Health financing and management in Belize : an assessment for policymakers : a compendium of technical notes

A rapidly growing population, inadequate financial resources, inefficient service organization and delivery, and inequitable access are contributing to the deterioration of the quality and quantity of services provided by the Ministry of Health (MOH). To this array of deficiencies we can add an undeveloped private sector that appears to capture only a portion of the demand for private services, and an unpopular social security system that provides inadequate benefits and insufficient population coverage. Ambiguous policies, unenforced legislation, and ad-hoc policymaking impede the ability of the government of Belize to confront these issues, or develop and implement solutions. The papers constituting this compendium focus on health care financing and provision in Belize. The papers on cost recovery, resource allocation, and pharmaceutical supply pertain to the public health system. The two remaining papers center on the private medical sector and social security system. Each follows a similar format: analysis of the current situation, presentation of the technical basis for selection of corrective strategies, proposals for policy and program reforms, and recommendations for specific implementation activities. Taken together, the studies seek to contribute to an informed debate on the future of health services in Belize and assist the government in improving health care. More specifically, they aim to provide policymakers with the technical tools to boost resource generation, improve efficiency, and enhance equity. Many of the most important recommendations in these reports imply political risk. In particular, effective cost recovery in public facilities -- a change that is essential to the financial soundness of the Belizean health system -- appears to imply a shift away from so-called "socialized medicine". Some government officials may believe that a shift away from the nominal government policy would result in an unpalatable political backlash. (Author abstract)