The Complexity of Public Health Finance

Financing is complex, involving many laws, market driving forces, available resources, and tradeoffs for policy makers—a short-term investment may have long-term impacts. There are many options to finance public services, each with their strengths and weaknesses. 

Securing adequate and sustainable financing for public health services has been a recurring topic in the media lately. Still, it has been a persistent, prevailing theme within the practice community for what seems like forever. It is an important topic because the strings involved and intentions behind different funding sources may have a massive impact on the services delivered.

But what is “public health finance,” and what does it mean to finance public health services?

Key Approaches to Financing Public Health

Financing is complex, involving many laws, market driving forces, available resources, and tradeoffs for policy makers—a short-term investment may have long-term impacts. There are many options to finance public services, each with their strengths and weaknesses. Most financing comes at a cost (eg, debt interest) and generally includes repayment rules to the financier or lender.¹

I divide my thinking into what may be considered traditional public financing, traditional private financing, and public-private partnerships, and then highlight select innovations that have benefitted other sectors.

Traditional Public Financing

Public financing balances political measures of success and leverages…