Level Of Cost Recovery Research Articles

New approaches for aid agencies; FUPROVI's community based shelter programme

New approaches for aid agencies; FUPROVI's community based shelter programme describes the work of a Costa Rican NGO which has pioneered new ways to work with low-income households in mobilizing resources for building or improving housing, working in participatory ways and achieving high levels of cost recovery. It also discusses what this programme implies for development assistance in other parts of Latin America.

Health insurance and private providers: A study of the civil servants' medical benefit scheme in bangkok, Thailand

AbstractCompulsory health insurance schemes have received attention recently as a means of creating a reliable extra‐budgetary source of health care funding. Yet, the full implications of such schemes in a developing country context are unclear; in particular, the impact on and relationship with private sector providers has infrequently been explored. This study examines patterns of public and private sector utilization under the Civil Servants' Medical Benefit Scheme (CSMBS) in Bangkok, Thailand. The CSMBS currently provides limited reimbursement for private inpatient care, but recent proposals suggest increasing benefit levels for care sought in the private sector. The study shows that despite high level of cost recovery in the public sector, charges were much lower than those in the private sector. Different patterns of diagnosis in the two sectors were found with private hospitals tending to treat a less complex case mix. Within the private sector, there was a limited tendency to specialize in certain types of care. It is concluded that under the current payment mechanism of fee‐for‐service reimbursement, measures to enhance access to private sector care should be approached with caution. In the long run, the scheme should merge with the recently established social security scheme.

Cost Recovery in Family Planning

Recovering costs has almost never been an objective of publicly sponsored family-planning programs. Most family-planning programs in LDCs have aimed at low-income couples who could not afford or did not have access to private-sector options. Even contraceptive socialmarketing projects have avoided cost recovery, aiming instead at establishing prices that ensure sufficient incentives for distributors and are in line with similar purchases of low-income families. Deteriorating economic conditions combined with a growing demand for contraceptives are forcing governments to reconsider the nature and scope of their subsidized service-delivery programs. Government-sponsored family-planning programs are being required to make choices regarding whom they subsidize and by how much. Their choices are to accept the reduction in funding or seek alternative sources of revenues through donor support, borrowing at commercial rates, or seeking some level of cost recovery from users. This article is concerned with the cost-recovery option. Recovering some portion of program costs has decided benefits: government subsidies can be reduced, the number of contraceptive outlets can be increased, and the quality of services could well improve if worker salaries are tied to client expenditures and, therefore, their satisfaction. There are costs to cost recovery as well, notably, fee collection and handling costs, and possible negative effects on familyplanning use among those unable to afford even modest charges. These issues are discussed further below, and it is important to keep them in mind, since they impinge so directly on the cost effectiveness and therefore on the desirability of cost-recovery efforts. This article uses a simple demand-and-supply framework to address the major topic touched on above. The next section sets out the conceptual framework. Following this, the prices consumers face, the affordability of those prices for the average consumer, and consumer willingness to pay for family-planning services are discussed. Subse

THE IMPACTS OF WATERWAY USER FEES ON GRAIN TRANSPORTATION ON THE SNAKE‐COLUMBIA RIVER1

ABSTRACT: Grain transportation is a major economic activity on the multiple use Snake‐Columbia River System. Congress is currently considering increased transportation user fees aimed at recapturing federal expenditures for waterway operations and maintenance. Three types of fee structure and four levels of cost recovery are evaluated using a network program model. In each case traffic is diverted away from the river to other Puget Sound ports via truck and rail transport modes. Grain shippers in the region will be adversely affected by a higher transport bill. The Lower Columbia River port economic activities will be negatively affected; however, competitive uses of the river, recreation, and hydroelectric generation will likely benefit modestly.