Fragmented by Design

Abstract

Like our society, our health system also remains fragmented. Fragmentation is linked to structural issues of the health system, like how care is financed and organised. Fragmentation at the level of health system design plays out in the daily lives of people who access healthcare in the form of high financial burden, incomplete care, and high levels of unmet health needs. An attempt has been made to study the key drivers of fragmentation across the three prominent models of pooled health financing across various domains. While government-funded health insurance (GFHI) is being promoted as the most appropriate mechanism to address health system fragmentation, evidence suggests that the current GFHIs remain ineffective, whereas government-financed and publicly provided and social health insurance demonstrate greater promise despite systemic weaknesses.