Universal health care coverage provides safety net for the poor
Business World Weekender: For many poor people, health has become a difficult economic choice between getting better or poorer.
Often characterized by high out-of-pocket spending, health financing systems in low- and middle-income countries have contributed to the vicious cycle where diseases worsen poverty, while at the same time, poverty results in rising incidence of diseases.
The World Health Report 2010 estimated that about 150 million people globally suffer financial catastrophe when they avail of health services.
Similarly, 100 million people are pushed into poverty due to direct out-of-pocket spending.
In the Asia-Pacific region alone, about 80 million people experience financial catastrophe and 50 million others are impoverished due to health payments.
These happen since in low- and middle-income countries, health is paid for privately or mainly from out-of-pocket health care systems.
The same is true for the Philippines that reported a private out-of-pocket share of 54.3% while government funding was 26.2% and social insurance, 8.5%.
This was validated by the Social Weather Stations (SWS) survey of Filipinos on Health Services and Financing which revealed that for those who have consulted a doctor when they were sick, seven out of 10 of them paid from their own pockets.
The video documentary, "The Road to Universal Health Coverage", emphasized that when households spend a substantial part of their income on health, the results can be catastrophic.
In fact, the same SWS survey disclosed that almost three out 10 Filipinos deferred visits to doctors even if they were sick because they felt that they cannot afford to pay for health care. Seven out 10 respondents also believed that many families get impoverished when a member gets sick and has to be hospitalized.
In shielding families from financial catastrophe and other disastrous social outcomes of direct out-of-pocket health payments, the video documentary highlighted the pressing need for countries to adopt and implement financing strategies leading to universal health coverage.
Universal health coverage, as defined by World Health Organization (WHO) Director General Margaret Chan, means in practical terms that all people in the country should receive some degree of financial protections from the cost of basic health services.
Furthermore, it means that no one in need of health care, whether curative or preventive, should risk financial ruin as a result of paying for health care.
The documentary, which is a joint project of the WHO and the Asian Institute of Management Dr. Stephen Zuellig Center for Asia for Business Transformation, featured countries in the Asia and the Pacific that have started to implement strategies centered on raising sufficient funds for health prepayment financing mechanisms, reducing heavy reliance on out-of-pocket spending, as well as improving efficiency and cutting wastage in the health system.
The governments of Mongolia, China, Laos, Cambodia, Vietnam and the Philippines have operationalized schemes that extend insurance coverage to more people, offer more and quality services, and pay more for health care costs.
For instance, Mongolia’s health financing system has provided citizens access to primary health care free of charge.
China, on the other hand, has recently implemented the New Rural Cooperative Medical Scheme that has reached about 90% of the whole rural population. China has achieved a breakthrough in its rural health insurance program by increasing central and local government subsidy to rural populations.
Meanwhile, Cambodia’s Health Equity Fund is designed to strengthen the safety net for the poor by paying for their health care and providing transportation and food subsidy. Hence, the Health Equity Fund seeks to reduce financial barriers to access health services by the poor. At the moment, the equity fund has covered 70% of the total population living under the national poverty line.
Laos has also introduced community-based insurance to complement the national social insurance. Out of the 23 districts covered by the community-based insurance, 11 are in rural areas.
In the Philippines, the documentary featured the government’s conditional cash transfer program for the 5.2 million Filipino families living below poverty line. Under this initiative, poor Filipino families are given a conditional grant provided that they meet monthly health and education requirements.
WHO stressed that universal health coverage is vital for growth, security and prosperity. The Philippines, along with its neighbors in the Asia Pacific, have already institutionalized some forms of health financing systems.
These financial health systems can be enhanced to offer more protection for the poor so that they may access quality health care regardless of their ability to pay. It is, after all, the essence of universal health care.