Health Insurance Trends in Asia and Pacific:Comparative Analysis of Trends and Future Directions

1. Asia Pacific Summit on Health Insurance and Managed CAre 1 Health Insurance Trends in Asia and Pacific:Comparative Analysis of Trends and Future Directions

2. Asia Pacific Summit on Health Insurance and Managed CAre 2 F. Marilyn E. Lorenzo, DrPHDirector, Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines, ManilaManolito NovalesSenior Technical Coordinator, GTZ Social Health Insurance Component of the German Support to the Philippine Health Sector, Manila This presentation is possible through the support of the GTZ support to the Philippine Health Sector

3. Asia Pacific Summit on Health Insurance and Managed CAre 3 Presentation Outline Health Insurance, Social Security and Health System Development Current Situation of Selected Asian Insurance: Comparative Indicators Comparative Analysis of Health Insurance Arrangements Key Issues and Future Directions

4. Asia Pacific Summit on Health Insurance and Managed CAre 4 Methods Secondary analysis of published information on health insurance trends in South Korea, India, Indonesia, Japan, Malaysia, Philippines, Thailand, Taiwan Aims to describe current trends and future directions of health insurance for benchmarking Constrained by available published information accessible to reviewers

5. Asia Pacific Summit on Health Insurance and Managed CAre 5 Health Insurance, Social Security and Health System Development Health Insurance regular prepayment of defined contributions by and on behalf of specific individuals for stipulated benefits. tool of health system development that provides financing mechanisms to sustain quality health care (Ron; Normand and Weber, 2000;1994) accord mutual support or solidarity

6. Asia Pacific Summit on Health Insurance and Managed CAre 6 Health Insurance, Social Security and Health System Development Four main categories of funding health services : Government finance raised through taxes Social Insurance Private Actuarial Insurance Out-of-pocket payment for services by patients

7. Asia Pacific Summit on Health Insurance and Managed CAre 7 Health Insurance, Social Security and Health System Development Funding systems all provide risk pooling or risk sharing except for out-of-pocket arrangements Solidarity or mutual support accorded is important: those with higher incomes and low risks support those with lower incomes and higher risks

8. Asia Pacific Summit on Health Insurance and Managed CAre 8 Health Insurance, Social Security and Health System Development Health Insurance provides �safety nets� as variants of social security arrangements Existing social security arrangements in the comparison countries consist mainly of employer/employee co-financed contributory social insurance schemes and provident fund arrangements

9. 9 Comparative Country Indicators,(1997)

10. Asia Pacific Summit on Health Insurance and Managed CAre 10 Comparative Country Indicators Selected Asian Pacific Countries categorized into societies with developed and developing economies Variant human development indicators All countries have some form of health insurance developed

11. 11 Comparison of Current Health Insurance Schemes

12. Asia Pacific Summit on Health Insurance and Managed CAre 12 Comparison of Current Health Insurance Schemes Variance in nature,population coverage, benefits provision Variance in patterns of risk sharing and cost sharing between government, beneficiaries, and private sectors Benefits provided include illness, maternity,health, work injury, old age and disability but in varied proportions Quality of health services variable

13. Asia Pacific Summit on Health Insurance and Managed CAre 13 Comparison of Current Health Insurance Schemes Predominant Drivers of Health Insurance Development Political Goals (Taiwan, Japan) Market Forces (South Korea,Thailand) Mixed Forces (India, Malaysia, Philippines, Indonesia)

14. Asia Pacific Summit on Health Insurance and Managed CAre 14 Comparison of Current Health Insurance Schemes Key Issues vary according to stage of development: Those without universal coverage are still struggling to attain substantial population coverage, achieve efficiency, and promote equity and access Those with universal coverage are grappling with cost containment, quality of care management, and equity issues (distribution), utilization regulation, and policy redefinition Integration of social security arrangements Inclusion of cultural and alternative forms of health care

15. Asia Pacific Summit on Health Insurance and Managed CAre 15 Comparison of Current Health Insurance Schemes Common key Issues include: Long-term financial viability /sustainability Compliance Issues Policy environment, and Solidarity and access provision Demographic changes especially aging of population and population movements

16. Asia Pacific Summit on Health Insurance and Managed CAre 16 Future Directions Depending on key issues each country is facing: Continuing Health Care Reform that is evaluation based Health Policy Refinements Health System Development : Decentralization of Health Systems (District Health Systems) Local Initiatives Development - Community based Financing Capacity Building and Training

17. Asia Pacific Summit on Health Insurance and Managed CAre 17 Thank You !Salamat!Mabuhay !