<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">Health</journal-id><journal-title-group><journal-title>Health</journal-title></journal-title-group><issn pub-type="epub">1949-4998</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/health.2018.101010</article-id><article-id pub-id-type="publisher-id">Health-82030</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  Why Are Risk-Pooling and Risk-Sharing Arrangements Necessary for Financing Healthcare and Improving Health Outcomes in Low and Lower Middle-Income Countries
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ali</surname><given-names>Ahangar</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ali</surname><given-names>Mohammad Ahmadi</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Amir</surname><given-names>Hossein Mozayani Mozayani</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sajjad</surname><given-names>Faraji Dizaji</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>School of Economics and Management, Tarbiat Modarres University (TMU), Tehran, Iran</addr-line></aff><aff id="aff3"><addr-line>Department of Economic Development and Planning, School of Economics and Management, Tarbiat Modarres University (TMU), Tehran, Iran</addr-line></aff><aff id="aff2"><addr-line>Economic Research Center (ERC), Tarbiat Modarres University (TMU), Tehran, Iran</addr-line></aff><author-notes><corresp id="cor1">* E-mail:<email>ali_ahangar51@yahoo.com(AA)</email>;<email>aahmadi@modares.ac.ir(AMA)</email>;</corresp></author-notes><pub-date pub-type="epub"><day>03</day><month>01</month><year>2018</year></pub-date><volume>10</volume><issue>01</issue><fpage>122</fpage><lpage>131</lpage><history><date date-type="received"><day>2,</day>	<month>December</month>	<year>2017</year></date><date date-type="rev-recd"><day>23,</day>	<month>January</month>	<year>2018</year>	</date><date date-type="accepted"><day>26,</day>	<month>January</month>	<year>2018</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Health is important to economic development, and economic development has an important impact on health outcomes. Health Expenditure makes up a substantial part of the global economy. In the world, the costs of healthcare are increasing; patients are compelled to pay more for treatment, and that makes a lot of people faced to Catastrophic Health Expenditures (CHE) and in long run fall below the poverty line. One of the most urgent and vexing challenges faced by many low- and middle-income countries is how to provide health care for the more than two billion poor people who live in these areas (developing countries). As much as more than 65% (in 2014) of total private health care expenditure in low-income countries comes from out-of-pocket payment by patients. In addition, according to World Bank report (2007), in low and lower middle-income countries was speared nearly 13% of global health spending with 87% the global disease burden. The WHO considers health financing models with high risk pooled, such as health insurance and prepaid schemes, a promising means for achieving universal health-care coverage and promotion health care. A crucial concept in health financing is that of pooling. The WHO defines risk-pooling as the “accumulation and management of revenues in such a way as to ensure that the risk of having to pay for health care is borne by all members of the pool and not by each contributor individually”. The larger degree of pooling, the less people will have to bear the health financial risks. Furthermore, adopting and operating financing policies based on greeter risk pooling/sharing (prepayments) are recommended to all countries (especially in low and lower-middle income countries). It means risk sharing/pooling plays a key role in all financing systems for achieving effectiveness and efficiency health systems.
 
</p></abstract><kwd-group><kwd>Risk Pooling</kwd><kwd> Risk Sharing</kwd><kwd> Health Care Financing</kwd><kwd> Health Economics</kwd><kwd> Low and Middle Income</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>Financial Support and Sponsorship</title><p>This study was approved and scientifically supported by the Tarbiat Modarres University (TMU), Tehran, Iran.</p></sec><sec id="s2"><title>Conflict of Interests</title><p>The authors declare that there is no conflict of interests.</p></sec><sec id="s3"><title>Biography</title><p>Ahangar A. (PhD Candidate in Health Economics, School of Economics and Management); Ahmadi A.A. (Corresponding Author, Assistant Professor, PhD, Economic Research Center (ERC); Mozayani A.H. (Associate Professor, PhD, Economic Research Center (ERC); Faraji Dizaji S. (Assistant Professor, PhD, School of Economics and Management), Tarbiat Modarres University (TMU), Tehran, Iran.</p></sec><sec id="s4"><title>Cite this paper</title><p>Ahangar, A., Ahmadi, A.M., Mozayani, A.H. and Faraji Dizaji, S. (2018) Why Are Risk-Pooling and Risk-Sharing Arrangements Necessary for Financing Healthcare and Improving Health Outcomes in Low and Lower Middle-In- come Countries. Health, 10, 122-131. https://doi.org/10.4236/health.2018.101010</p></sec></body><back><ref-list><title>References</title><ref id="scirp.82030-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Ahangar, A., Ahmadi, A.M., Mozayani, A.H. and Faraji Dizaji, S. (2018) Transition of Health Financing Models and Cost Risk Sharing in the Health Sector: A Systematic Review. Iranian Red Crescent Medical Journal. (In Publishing)</mixed-citation></ref><ref id="scirp.82030-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Shigeoka, H. 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