Analyzing the Financial Sustainability of User Fee Removal Policies: A Rapid First Assessment Methodology with a Practical Application for Burkina Faso

Jacky Mathonnat (), Martine Audibert and Salam Belem
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Jacky Mathonnat: University Clermont Auvergne and FERDI (Fondation pour les Etudes et Recherches sur le Développement International)
Martine Audibert: University Clermont Auvergne, CERDI (Centre d’Etudes et de Recherches sur le Développement International)
Salam Belem: Ministry of Health

Applied Health Economics and Health Policy, 2020, vol. 18, issue 6, No 4, 767-780

Abstract: Abstract The purpose of this paper is to briefly present a methodological framework that does not require cumbersome investigations for a first assessment of the financial sustainability of policies aiming to remove or reduce healthcare user fees (the so-called free healthcare policy [FHCP]). This paper is organized in two main sections. The first analyzes the various possibilities available to finance an FHCP. Using several scenarios, it includes a special focus devoted to the calculus of what to consider when assessing the sustainability of expanding fiscal space for financing the FHCP. The second section relies on the current FHCP being implemented in Burkina Faso to illustrate a selection of specific issues raised in the methodological framework. The results suggest that sustainable FHCP financing is not outside the range of the government but does represent a significant challenge, as it will require, both currently and in the future, complex and delicate budget trade-offs at the highest governmental levels, regardless of other policy options to be considered.

Date: 2020
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DOI: 10.1007/s40258-019-00506-2

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