Towards Alternative Financing Proposals for Health Care for the Elderly with Chronic Conditions ? Jamaica

This is the final paper in a series of four which examines the results of a study on the impact of user fees on the demand for preventive health services in Jamaica. The paper examines policy options for user fees and mechanisms to bridge the gap between policy-makers and researchers, to ensure that research results could be more systematically used in policy decisions. The paper argues that fees did not improve the quality of health services offered. On the basis of the findings of the burden of costs, the paper recommends that the elderly with chronic diseases should not be required to pay user fees and that the cost of transportation in rural areas should be subsidised. These measures would involve a loss of income and the paper examines the extent of the loss and proposes alternative financing measures to recoup these losses. The process of consultation between researchers and policy-makers was overtaken by political events and while user fees in health were removed, the larger problem of the cost of transportation and drugs remains.