Session: 18

Health Seminar

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Summary

Social health insurance and private insurance both represent mechanisms which enable the burden of the direct cost of medical care for the individual to be spread, either over a period of time rather than having to be made at the time and point of delivery, and or among a group of protected people who share the risk of costs of medical care. On the other hand, health care issues cannot be addressed without some level of government involvement. This is the idea behind the need for health policy planning and implementation.

There is a considerable number of issues involved with this process; they are of different nature and present various technical and practical degrees of complexity. Nevertheless, all agree that funding is the chief issue. There are different ways of funding for health services: government financing through taxes, social insurance, private health insurance, and direct payment for services by patients. With the exception of the last, these systems all provide an element of insurance, i.e. risk pooling or risk sharing.

Actuaries have an important role to play in the process of policy-making and funding health services, regardless the specific techniques applied and the type of organization of health delivery.

This paper reviews recent experience in this field and makes some reflections about funding health services and the degree of the actuay's involvement in this process.

Member of the Association of Swiss Actuaries (Switzerland).

Alvaro Castro-Gutiérrez is an actuary from the University of Rome. Worked as actuary and chief actuary in private and social insurance organizations in Nicaragua and Costa Rica; he also lectured mathematics of finance, statistics and statistical inference in the national universities in both countries. 

He joined the Social Security Department of the International Labour Office (ILO) in 1973, where he took part in the Technical Co-operation Programme, both as an actuary and as social security expert. Technical and Actuarial adviser at the International Social Security Association (ISSA) from 1979-1990. 

Chief of the Benefits Branch of the ILO from 1991-1993. Since August 1993 is the General Manager of the Statistical and Actuarial Programmes and of the Regional Programme for the Americas of the ISSA. Since 1975 lectures at seminars and training courses of different international agencies, among others the ILO, ISSA, OECD and CIESS. Author of over 50 papers and research works. Director of ISSA interregional and high-level actuarial seminars. Member of the AFIR/ERM Section of IAA, of the Association of Swiss Actuaries (Actuary ASA) and of the Actuarial Institute of Argentina.