Sustainable Financing Models for Public Health Systems: Navigating Economic Constraints to Achieve Universal Coverage
Анотація
Sustainable health financing — the capacity of health systems to raise adequate and predictable funds, pool those funds equitably, and purchase health services efficiently — is the foundational prerequisite for universal health coverage and effective public health. This article examines the principal financing models available to public health systems general taxation, social health insurance, community-based insurance, and voluntary private insurance — and analyses their performance across the dimensions of revenue adequacy, equity, efficiency, and sustainability under conditions of fiscal constraint. Drawing on health economics theory, comparative health system research, and the WHO framework for health financing, the paper reviews the evidence on the relationship between financing arrangements and universal health coverage outcomes, and argues that achieving and sustaining universal coverage requires not only adequate revenue mobilisation but deliberate institutional design to ensure that pooling and purchasing arrangements serve equity and efficiency goals.
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