Current challenges in delivering social security health insurance
|
|
- Edith Rich
- 8 years ago
- Views:
Transcription
1 International Social Security Association Afric ISSA Meeting of Directors of Social Security Organizations in Asia and the Pacific Seoul, Republic of Korea, 9-11 November 2005 Current challenges in delivering social security health insurance Current needs and challenges in delivering social health insurance in Asia and the Pacific Mr. Regional Adviser in Health Care Financing WHO Regional Office for Western Pacific Philippines ISSA/ASIAPACIFIC/DM/SEOUL/1-WHO
2 Current challenges in delivering social security health insurance Current needs and challenges in delivering social health insurance in Asia and the Pacific Regional Adviser in Health Care Financing WHO Regional Office for Western Pacific Philippines Introduction Today, many countries in Asia and the Pacific are struggling to ensure large population access to appropriate health services. The policy objectives to reach broad and universal access require equitable and effective health financing arrangements affordable by all population segments. The Fifty-Seventh World Health Assembly held in May 2005 adopted the resolution that supports universal coverage through general taxation and social health insurance. The Fifty-Sixth Session of the WHO Regional Committee for Western Pacific held in September 2005 endorsed the Strategy on Health Care Financing for Countries of South East Asia and Western Pacific. The strategy provides the framework for increased health investment and effective health spending with greater access, coverage and equity that contribute to the attainment of national and international health goals and objectives such as the Millennium Development Goals (MDG). Through these policy and strategic documents, WHO advocates prepayment health care financing arrangements in the form of general taxation and social health insurance that share risks and pool funds among the population. The Asia and Pacific region has good experience in practicing social health insurance based upon the principles of social solidarity. Some countries such as Japan and the Republic of Korea have achieved universal coverage under compulsory social health insurance. Other countries such as China, India, Indonesia, Mongolia, Philippines, Thailand and Vietnam have introduced social health insurance for the formal sectors and the coverage is now gradually expanding to the informal sector. Interest in social health insurance is on the rise for many other countries such as Cambodia, Federated States of Micronesia, Fiji, Lao PDR, Papua New Guinea, Samoa, Tonga and Vanuatu.
3 2 Regional experience and evidence show that social health insurance is an attractive and feasible option for low and middle-income countries, if it is appropriately designed. Strong political commitment and government support are necessary conditions for the successful operation of social health insurance. But there are some challenges that countries face in the process of developing and delivering an effective social health insurance mechanism. This paper addresses the main challenges in the extension of coverage under social health insurance in Asia and the Pacific. Description of the situation Developing health systems that assure equitable access to health care for all citizens is one of the most important policy objectives in Asia and the Pacific. The attainment of this policy objective largely depends upon the adequacy, affordability and sustainability of health system financing. The best available evidence shows that health systems, which are mainly funded by private sources, do not ensure equitable access to health services, particularly for the poor and vulnerable. On the other hand, when health systems are funded through general taxation or social health insurance arrangements, there is a greater chance of equity in financing and service delivery. Today, most developing countries in the region need additional financial resources to ensure necessary access and coverage for their population. Social health insurance is one of the options to increase financial resources for health through equitable and affordable contributions. Many experts also agree that social health insurance has a big potential to translate out-of-pocket payments to prepayment. In recent years, social health insurance, because of its potentials in contributing to universal coverage, financial protection, access and equity in financing and delivering health services, has gained more attention in this region. There is an increasing awareness that, as part of a broader social security framework, social health insurance can provide greater financial protection, adequate coverage and equitable access to health services. Addressing equity, access, and coverage is a critically important issue to protect and improve the health status of the people, especially for the poor and vulnerable living in Asia and the Pacific. Today more than one-third of the world s 1.3 billion absolute poor people live in Asia. Health care cost is one of the major contributing factors to the increase in poverty in Asia. Evidence shows that when available health services are expensive at the point of delivery and there is inadequate financial protection, the cost of illness pushes many low-income and vulnerable people into deep poverty. Even modestly charged health services may lead to catastrophic expenses 1 if the frequency of their use is sufficiently high. 1 Catastrophic spending is defined as being 40 per cent or more of a household s effective income, net of subsistence (food) expenditure.
4 3 Recent national health accounts (NHA) data estimate that Asians pay for services more than anyone else compared to other regions. Health systems in most developing and low-income countries in the region heavily rely on out-of-pocket payments, which account for almost per cent of their total health financing. As a result, the highest incidence of catastrophic health spending with large poverty impact is increasingly occurring in Asia and the Pacific. Some studies show that about 100 million people were pushed into poverty in Asia because of the poor health status and cost of illness. The WHO Commission Report on Health and Macroeconomics (CMH) urged all countries and international communities to consolidate their efforts to halve poverty by 2010 by enhancing health investments and public health spending towards scaling up essential health interventions with large impact on improving the health status of the poor and vulnerable. Despite the variety of financing resources, the level of available health resources in the region is relatively low. Many countries spend less than 5 per cent of their GDP on health. Economic constraints often limit the amount of health care available to a population because health care is becoming more expensive both in developed and developing countries. However, to achieve important health goals and objectives, low-income and developing countries need to mobilize additional resources. The CMH policy recommendations for low-income developing countries to increase government spending on health by 1 per cent of GDP by 2007 is an important target to ensure additional financial resources are made available for scaling up pro-poor health interventions. As mentioned earlier, social health insurance is included in policy level discussions in a number of countries as a potential alternative source of financing that provides equitable access to needed health services regardless of the degree of health risks and the amount of contribution. This allows the insured members to pay health insurance premiums to the common pool according to their income, but use the necessary health services according to their needs. However, there are several challenges in delivering and enhancing effective social health insurance coverage among all population segments. Country specific experiences, practices and evidence, the common challenges that limit adequate social health insurance coverage across different population groups are discussed below. Issues and challenges There are several issues and challenges in the extension of social health insurance coverage in Asia and the Pacific. Currently, few countries in Asia and the Pacific have reached universal coverage through social health insurance or prepayment mechanisms. Several low and middle-income developing countries have introduced social health insurance in recent years, but their coverage is still low. It means that the majority of the population in Asia and the Pacific are still not covered adequately by social safety nets for health. Most of the schemes are in the early stages of development. Their main challenge is the extension of coverage to various
5 4 population segments which are currently excluded from the coverage of existing schemes. The largest population segment excluded from social health insurance coverage and benefit is the rural population and other self-employed people running various smallscale family businesses. Almost all countries, which have introduced social health insurance in the past, initially started it for the salaried sector, including civil servants. It is clear that many important features of the registered and organized labour force such as stable and predictable salary income facilitated the process of designing and implementing social health insurance in the formal sector. Today, several countries have reached near universal coverage for the formal but coverage is still inadequate because the formal sector comprises only a small fraction of the total labour force. Another excluded population segment are family dependants. Currently, many social health insurance schemes in low-income developing countries exclude family dependants of the insured individual. In most cases, the dependants such as the non-working spouse, children and elderly, are recognized as vulnerable and inactive economically. In reality, many women reach old age without having worked at all and the only health insurance coverage for them is through their economically active spouses. Experience, therefore, shows that health insurance coverage and benefit provision of the contributing members do not adequately support the policy objective of universal coverage and population health improvement at large. Some governments policies provide for free or subsidized health care to children and the aged in public health facilities, but because of weak regulation and lack of government budget, such services do not always reach the target population. In this regard, some countries have begun to discuss the possible shift of health insurance unit from a paying member to the family. This policy shift will definitely contribute to broad coverage and benefit provision not only for the insured members, but also for their legal family dependants. The third important population segment excluded from any type of health insurance are the poor and low-income people. The poor people have greater need for health services, but they demand less because of many barriers and limitations. Currently, no country uses health insurance as the main mode of delivery of health service for the poor and vulnerable. But health insurance has a good potential to cover and provide at least the basic health services through effective cross subsidy between the rich and poor. There are some good experiences which show that premium subsidy for the poor and low-income population largely increases health insurance coverage among the poor and the low-income population group. Such insurance coverage allows the poor and low-income people to have access to health services when they get sick or seek consultations in public health facilities without significant financial barriers. It is a very important policy direction for low-income developing countries as long as they recognize the importance of population health improvement and financial protection in their poverty alleviation efforts, which contribute largely to their socio-economic development. The full inclusion of the high-income population group into the common pool will also broaden the potential to cover the poor and vulnerable. The inclusion of higher paid and more educated workers also can increase the pressure on health insurance
6 5 management to improve the quality of the benefits and transparency in fund management. But many countries still struggle with the situation where most private sector employees and even better-paying public sector workers largely remain outside the social health insurance schemes. Likewise, there are several other issues such as weak regulatory framework, fragmented administration, low premium contribution, poor compliance, and limited portability of coverage that countries need to address in order to achieve adequate and effective coverage among all population. Policy and decision makers are exerting efforts to identify and address these challenges through building up appropriate technical capacity, legislative, financial and administrative structures suited to country specific situations. In the end, it will lead to universal coverage where the whole population is granted with equitable access to necessary health services that would effectively respond to population health needs and improvements at large and contribute to many important national and international health development goals such as MDG. Recent and future reforms Recent and future reform measures towards enhancing the coverage of social health insurance in Asia and the Pacific need to answer several important policy questions. One of them is whether social health insurance is feasible for low-income developing countries. Mongolia s health care reform might be an interesting example to cite. Today, the Mongolian health care system continues to persist against the economic hardship caused by the fundamental socio-economic reforms. Low income, low population density, existence of a large informal sector including nomads, a high dependency ratio and newly emerging social problems such as unemployment and poverty led to multidimensional needs in reforming health care finance. Mongolia introduced social health insurance in 1993 and the whole development process has had successes, failures and challenges. However, appropriate policy measures played a critical role in the establishment of a social health insurance scheme as a new funding source. High government commitment and targeted subsidies ensured near universal coverage in a short period of time. Currently, almost 80 per cent of the population is covered by social health insurance. Under health insurance, individuals are relatively well-protected from high financial burdens related to medical care costs including catastrophic illnesses. Analysis of the achievements and challenges of social health insurance development in Mongolia may contribute to the discussion on many important aspects of social health insurance development including the issue of whether a developing and lowincome country can commit to universal coverage through a contributory prepayment mechanism under the given conditions. Mongolia s experience suggests that it is feasible if there is high political commitment and financial support for the low-income and vulnerable population groups. Another related policy question would be likely where universal coverage is achievable when the labour force has a large informal sector. It is expected that the informal sector will continue to play a major role in economic development in many developing countries in Asia and the Pacific. As regards to universal coverage, two main tendencies of social health insurance development are observed in the region.
7 6 First, some countries pursue health care financing reform to support broad population coverage through the existing social insurance schemes. In such situations, the overall intention is to increase the contribution base through enforcement of registration of small businesses, including self-employed entrepreneurial activities of vendors or service providers. At a policy level, it is intended to achieve universal coverage through a single national scheme that covers both the formal and informal sectors. The second tendency is that some countries with large informal sectors are initiating innovative approaches to develop community-based health insurance pilot schemes or other social safety net approaches exclusively for the informal sector. This is mainly due to the challenges in extending coverage to the informal sector, slow progress in expansion, poor quality of services, inadequate budgetary financing, unmet health demand and needs of the people engaged in the informal economies. There are also some other reasons linked to the management capacity of the social health insurance schemes to diversify its operation to remote provinces and rural settlements. Concerns with the links between poverty and health have also demonstrated the necessity to provide access to health care for the poor and vulnerable living in rural provinces and communities. In many cases, effective and equitable health care financing options such as community or micro health insurance schemes are seen as a feasible way to make services available while at the same time, to provide financial protection for the poor and vulnerable. Ongoing health care financing reforms also demonstrate their potentials to be both pro-poor and effective to combat poverty caused by sickness. But evidence shows that the key factor in the coverage of the low-income, self-employed and informal sector is the subsidization of their contributions by government. Experiences show that it is reasonable to develop social health insurance schemes for the formal and informal sector populations, through a national approach, or through a parallel approach, promoting compulsory social security schemes for the salaried population and community health insurance schemes for the rest of the population. In both cases, the major issues influencing enrolment and sustained membership by the informal sector is the affordability of contributions, with the family as the unit of coverage, flexibility in collection and a balanced range of health care benefits. But the formal commitment by government to support the poor and other vulnerable populations is critically important to ensure that all population segments are covered under such schemes. Another essential factor to reach universal coverage is good governance. Revenues from contributions are dependent on honest reporting of salaries by employers and income or assets in the case of the self-employed, and these are dependent on governance. The next important question can be whether specific provider payment methods have any impact on increasing the potential for the extension of coverage. Despite the tight controls that are imposed on the levels of income of providers, fee-for-service has remained the preferred method for providers in most countries in the region.
8 7 The social health insurance schemes, however, are keen to shift to other mechanisms, such as more case payment and capitation. The capitation method, which facilitates cost control and requires a less complex and less costly billing system, has therefore been adopted by several new social health insurance schemes. Finally, many countries well recognize that the efforts to reach the critical mass of coverage through social health insurance require good coordination and regulation that would ensure the optimal spread of risks and pooling of funds through the principles of solidarity by the sharing of interest between all population segments. Universal coverage cannot be reached without a sound legislative base and regulation and without reaching a broad consensus on social health insurance development and operational principles or without effective translation of long-term policy commitments into concrete actions. Available knowledge, expertise, best practices and experiences across countries and regions will help to identify the issues and challenges, to achieve universal coverage in a given socioeconomic situation. Conclusion Health care is becoming more expensive both in developed and developing countries in Asia and the Pacific. Lack of public financing, extensive use of various cost recovery and cost sharing initiatives, and out-of-pocket payments are beginning to play a dominant role in total health care financing in most low-income developing countries in the region. Even modestly charged service fees in public health facilities lead to catastrophic health expenses because of poor regulation and monitoring user fees. Such private payments create equity concerns in accessing health services if there are inadequate financial protection or social safety mechanisms. Health services are available only to those who can afford to pay or those who are covered by health insurance. The last, and the most preferred option, contributes to equity and access among large population because of the risk sharing and fund pooling potentials. Broad population coverage under social health insurance is a critical issue in delivering social health insurance. But several challenges exist. Even though social health insurance have been introduced in a number of countries in the region, large population segments such as informal sector employees, self-employed workers, family dependants, the poor and vulnerable are still excluded from the existing social health insurance schemes. Ensuring universal coverage under social health insurance is necessary for many low-income countries to achieve many important national and international health goals such as the MDG. But the existing challenges require more innovative approaches and action that would lead to gradual extension of health insurance coverage and benefit through effective regulatory and management mechanisms.
9 8 References Dennis Dreshsleri and Johannes P. Juttingii. March Private health insurance in low and middle-income developing countries: Scope, limitations and policy responses. OCED Development Centre. Health and Poverty Reduction: The Approaches of WHO's Western Pacific Regional Office, November Social Health Insurance: Selected case studies from Asia and the Pacific. March World Health Organization's Regional Offices for Western Pacific and South East Asia. Strategy on health care financing for countries of South East Asia and Western Pacific, WHO Regional Office for Western Pacific and South East Asia, September Van Doorslaer, E., O., O'Donnell, Rannan-Eliya, R.P., Somanathan, A., et al. March Paying out of pocket for health care in Asia: catastrophic and poverty impact, EQUITAP Project working paper #2. World Health Assembly Resolution, WHA58.33, May World Health Organization's Commission Report: Macroeconomics and Health, November World Health Organization's Regional Committee Resolution, WPR/RC56.R13, September World Health Report Annex Table, May 2005.
The Evolution and Future of Social Security in Africa: An Actuarial Perspective
w w w. I C A 2 0 1 4. o r g The Evolution and Future of Social Security in Africa: An Actuarial Perspective Presented by Members of the Actuarial Society of South Africa Social Security Committee Fatima
More informationColombia REACHING THE POOR WITH HEALTH SERVICES. Using Proxy-Means Testing to Expand Health Insurance for the Poor. Differences between Rich and Poor
REACHING THE POOR WITH HEALTH SERVICES 27 Colombia Using Proxy-Means Testing to Expand Health Insurance for the Poor Colombia s poor now stand a chance of holding off financial catastrophe when felled
More informationUniversal Health Coverage: Concepts and Principles. David B Evans, Director Health Systems Financing
Universal Health Coverage: Concepts and Principles David B Evans, Director Health Systems Financing Outline Universal Coverage: definitions and the state of the world Health financing systems for Universal
More informationComparisons of Health Expenditure in 3 Pacific Island Countries using National Health Accounts
Comparisons of Health Expenditure in 3 Pacific Island Countries using National Health Accounts Hopkins Sandra* Irava Wayne. ** Kei Tin Yiu*** *Dr Sandra Hopkins PhD Director, Centre for International Health,
More informationIslamic Republic of Afghanistan Ministry of Public Health. Contents. Health Financing Policy 2012 2020
Islamic Republic of Afghanistan Ministry of Public Health Contents Health Financing Policy 2012 2020 Table of Content 1. Introduction 1 1.1 Brief County Profile 1 1.2 Health Status Data 1 1.3 Sources
More informationSocial Protection in ASEAN Policy gaps and common challenges. Cheng Boon Ong 17 November 2014, Bangkok
Social Protection in ASEAN Policy gaps and common challenges Cheng Boon Ong 17 November 2014, Bangkok Methodology ABND for 7 Member States: Vietnam 2010-2011 Cambodia 2011-2012 Indonesia 2011-2012 Thailand
More informationQuestions and Answers on Universal Health Coverage and the post-2015 Framework
Questions and Answers on Universal Health Coverage and the post-2015 Framework How does universal health coverage contribute to sustainable development? Universal health coverage (UHC) has a direct impact
More information3. Financing. 3.1 Section summary. 3.2 Health expenditure
3. Financing 3.1 Section summary Malaysia s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded through
More informationHealthcare Reform: Opportunity for Public-Private-Partnership
Healthcare Reform: Opportunity for Public-Private-Partnership Sam Yeung Munich Re Session Number: MBR7 Joint IACA, IAAHS and PBSS Colloquium in Hong Kong www.actuaries.org/hongkong2012/ HEALTHCARE REFORM:
More informationOverview of East Asia Infrastructure Trends and Challenges
Overview of East Asia Infrastructure Trends and Challenges Christian Delvoie. Director, Knowledge Strategy Group, The World Bank Until September 28: Director, Sustainable Development, East Asia and Pacific
More informationTOWARDS UNIVERSAL HEALTHCARE COVERAGE LESSONS FROM THE HEALTH EQUITY & FINANCIAL PROTECTION IN ASIA PROJECT
TOWARDS UNIVERSAL HEALTHCARE COVERAGE LESSONS FROM THE HEALTH EQUITY & FINANCIAL PROTECTION IN ASIA PROJECT Eddy van Doorslaer Institute for Health Policy & Management & School of Economics Erasmus University
More informationWorld Social Protection Report 2014/15
UNDER EMBARGO until June 3 at 00:01 GMT World Social Protection Report 2014/15 Executive summary Social protection policies play a critical role in realizing the human right to social security for all,
More informationILO-RAS/NET/Vanuatu/R.2. Vanuatu. Report on the implementation of the Health Insurance Scheme in Vanuatu
ILO-RAS/NET/Vanuatu/R.2 Vanuatu Report on the implementation of the Health Insurance Scheme in Vanuatu International Labour Office, 2006 Contents 1. Introduction 3 2. Background: Health expenditure in
More informationHEALTH INSURANCE IN VIETNAM: HEALTH CARE REFORM IN A POST-SOCIALIST CONTEXT
HEALTH INSURANCE IN VIETNAM: HEALTH CARE REFORM IN A POST-SOCIALIST CONTEXT By Amy Dao, Columbia University Vietnam s economic and social reform program in 1986 called Đổi Mới (Renovation) signaled the
More informationDevelopment of Health Insurance Scheme for the Rural Population in China
Development of Health Insurance Scheme for the Rural Population in China Meng Qingyue China Center for Health Development Studies Peking University DPO Conference, NayPyiTaw, Feb 15, 2012 China has experienced
More informationGoal 2: Achieve Universal Primary Education
92 Goal 2: Achieve Universal Primary Education In eight economies in the region including a number from the Pacific, total net enrollment ratios in primary education are below 80%. Eleven economies including
More informationNational Health Insurance Policy 2013
National Health Insurance Policy 2013 1. Background The Interim Constitution of Nepal 2007 provides for free basic health care as a fundamental right of citizens. Accordingly, the Government of Nepal has
More informationNumber 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE
Number 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE Every year, more than 150 million individuals in 44 million households face financial catastrophe as a direct
More informationJoseph E. Zveglich, Jr.
Joseph E. Zveglich, Jr. Assistant Chief Economist, Asian Development Bank 1 Overseas Development Institute London, 12 April 2012 Key messages Developing Asia to maintain growth momentum despite weak global
More informationHealth insurance for the rural poor?
Health insurance for the rural poor? For most people living in developing countries health insurance is an unknown word. It is generally assumed that, with the exception of the upper classes, people cannot
More informationINDONESIA: PROVIDING HEALTH INSURANCE FOR THE POOR
SERIES: SOCIAL SECURITY EXTENSION INITATIVES IN SOUTH EAST ASIA INDONESIA: PROVIDING HEALTH INSURANCE FOR THE POOR ILO Subregional Office for South East Asia Decent Work for All Asian Decent Work Decade
More informationPrivate Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff
Private Health Insurance Options in Egypt Discussion with EISA Chairman and senior staff Ibrahim Shehata April 27, 2006 Background Health expenditure is dominated by household direct out-ofpocket payments
More informationCOUNTRY CASE STUDIES TAX AND INSURANCE FUNDING FOR HEALTH SYSTEMS FACILITATOR S NOTES. Prepared by: Health Economics Unit, University of Cape Town
COUNTRY CASE STUDIES TAX AND INSURANCE FUNDING FOR HEALTH SYSTEMS FACILITATOR S NOTES Prepared by: Health Economics Unit, University of Cape Town Preparation of this material was funded through a grant
More informationVOLUNTARY HEALTH INSURANCE FOR RURAL INDIA* GYAN SINGH** ABSTRACT
Health and Population - Perspectives and Issues 24(2): 80-87, 2001 VOLUNTARY HEALTH INSURANCE FOR RURAL INDIA* GYAN SINGH** ABSTRACT The rural poor suffer from illness are mainly utilising costly health
More informationSummary. Developing with Jobs
Do not publish or DiStribute before 00:01 Gmt on tuesday 27 may 2014 Summary Developing with Jobs World of Work Report 2014 Developing with jobs Executive Summary INTERNATIONAL LABOUR ORGANIZATION RESEARCH
More informationInput to the Secretary General s report on technology transfer mechanisms. Economic and Social Commission for Asia and the Pacific (ESCAP)
Input to the Secretary General s report on technology transfer mechanisms Economic and Social Commission for Asia and the Pacific (ESCAP) I. Functions, format and working methods Technology transfer may
More informationThe Cypriot Pension System: Adequacy and Sustainability
Cyprus Economic Policy Review, Vol. 6, No. 2, pp. 49-58 (2012) 1450-4561 49 The Cypriot Pension System: Adequacy and Sustainability Philippos Mannaris Aon Hewitt Abstract The fundamental objective of pension
More informationIntroduction to Universal Health Coverage and Financing
Introduction to Universal Health Coverage and Financing Awad MATARIA, PhD Health Economist World Health Organization Eastern-Mediterranean Regional Office Regional Workshop on Cost-Effectiveness Analysis:
More informationChild Survival and Equity: A Global Overview
Child Survival and Equity: A Global Overview Abdelmajid Tibouti, Ph.D. Senior Adviser UNICEF New York Consultation on Equity in Access to Quality Health Care For Women and Children 7 11 April 2008 Halong
More informationMedical Insurance for the Poor: impact on access and affordability of health services in Georgia
Medical Insurance for the Poor: impact on access and affordability of health services in Georgia The health care in Georgia is currently affordable for very rich and very poor Key informant Key Messages:
More informationSocial Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman
Social Health Insurance In Three Asian Countries: China, Thailand and Vietnam 1 July 2014 Roli Talampas Asian Center UP Diliman Outline Objectives & Questions Framework Methods Findings Summary Objectives
More informationCollecting revenue, pooling risk, and purchasing services
2 Collecting revenue, pooling risk, and purchasing services Countries need to mobilize sufficient resources to provide essential health services for their populations, reduce inequalities in the ability
More informationUNITED NATIONS Economic and Social Commission for Asia and the Pacific 53 member States 9 associate members
UNITED NATIONS Economic and Social Commission for Asia and the Pacific 53 member States 9 associate members South and South-West Asia Afghanistan Bangladesh Bhutan India Iran Maldives Nepal Pakistan Sri
More informationAssessment of Social Health Insurance Feasibility and Desirability in Fiji
Assessment of Social Health Insurance Feasibility and Desirability in Fiji Ravi P. Rannan-Eliya Wayne Irava Shanaz Saleem June 2013 2 Acknowledgements This report was prepared by WHO consultants Ravi P.
More informationPension schemes are integral parts of China s social protection system
Dewen Wang World Bank March 26-27, 2014, Incheon, Republic of Korea Pension schemes are integral parts of China s social protection system SP programs Social Insurance Social Assistance Social Welfare
More informationShaping national health financing systems: can micro-banking contribute?
Shaping national health financing systems: can micro-banking contribute? Varatharajan Durairaj, Sidhartha R. Sinha, David B. Evans and Guy Carrin World Health Report (2010) Background Paper, 22 HEALTH
More informationCOMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS
EUROPEAN COMMISSION Brussels, 20.8.2012 COM(2012) 446 final COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE
More informationSingle Payer Systems: Equity in Access to Care
Single Payer Systems: Equity in Access to Care Lynn A. Blewett University of Minnesota, School of Public Health The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform Journal of
More informationWorld Health Organization 2009
World Health Organization 2009 This document is not a formal publication of the World Health Organization (WHO), and all rights are reserved by the Organization. The document may, however, be freely reviewed,
More informationHow To Promote Private Health Insurance In Korea
Institute for Economic Research and Policy Consulting in Ukraine German Advisory Group on Economic Reform Reytarska 8/5-A, 01034 Kyiv, Tel. (+38044) 278-6342, 278-6360, Fax 278-6336 E-mail: institute@ier.kiev.ua,
More informationNATIONAL TREASURY STRATEGIC PLAN 2011/14
NATIONAL TREASURY STRATEGIC PLAN 2011/14 PRESENTATION TO PARLIAMENTARY FINANCE COMMITTEES Presenter: Lungisa Fuzile Director General, National Treasury 31 May 2011 TREASURY AIMS AND OBJECTIVES Chapter
More informationHow To Help The World
The World We Want A North-East Asian Youth Vision This Declaration was handed to His Excellency Kim Sung-hwan, Minister of Foreign Affairs and Trade of the Republic of Korea, in Seoul on 9 th of January
More informationIntroduction of a national health insurance scheme
International Social Security Association Meeting of Directors of Social Security Organizations in the English-speaking Caribbean Tortola, British Virgin Islands, 4-6 July 2005 Introduction of a national
More informationSocial protection for migrant workers: ILO s approach and ASEAN perspective
Social protection for migrant workers: ILO s approach and ASEAN perspective Loveleen De, ILO Presented at the Asian Conference on Globalization and Labor Administration: Cross-Border Labor Mobility, Social
More informationConceptual frameworks, health financing data and assessing performance: A stock-take of tools for health financing analysis in the Asia-Pacific region
HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB WORKING PAPER SERIES NUMBER 5 APRIL 2010 Conceptual frameworks, health financing data and assessing performance: A stock-take of tools for health financing
More informationMongolia: Strengthening the Health Insurance System
Technical Assistance Report Project Number: 47007 Capacity Development Technical Assistance (CDTA) September 2013 Mongolia: Strengthening the System (Financed by the Japan Fund for Poverty Reduction) The
More informationmedicaid and the uninsured June 2011 Health Coverage for the Unemployed By Karyn Schwartz and Sonya Streeter
I S S U E kaiser commission on medicaid and the uninsured June 2011 P A P E R Health Coverage for the Unemployed By Karyn Schwartz and Sonya Streeter In May 2011, 13.9 million people in the U.S. were unemployed,
More information53rd DIRECTING COUNCIL
53rd DIRECTING COUNCIL 66th SESSION OF THE REGIONAL COMMITTEE OF WHO FOR THE AMERICAS Washington, D.C., USA, 29 September-3 October 2014 CD53.R14 Original: Spanish RESOLUTION CD53.R14 STRATEGY FOR UNIVERSAL
More informationThe Current State and Future Development of Social Security Yeun-wen Ku i and Chiu-yen Lee ii
Meeting on Social Indicators and Social Accounting Joint OECD/Korea Regional Centre for Health and Social Policy (RCHSP) Seoul, 8-9 May 2006 The Current State and Future Development of Social Security
More informationHealth Financing in Vietnam: Policy development and impacts
Health Financing in Vietnam: Policy development and impacts Björn Ekman Department of Clinical Sciences Lund University, Sweden Sydney 17 September, 2008 Outline of Presentation Part A: Health financing
More informationFinancing Urbanization
Commission des finances locales pour le développement Committee on Local Finance for Development Comisión de Financiación Local para el Desarrollo 1. INTRODUCTION Think Piece on Financing Urbanization
More informationSUBMISSION TO THE SENATE INQUIRY INTO OUT-OF- POCKET COSTS IN AUSTRALIAN HEALTHCARE. Prepared by National Policy Office
SUBMISSION TO THE SENATE INQUIRY INTO OUT-OF- POCKET COSTS IN AUSTRALIAN HEALTHCARE Prepared by National Policy Office May 2014 COTA Australia Authorised by: Ian Yates AM Chief Executive iyates@cota.org.au
More information3. The first stage public consultation conducted from March to June 2008 aimed at consulting the public on
EXECUTIVE SUMMARY The Government published the Healthcare Reform Consultation Document Your Health, Your Life (the Consultation Document ) on 13 March 2008 to initiate the public consultation on healthcare
More informationThinking of introducing social health insurance? Ten questions
Thinking of introducing social health insurance? Ten questions Ole Doetinchem, Guy Carrin and David Evans World Health Report (2010) Background Paper, 26 HEALTH SYSTEMS FINANCING The path to universal
More informationHealth Insurance for the Formal Sector in Africa: Yes, But
5 Health Insurance for the Formal Sector in Africa: Yes, But Joseph Kutzin Health Economist, Analysis, Research, and Assessment Division, World Health Organization Health insurance can be organized in
More informationInclusive Development in Myanmar: Learning from Neighbours. Thangavel Palanivel UNDP Regional Bureau for Asia-Pacific
Inclusive Development in Myanmar: Learning from Neighbours Thangavel Palanivel UNDP Regional Bureau for Asia-Pacific Outline Myanmar vis-à-vis its neighbours Economic reforms in selected Asian countries
More informationVIETNAM: SOCIAL HEALTH INSURANCE: CURRENT ISSUES AND POLICY RECOMMENDATIONS
SERIES: SOCIAL SECURITY EXTENSION INITATIVES IN EAST ASIA VIETNAM: SOCIAL HEALTH INSURANCE: CURRENT ISSUES AND POLICY RECOMMENDATIONS ILO Subregional Office for East Asia Decent Work for All Asian Decent
More informationLuncheon Briefing to HK Women Professionals and Entrepreneurs Association 16 April 2008
Your Health Your Life Public Consultation on Healthcare Reform Luncheon Briefing to HK Women Professionals and Entrepreneurs Association 16 April 2008 Problems in the Existing Healthcare System (1) Primary
More informationPROPOSED MECHANISMS FOR FINANCING HEALTHCARE FOR THE POOR.
PROPOSED MECHANISMS FOR FINANCING HEALTHCARE FOR THE POOR. Concept Summary Aug 2014 Insight Health Advisors Dr. Gitonga N.R, Prof. G. Mwabu, C. Otieno. PURPOSE OF CONCEPT Propose a mechanism for mobilizing
More informationPublic private partnerships in agricultural insurance
Public private partnerships in agricultural insurance William Dick Consultant Agricultural Insurance Development Program (AIDP) The World Bank January 30, 2014 Agriculture Insurance Development Program
More informationInstitutional Options for Achieving Scale and Sustainability: Lessons from the Philippines (Microinsurance MBA Model)
Institutional Options for Achieving Scale and Sustainability: Lessons from the Philippines (Microinsurance MBA Model) By: Jaime Aristotle B. Alip, Ph D. RIMANSI Organization for Asia and the Pacific, Inc.
More informationMoving from universal health coverage to effective financial protection: Evidence from a health insurance experiment in the Philippines
Moving from universal health coverage to effective financial protection: Evidence from a health insurance experiment in the Philippines SA. Quimbo University of the Philippines School of Economics Prince
More information1. Bank Group Support to Health Financing
1. Bank Group Support to Health Financing Highlights The way that health services are financed affects human welfare because it influences how health systems perform in improving health outcomes, and more
More informationHarmonization of Health Insurance Schemes in China
Harmonization of Health Insurance Schemes in China Hai Fang Professor of Health Economics China Center for Health Development Studies Peking University China Presentation at the First National Conference
More informationHow To Get A New Bronwell Drug Plan
Questions and Answers New Brunswick Drug Plan December 10, 2013 1) What is the New Brunswick Drug Plan? The New Brunswick Drug Plan is a prescription drug insurance plan that provides drug coverage for
More informationTHE NEW DELHI DECLARATION ON SOUTH-SOUTH COOPERATION FOR CHILD RIGHTS IN ASIA AND THE PACIFIC
THE NEW DELHI DECLARATION ON SOUTH-SOUTH COOPERATION FOR CHILD RIGHTS IN ASIA AND THE PACIFIC We, the delegations of the governments of Afghanistan, Bangladesh, Bhutan, Brunei Darussalam, Cambodia, China,
More informationAnnex I ROLE OF THE INFORMAL SECTOR
Annex I ROLE OF THE INFORMAL SECTOR A. Background 1. Role and challenges of the informal sector during economic downturns Chapter I discusses in detail the increase in unemployment as a direct result of
More informationComparative desk-review of social health insurance experiences. Japan, Korea, Taiwan and Mongolia
EQUITAP Working Paper #20: Comparative desk-review of social health insurance experiences in Japan, Korea, Taiwan and Mongolia Jui-fen Rachel Lu Soonman Kwon Dorjsuren Bayarsaikhan Chang Gung University,
More informationEvolution of informal employment in the Dominican Republic
NOTES O N FORMALIZATION Evolution of informal employment in the Dominican Republic According to official estimates, between 2005 and 2010, informal employment fell from 58,6% to 47,9% as a proportion of
More informationUNITED NATIONS INDEPENDENT EXPERT ON THE QUESTION OF HUMAN RIGHTS AND EXTREME POVERTY
UNITED NATIONS INDEPENDENT EXPERT ON THE QUESTION OF HUMAN RIGHTS AND EXTREME POVERTY Questionnaire JAN/2011 Post-crisis adjustment and fiscal consolidation processes (2010 onwards) 1. Has your country
More informationOpting Out of Mandatory Health Insurance In Latin American Countries. Implications for Policy and Decision Making in Russian Federation
Opting Out of Mandatory Health Insurance In Latin American Countries Implications for Policy and Decision Making in Russian Federation Hernan Fuenzalida March 2003 Health, Nutrition and Population (HNP)
More informationHealth Insurance. Dr Sanjay Arya
Health Insurance Dr Sanjay Arya Definition A contract where individual or group purchase in advance health coverage by paying a fee called premium. Also defined as, including all financial arrangements
More informationBOTSWANA. Contribution to the 2015 United Nations Economic and Social Council (ECOSOC) Integration Segment
BOTSWANA Contribution to the 2015 United Nations Economic and Social Council (ECOSOC) Integration Segment 1 2015 ECONOMIC AND SOCIAL COUNCIL (ECOSOC) INTEGRATION SEGMENT: ACHIEVING SUSTAINABLE DEVELOPMENT
More informationCurrent Issues, Prospects, and Programs in Health Insurance in Zimbabwe
11 Current Issues, Prospects, and Programs in Health Insurance in Zimbabwe T. A. Zigora, Deputy Secretary, Ministry of Health and Child Welfare, Zimbabwe Health care is receiving increasing attention worldwide,
More informationSummary of the Major Provisions in the Patient Protection and Affordable Health Care Act
Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,
More informationHow To Write The Who Disability And Rehabilitation Guidelines
WORLD HEALTH ORGANIZATION CONCEPT PAPER WHO Guidelines on Health-Related Rehabilitation (Rehabilitation Guidelines) MANDATE The World Health Assembly Resolution on "Disability, including prevention, management
More informationStrengthening Health Financing in Partner Developing Countries
Strengthening Health Financing in Partner Developing Countries RAVINDRA P. RANNAN-ELIYA* THE HEALTH CHALLENGES CONFRONTING DEVELOPING COUNTRIES Three serious health challenges confront developing countries
More informationA HEALTH FINANCING REVIEW OF VIET NAM
A HEALTH FINANCING REVIEW OF VIET NAM WITH A FOCUS ON SOCIAL HEALTH INSURANCE Bottlenecks in institutional design and organizational practice of health financing and options to accelerate progress towards
More informationSwe den Structure, delive ry, administration He althcare Financing Me chanisms and Health Expenditures Quality of Bene fits, C hoice, Access
Sweden Single payer, universal healthcare system, with 21 county councils as the primary payer (reimburser) Administration of healthcare plan is decentralized in the hands of the county councils Central
More informationBetter Factories Cambodia
Cambodia: Moving forward toward Better Social Security Better Factories Cambodia Social Security An Overview The 1948 United Nations Universal Declaration of Human Rights stipulates that everyone, as a
More informationFramework. Australia s Aid Program to Papua New Guinea
Framework Australia s Aid Program to Papua New Guinea 21 October 2002 Our Unique Development Partnership our close bilateral ties are reflected in our aid program Enduring ties bind Papua New Guinea with
More informationTitle Registration Form Campbell Collaboration Social Welfare Coordinating Group
Title Registration Form Campbell Collaboration Social Welfare Coordinating Group 1. Title of review (Suggested format: [intervention/s] for [outcome/s] in [problem/population] in [location/situation] Example:
More informationMDG 4: Reduce Child Mortality
143 MDG 4: Reduce Child Mortality The target for Millennium Development Goal (MDG) 4 is to reduce the mortality rate of children under 5 years old (under-5 mortality) by two-thirds between 1990 and 2015.
More informationVietnam s Health Care System: A Macroeconomic Perspective*
Vietnam s Health Care System: A Macroeconomic Perspective* Paper Prepared for the International Symposium on Health Care Systems in Asia Hitotsubashi University, Tokyo January 21-22, 2005 Susan J. Adams,
More informationCooperation between KDI School (KDIS) and World Bank Institute (WBI): Building Capacity for Development in Asia
Cooperation between KDI School (KDIS) and World Bank Institute (WBI): Building Capacity for Development in Asia September 21, 2005 Ji-Hong Kim World Bank Institute I. Introduction of KDI I-1. Organization
More informationSIERRA LEONE UPDATES FROM THE INSTANBUL PRIORITY AREAS OF ACTION
SIERRA LEONE UPDATES FROM THE INSTANBUL PRIORITY AREAS OF ACTION 1 OUTLINE OF PRESENTATION Recent Developments Istanbul Priority Areas of Action Poverty Levels Agenda for Prosperity Challenges Conclusion
More informationRio Political Declaration on Social Determinants of Health
Rio Political Declaration on Social Determinants of Health Rio de Janeiro, Brazil, 21 October 2011 1. Invited by the World Health Organization, we, Heads of Government, Ministers and government representatives
More informationRecommendation for a COUNCIL RECOMMENDATION. on Poland s 2014 national reform programme
EUROPEAN COMMISSION Brussels, 2.6.2014 COM(2014) 422 final Recommendation for a COUNCIL RECOMMENDATION on Poland s 2014 national reform programme and delivering a Council opinion on Poland s 2014 convergence
More informationSPECIAL PROGRAMME OF RESEARCH, DEVELOPMENT AND RESEARCH TRAINING IN HUMAN REPRODUCTION: MEMBERSHIP OF THE POLICY AND COORDINATION COMMITTEE
W O R L D H E A L T H ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU RÉGIONAL DU PACIFIQUE OCCIDENTAL REGIONAL COMMITTEE WPR/RC66/11 Sixty-sixth session 27
More informationUniversal Health Coverage Assessment: Taiwan. Universal Health Coverage Assessment. Taiwan. Jui-fen Rachel Lu. Global Network for Health Equity (GNHE)
Universal Health Coverage Assessment Taiwan Jui-fen Rachel Lu Global Network for Health Equity (GNHE) December 2014 1 Universal Health Coverage Assessment: Taiwan Prepared by Jui-fen Rachel Lu 1 For the
More informationThe Uninsured Population in Texas:
REPORT The Uninsured Population in Texas: July 2014 Understanding Coverage Needs and the Potential Impact of the Affordable Care Act Prepared by: Katherine Young and Rachel Garfield Kaiser Family Foundation
More informationPOTENTIAL RESEARCH OPPORTUNITY FOR SECURED TRANSACIONS REFORM IN COLOMBIA
POTENTIAL RESEARCH OPPORTUNITY FOR SECURED TRANSACIONS REFORM IN COLOMBIA Alejandro Alvarez de la Campa, IFC Boston, September 16, 2011 OUTLINE 1) SECURED TRANSACTIONS: WHAT, WHY, HOW? 2) POTENTIAL IMPACT
More informationDoing Business in Australia and Hong Kong SAR, China
Doing Business in Australia and Hong Kong SAR, China Mikiko Imai Ollison Private Sector Development Specialist Nan Jiang Private Sector Development Specialist Washington, DC October 29, 2013 What does
More informationHong Kong Declaration on Sustainable Development for Cities
Hong Kong Declaration on Sustainable Development for Cities 1. We, the representatives of national and local governments, community groups, the scientific community, professional institutions, business,
More informationRecent trends of dynamically growing and developing life insurance markets in Asia
Recent trends of dynamically growing and developing life insurance markets in Asia Tomikazu HIRAGA, Ph.D. and LL.M. General Manager for Asia, NLI Research Institute Asia is a growth market where foreign
More informationSecond Generation of Reform in Indian Insurance Industry: Prospects and Challenges
Second Generation of Reform in Indian Insurance Industry: Prospects and Challenges By Dr. R. Kannan Member (Actuary) Insurance Regulatory and Development Authority, India June 24, ICRIER, India 1 Historical
More informationTypes of Good Practices Focusing on Family Poverty Reduction and Social Exclusion
Types of Good Practices Focusing on Family Poverty Reduction and Social Exclusion Zitha Mokomane Human Sciences Research Council of South Africa Social science that makes a difference Date: 16 May 2012
More informationMainstreaming Disaster Risk Reduction into National and Sectoral Development Process
Mainstreaming Disaster Risk Reduction into National and Sectoral Development Process Safer Training Health Course Facilities Regional Consultative Committee on Disaster Management (RCC) Training Course
More informationG20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013
G20 Labour and Employment Ministers Declaration Moscow, 18-19 July 2013 1. We, the Ministers of Labour and Employment from G20 countries met in Moscow on July 18-19, 2013 to discuss the global labour market
More informationDecree On National Health Insurance Fund. Government issued Decree: Chapter I General Provisions
Government Lao People s Democratic Republic Peace Independence Democracy Unity Prosperity ------------------ No.../ GO Vientiane Capital, date./ Decree On National Health Insurance Fund - Pursuant to Law
More information