Social Health Insurance

This guidebook is designed to be used by planners, policy-makers and stakeholders in countries that are considering the introduction of social health insurance as a replacement for or supplement to existing financing mechanisms for health care. The first law leading to a comprehensive social health insurance system was introduced in Germany more than 100 years ago. Over time, health financing systems are changing in order to provide better access for whole populations to health care that is affordable, appropriate and of high quality – while maintaining control over costs.
Countries use different financing approaches to achieve universal coverage – including varieties of health insurance, tax-funded systems and combinations of the two. The focus of this guidebook is on one particular approach – social health insurance – and not on the relative merits of different mechanisms. The guidebook has both technical and policy objectives.
The technical objective is to lead policy-makers and programme planners through the process of successfully establishing a social health insurance system. The policy objective is to contribute to attaining universal coverage with affordable access to health care services. Both aspects of social health insurance are explained clearly and in detail.