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Jamaica - Health sector review : present status and future options (Inglês)

Jamaica's health indicators are generally more favorable than those of other countries in the Latin American and Caribbean region at similar levels of income. Over the last 25 years there has been a progressive improvement in both an aging population due to declining fertility and mortality, and changes in risks attributable to urbanization, industrialization and lifestyles. The Government is now at a critical juncture in health sector policy. The Jamaican public health system is presently overextended. Despite the major involvement of the private sector, the government still attempts to finance and provide the full range of health care services - inpatient and outpatient - through a large system of public infrastructure without the means to support its effective functioning. Yet the large and growing share of chronic illnesses in Jamaica's disease profile, combined with public financing of most inpatient care, is a time bomb of costs that will eventually force the government to make choices about how much and what kind of care it can afford, and for whom. The choice for government is whether it should continue attempting to finance and provide the full range of health services - of questionable quality and access - or decide to prioritize and ration the services to be financed publicly and leave the remainder to private means. Jamaica is not alone in grappling with this issue. Countries around the world - both developed and developing - are reforming their health care systems. The major issues facing policy makers involved in health sector reform revolve around the complex related questions of access to and quality of health services, who provides them and who pays for them. While the issues are similar, there is a wide diversity in the organization and financing strategies that have evolved. No one strategy fits all countries. The report draws on the experience of other countries, notably the United States and in Europe, in presenting alternatives for financing and providing health care.

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