Universal health coverage -- Indonesian model

Universal health coverage in a resource-starved country is possible only if there is strong political commitment , Indonesia’s vice-minister for health Ali Gofran Mukti says.

Nurul Islam Hasibbdnews24.com
Published : 20 April 2013, 03:36 AM
Updated : 22 Nov 2014, 11:37 AM

Citing the Indonesian experience of bringing nearly 60 percent of the population under prepaid financing schemes to cover healthcare services financing mechanisms, Mukti said this is the route to the universal health coverage in a decade.

“I think political commitment was the key. Politicians have to push hard for ensuring universal health coverage. We (in Indonesia) allocate budgets for that,” he told bdnews24.com Saturday on the sidelines of the two-day symposium on healthcare financing in Dhaka.

Dhaka University’s Institute of Health Economics (IHE), with the support of Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) GmbH and the Ministry of Health and Family Welfare, have brought together global health economists for the symposium, so Bangladesh could take pointers for its healthcare financing strategy.

Mukti said people who can afford have to contribute to their pool for prepaid financing for heathcare services . 'But who cannot afford don’t have to contribute.’

Bangladesh is also toying with the idea of universal health coverage, as studies show people have to spend 65 percent out-of-pocket for medicare, which in turn pushes 5 percent of them into poverty every year.

Experts say preventive aspects of healthcare is usually ignored in the present system , so people eventually have to pay more when they arrive in the hospitals.

The universal health coverage ensures people’s access to healthcare without suffering a financial catastrophe.

Countries like Germany, Costa Rica, Mexico and Singapore where a large number of people are under formal employment are pooling a part of salaries for financing health services.
Many countries also use part of their general taxes or specific taxes like imposing a tax on tobacco products for health insurance.
But experts say Bangladesh has to find its own way out as as most of its people are employed in informal sector and National Board of Revenue says general tax collection is still low.
The recently approved healthcare financing strategy aims to achieve the universal health coverage in the next 20 years.
Dhaka University’s Vice Chancellor Professor A A M S Arefin Siddique inaugurated the symposium saying that his university would its best to strengthen the Institute of Health Economics that is now offering degrees.
GIZ Health Bangladesh’s Principal Advisor Dr Paul Rueckert said the conference would give Bangladesh's policy-makers sample and review international experiences and learn the best practices from around the world.
Health economists from India, Indonesia, Philippines, Cairo and Germany joined the symposium with the local academics, practitioners and policy makers in the conference at the Dhaka University.
Organisers say they would also discuss ‘challenges and emerging issues’ of health economics in the conference.
The Health Minister AFM Ruhal Haque earlier said they were trying to introduce a ‘prepaid card’ for the poorest of the poor so that ‘they get confidence to the hospital to avail free health services.’
The Ministry carried out its activities with the Health Economics Unit that was established in 1994 as a project.
Two years back the project has been transferred to the revenue sector. Its present director Md. Hafizur Rahman says they were mapping out available resources to push forward the health financing issues properly in Bangladesh.
“The conference would help us in this regard,” he said and that they had also funds for conducting research.