There is a wide range of ways to change the organizational incentive regime of health
services. In many Latin American countries, including Argentina and Brazil, decentralization
has led to a shift in decision-making control and often revenue rights and responsibilities
from central to lower levels of government. The devolution of central control to provinces
in Sri Lanka is another form of decentralization. The creation of semi-autonomous hospitals
in Indonesia shifted decision-making and control even further down the line to the
level of facilities. In Hungary, during the early 1990s, general practitioners were transformed
from civil servants into semi-autonomous practitioners on contract with local governments
and the newly created National Health Insurance Fund.