government? | • The private sector sifts resources from the public sector through direct and indirect government subsidies |