Private and public financing

Mixed health systems (public and private) are the norm, and finding the right balance between public and private service delivery (including support functions) is critical to achieving the best health outcomes.

The government’s role in stewardship and management of the mixed health system is critical; this means that those in government need to recognise the importance of the private sector and understand how this sector can be harnessed to provide benefits to health outcomes of the country, and even strengthen the public sector. Having said this, because health care is a public good, ultimate responsibility for delivery must rest with the government, and given the importance of equity in health systems, most governments should aim to finance most health care through progressive taxation. Other generally agreed aims to promote equity and move to universal health coverage are having a total health expenditure at least 5% of gross domestic product; keeping out-of-pocket spending below 20% of total health expenditure and aiming for 15% of total government expenditure to be on health.

Below, in the “Downloads” section, you will find a PDF titled “Supply and Demand” which contains a graphic from our presentation that lists on one side the “market players” and on the other side “supporting functions”. Consider this graphic and reflect on each of the items listed as they apply in a country with which you are familiar.