Common corruption risks in the health sector
2. Different types of systems: Health Financing
When it comes to financing, two characteristic features of the sector have been addressed: 1) Very large amounts of money are involved and 2) The payer is often not the receiver of services. While corruption can be observed across the world, a country’s particular vulnerability depends on how funds are mobilized, managed and paid. For this reason, it is useful to classify a health system into one of two broad categories depending on its institutional financing structure:
1) Systems in which the public sector finances and directly provides healthcare services.
2) Systems that separate public financing from service provision.
Ad 1) Direct public provision
The first, “direct public provision,” refers to a system that offers healthcare services at little to no cost at the time of service (e.g. Spain, Sweden). The most common way these systems are structured involves a Ministry of Health or its equivalent, which:
- Hires the necessary administrative, medical and support staff.
- Builds facilities.
- Organizes the purchase and distribution of medications, equipment, and supplies.