Global Health Systems and Emerging Markets

Every country has to answer the same three questions: how to raise money for healthcare, how to pool the risk, and how to pay the people and institutions that provide care. The answers differ enormously. The US spends ~17% of GDP on health, more than any other country and over 40% of all health spending in the world, through a mix of employer insurance, government programmes and out-of-pocket payments. The UK runs a tax-funded National Health Service. Germany and Japan run compulsory social insurance. India and Nigeria still finance a large share of care out of patients' pockets. Ghana built a national health insurance scheme funded largely by a sales levy, Rwanda reached near-universal coverage through community-based insurance, and China extended basic insurance to ~95% of its population in about a decade. For a healthcare company, the system determines who the buyer is, how prices are set and how fast anything new can spread. This section covers the main system models, how financing and provider payment work, profiles of the systems that matter most for business (the UK, Europe, Japan, Singapore, China, India, South Africa, Ghana, Nigeria, Kenya and Rwanda), mobile health and logistics innovation in Africa, cross-border companies, and how an expert thinks about entering a new health market.