Weak Links in the Chain Ii: A Prescription for Health Policy in Poor Countries

Posted: 29 Feb 2008

See all articles by Deon Filmer

Deon Filmer

World Bank; World Bank - Development Research Group (DECRG)

Jeffrey S. Hammer

Princeton University - Woodrow Wilson School of Public and International Affairs

Lant Pritchett

Harvard University - Harvard Kennedy School (HKS); Center for Global Development

Abstract

In an earlier article, the authors outline some reasons for the disappointingly small effects of primary health care programs and identified two weak links standing between spending and increased health care. The first was the inability to translate public expenditure on health care into real services due to inherent difficulties of monitoring and controlling the behavior of public employees. The second was the crowding out of private markets for health care, markets that exist predominantly at the primary health care level.

This article presents an approach to public policy in health that comes directly from the literature on public economics. It identifies two characteristic market failures in health. The first is the existence of large externalities in the control of many infectious diseases that are mostly addressed by standard public health interventions. The second is the widespread breakdown of insurance markets that leave people exposed to catastrophic financial losses. Other essential considerations in setting priorities in health are the degree to which policies address poverty and inequality and the practicality of implementing policies given limited administrative capacities. Priorities based on these criteria tend to differ substantially from those commonly prescribed by the international community.

Suggested Citation

Filmer, Deon and Hammer, Jeffrey S. and Pritchett, Lant, Weak Links in the Chain Ii: A Prescription for Health Policy in Poor Countries. World Bank Research Observer, Vol. 17, No. 1, pp. 47-66, 2002, Available at SSRN: https://ssrn.com/abstract=873705

Deon Filmer (Contact Author)

World Bank ( email )

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Washington, DC 20433
United States

HOME PAGE: http://go.worldbank.org/MRWPOHRQJ0

World Bank - Development Research Group (DECRG)

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

Jeffrey S. Hammer (Contact Author)

Princeton University - Woodrow Wilson School of Public and International Affairs ( email )

Princeton University
Princeton, NJ 08544-1021
United States

Lant Pritchett (Contact Author)

Harvard University - Harvard Kennedy School (HKS) ( email )

79 John F. Kennedy Street
Cambridge, MA 02138
United States
617-496-4562 (Phone)
617-496-2554 (Fax)

HOME PAGE: http://ksghome.harvard.edu/~lpritch/

Center for Global Development

2055 L St. NW
5th floor
Washington, DC 20036
United States

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