Dominican Republic : Implementing a Health Protection System that Leaves No One Behind
During the last 50 years, the Dominican Republic has experienced important economic growth, with rates higher than most Latin American countries. However, despite the substantial reduction in poverty and indigence in recent years, average wages wit...
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| Language: | English |
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World Bank, Washington, DC
2018
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| Online Access: | http://documents.worldbank.org/curated/en/420311516172975669/Dominican-Republic-Implementing-a-health-protection-system-that-leaves-no-one-behind http://hdl.handle.net/10986/29182 |
| Summary: | During the last 50 years, the Dominican
Republic has experienced important economic growth, with
rates higher than most Latin American countries. However,
despite the substantial reduction in poverty and indigence
in recent years, average wages within the formal sector
remain extremely low, and a large proportion of the
working-age population is outside the formal sector. The
country introduced a structural health reform in 2001, which
has been successful in affiliating 70 percent of the
population to the Family Health Insurance, with a complete
package of services with the same content for all, although
with different forms of financing and provision of services.
However, the public service network, which is legally in
charge of providing care to the lower-income population,
lagged in its restructuring process, with serious problems
of quality, efficiency, and governance. Thus, although many
of the coverage goals have been achieved, population health
outcome indicators remain well behind most countries in the
Latin America region. Another key aspect of the pending
agenda to achieve greater health and financial protection
within social insurance is the in-depth revision of the
Basic Health Plan (Plan Básico de Salud). This revision’s
objective would be built on guaranteed coverage of certain
health conditions considered to be priorities, including the
restructuring of the health care model to introduce
rationality, control costs, reduce or eliminate funding
differences between the Contributory Regime (Regimen
Contributivo) and Subsidized Regime (Régimen Subsidiado),
and increase public funding for the Subsidized Regime. It is
necessary to ensure that the benefits provided in the Basic
Health Plan are delivered; that is, that the services
required by the population are effectively covered, which
will also reduce out-of-pocket spending. It is necessary to
monitor the financial situation of all entities of the
health system and to continue strengthening institutional
capacity to carry out the financial and technical audits of
health providers. The permanent monitoring of the financial
sustainability of the Family Health Insurance Subsidized
Regime and the Basic Health Plan is fundamental, while a
systematic analysis of the fiscal space is carried out. |
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