Cost recovery in public hospitals in Belize

This report examines one such mechanism: increased cost recovery through user fees at MOH facilities. Four simulations featuring partial and full cost-recovery estimates in Belize City Hospital and district facilities are represented. According to the report, merely enforcing the current fee collection system would increase cost recovery from its present level of only 2% to 10%. Doubling current charges and adding nominal fees for outpatient services would raise recovery to 25% in Belize City Hospital and 40% in the districts. Such a system is a necessary first step toward the development of full cost recovery, which would require establishment of a comprehensive health insurance system. As an incentive for fee collection, the MOH should grant some autonomy to the health facility managers and leave a substantial share of the fees paid with the facilities obtaining the payments. Fees should be charged to all patients but the extremely poor. The Social Development Department of the Ministry of Social Services and Community Development should be responsible for means testing to identify those eligible for free care. The report recommends that the MOH run demonstration projects for two years to test different cost recovery strategies and develop sound management and financial practices.