Revista Panamericana de Salud Pública
On-line version ISSN 1680-5348Print version ISSN 1020-4989
MOLINA, Raúl; PINTO, Matilde; HENDERSON, Pamela and VIEIRA, César. Health spending and financing: the current situation and trends. Rev Panam Salud Publica [online]. 2000, vol.8, n.1-2, pp.71-83. ISSN 1680-5348. http://dx.doi.org/10.1590/S1020-49892000000700010.
Being knowledgeable about national health expenditures and sources of financing is essential for decision-making. This awareness also makes it possible to evaluate the equity of allocation and the efficiency of utilization of these resources. Changes in financing have been a substantial component of health sector reform in the Americas. The goal has shifted from merely one of financial sustainability to simultaneously seeking equitable access to quality services. In this article the Pan American Health Organization (PAHO) presents a proposal for analyzing and designing a policy on health financing. The aim of the policy is to identify the mix of financing mechanisms most likely to simultaneously produce financial sustainability, equity, access, and efficiency. The PAHO proposal combines traditional mechanisms for generating resources (public funds from taxes, as well as private health insurance, national health insurance, and user fees) with complementary subsidy mechanisms for vulnerable groups. Health financing strategies ought to explicitly consider the financing both of care for individuals and of health interventions for the general public good, for which public financing is the most equitable and efficient approach.