Current challenges in delivering social health insurance in Asia and the Pacific

Chart3

883965245626046922

341631443714841326961212

2256357431884253471536

176441162057211513613

1019274538733590222

1605812495569440011937

4055375375216463521538954863

41411520331849610320549772688

Taxes

Social health insurance

Private health insurance

Out-of-pocket spending

Other private expenditure

Composition of health spending - 2001Data estimated using average annual exchange rate - Timor Leste not includedSource: NHA Unit, EIP/FER/RER, World Health Organization

World shares-data

RegionCountryCodeYearSS inUS$SS inInt$GGHE in USDGGHE in Int $Pvt HE in USDPvt HE in Int $Prepd inUS$Prepaid in Int$OOPS in USDOOPS in Int $Terr Gov /US$Terr Gov /Int$Other Pvt /US$Other Pvt /Int$

AFRAlgeriaDZA2001633145616933895563129529665061165106024392864

AFRAngolaAGO20012495611453271453272495610-0

AFRBeninBEN20014911856134561334911801

AFRBotswanaBWA20012214421132252346407922144250100

AFRBurkina FasoBFA20014319928132281284319914

AFRBurundiBDI2001147110501050147100

AFRCameroonCMR20011172411984091613331172413676

AFRCape VerdeCPV20018222161412412133900

AFRCentral African RepublicCAF20012311222107211022311215

AFRChadTCD2001291059338272910526

AFRComorosCOM200141338384130-0

AFRCongoCOG200141502328232841500-0

AFRCte d'IvoireCIV200110632655817115717650115351063260-0

AFRDemocratic Republic of the CongoCOD200111626514533214533211626500

AFREquatorial GuineaGNQ2001213014207102130710

AFREritreaERI200125901348134825900-0

AFREthiopiaETH20011390371133544112461893682083

AFRGabonGAB2001781218513185131781210-0

AFRGambiaGMB2001125213541148125216

AFRGhanaGHA200114871110048210048214871100

AFRGuineaGIN20015627248231482315627200

AFRGuinea-BissauGNB20016285245246280-0

AFRKenyaKEN20011917557022777672654741878191755160634

AFRLesothoLSO200133143938938331430-0

AFRLiberiaLBR200133001951803300015

AFRMadagascarMDG20016121931113517279661219-0-0

AFRMalawiMWI2001511599529625421295115951162

AFRMaliMLI2001501448022915435816550144721

AFRMauritaniaMRT20012489934934248900

AFRMauritiusMUS20017199223062157621578521100

AFRMozambiqueMOZ20011375836628222611113758340169

AFRNamibiaNAM2001391494477121355166133814643839

AFRNigerNER200125973915114331292597518

AFRNigeriaNGA200140184413262789132627894018440-0

AFRRwandaRWA20011511984115927105511971454

AFRSao Tome and PrincipeSTP2001120101120-0

AFRSenegalSEN2001127358892517218223012735800

AFRSeychellesSYC200124421119915244234

AFRSierra LeoneSLE2001207313471347207300

AFRSouth AfricaZAF200140821197257901697941811226112783747408211972331971

AFRSwazilandSWZ200130121145614563012100

AFRTogoTGO2001191032010920109191030-0

AFRUgandaUGA2001198788146583137831119878867269

AFRUnited Republic of TanzaniaTZA200119143621849710221814131914362762

AFRZambiaZMB200110929096256691841092902772

AFRZimbabweZWE200126082231499210934516451726082241130

AFR Total65215104562134426046170758839258399242943

AMRAntigua and BarbudaATG200123271517151723270-0

AMRArgentinaARG20017969132681360622653118751977136936149741312342563793857691280

AMRBahamasBHS200115121311416111416115121300

AMRBarbadosBRB20011091675685132043651091670-0

AMRBelizeBLZ200119312337233719310-0

AMRBoliviaBOL2001185466278702141356112712130593236924

AMRBrazilBRA20011608741458226105826881062089114500373671608741458410

AMRCanadaCAN2001950122647678615371961725319771699581026613250467286031116352111

AMRChileCHL20011474385320535366261768411055275815614080579151313

AMRColombiaCOL20017382501295310003154452295361817100734102215750212

AMRCosta RicaCRI200173014028051545370711510341655751432446

AMRCubaCUB200117972221287354220272179722216782

AMRDominicaDMA200111175757111700

AMRDominican RepublicDOM20011062444681079830191337734169136283593215

AMREcuadorECU2001218510480112547511124510535082026261580187

AMREl SalvadorSLV2001228493513110758512642962555120028561412

AMRGrenadaGRD2001152661061015260-0

AMRGuatemalaGTM2001263609485112451912042864445103222251546108

AMRGuyanaGUY2001301318338333013100

AMRHaitiHTI2001942428221137969424245115

AMRHondurasHND200136932065381824761436162423170445617

AMRJamaicaJAM200120927628838165862122792092761216

AMRMexicoMEX200111111163211670724542209823082110261508193912848455968221565829

AMRNicaraguaNIC200148125152399161423617150394104274512

AMRPanamaPAN2001310551535950240427458019534622539901

AMRParaguayPRY200110134320971233711499532624182310836900

AMRPeruPER200172817341405334411512741185441940223967716102661

AMRSaint Kitts and NevisKNA20011116686811160-0

AMRSaint LuciaLCA20015719261014101414190-0

AMRSaint Vincent and the GrenadinesVCT2001132781581513270-0

AMRSurinameSUR2001923401032668153931801129

AMRTrinidad and TobagoTTO200115621820428415201772461562181318

AMRUnited States of AmericaUSA20012033182033186174336174337742887742884961034961032054972054974141154141157268872688

AMRUruguayURY200133654294115151090175575812213325346059730-0

AMRVenezuela, Bolivarian Republic ofVEN20019531197472759362884362113416827503453377447390-0

AMR Total2298162488265196865418742678463196445006025579837610277856

EMRAfghanistanAFG20019140082360823609140000

EMRBahrainBHR2001112393181071432939749923831745

EMRDjiboutiDJI2001233616259142336711

EMREgyptEGY2001458153415435164161353988271487497710853630118394

EMRIran, Islamic Republic ofIRN20014172502710233123321329816024342412125271509660617305429516

EMRIraqIRQ200117107333668157436681574171073300

EMRJordanJOR20013739610034471133338433083739399684212

EMRKuwaitKWT20019961135267305267305996113500

EMRLebanonLBN200129940259079415112033249335122716512913923547

EMRLibyan Arab JamahiriyaLBY20014287163375623375624287160-0

EMRMoroccoMAR2001401356812312105135662398117792643641217733112

EMROmanOMN2001487744117178507748774467101

EMRPakistanPAK200125013065783013179293501792935032817070-0

EMRQatarQAT200138534013912347413853409282

EMRSaudi ArabiaSAU20016382100602176343080112638281305638210060547862

EMRSomaliaSOM2001266232773277266200

EMRSudanSDN200181232353100835110018123227

EMRSyrian Arab RepublicSYR200148531846194066619406648531840-0

EMRTunisiaTUN2001521180197533703131082702422438404541569-0-0

EMRUnited Arab EmiratesARE200118522010590641113122387420185220109099

EMRYemenYEM20011254412418532137571254412796

EMR Total574410213188433352535146051225623818615352545

EURAlbaniaALB2001195898303531661856351087924512

EURAndorraAND2001517559872436223381223

EURArmeniaARM20016834797496974966834700

EURAustriaAUT200164887855105151273046535634108313112855345640274875716867

EURAzerbaijanAZE20016226631132133012962266-00

EURBelarusBLR200114599658640149061829061644130180-0

EURBelgiumBEL20011134714199146141828857827235394493340042553267408919872487

EURBosnia and HerzegovinaBIH200112840221969021969012840200

EURBulgariaBGR20011967315351996117436114427339126529

EURCroatiaHRV20011357250114302637319588319588731360-0

EURCyprusCYP200116917135135538538988377381182184-00

EURCzech RepublicCZE20013286912438151059136010013601001529146700

EURDenmarkDNK200111239110572397235822121721762141112391105700

EUREstoniaEST20012045092385926816938571433483718

EURFinlandFIN20011333150863967235206523361711931707193150635727187212

EURFranceFRA200191557111454948841155042993536440159021935712758155313327405012751552

EURGeorgiaGEO2001188843213713511713502512500

EURGermanyDEU200113661315969114883817398249822582381671319537211382470912225142911197113992

EURGreeceGRC2001214832656142933948307344215327357054293994607410451588

EURHungaryHUN200121905810263369858772326113075019894431175116307

EURIcelandISL200116217657762511912911912941544900

EURIrelandIRL20015158502056671587179245150987698949695609260294

EURIsraelISR2001259829137005785431233501312335014407494100

EURItalyITA20011832546906196110226353150181411331858425863688789585632374505

EURKazakhstanKAZ200141519112731254273125441519110-0

EURKyrgyzstanKGZ2001327302623127631276272350-0

EURLatviaLVA200113532825962823456812233567124300-0-1

EURLithuaniaLTU200144810385071175212491195451591371840

EURLuxembourgLUX200180189510331154116130171987972322591314

EURMaltaMLT20011271282172189910099100909000

EURMonacoMCO200130373138253025301100

EURNetherlandsNLD200120381248922173426544125801536453356516303437061353165242105142

EURNorwayNOR20011151011274194619061884184611510112746260

EURPolandPOL20016155134048022174683135682723851928976308186740640-0

EURPortugalPRT2001472779697411496313751711342211834302465021071711691926

EURRepublic of MoldovaMDA20014223843242432424223800

EURRomaniaROU20011837722720808184545214643169502197724395700

EURRussian FederationRUS20012468979111313448755280209422409524457176788845350845832312

EURSan MarinoSMR20011319263671071013170-0

EURSerbia-MontenegroYUG20016283753703420018511021851102754470-0

EURSlovakiaSVK2001986311710373279124393124393511620-0

EURSloveniaSVN2001947178312222301409770239449170321275518-00

EURSpainESP200128884263313074621712516184771760259810368153052841941954389574

EURSwedenSWE200116299172142823298228232982162991721400

EURSwitzerlandCHE200110991966015614137241172010302278524488661761346234064274242

EURTajikistanTJK200110762518825188107601

EURThe former Yugoslav Republic of MacedoniaMKD20011745011985733510235102247200

EURTurkeyTUR20011519410653041433221675856266921425788378510226-1-1

EURTurkmenistanTKM20015322719784872309198153227144621-01

EURUkraineUKR20011098589952127995212799109858990-0

EURUnited KingdomGBR200188732961651924920861331135881065211544887329616552865729

EURUzbekistanUZB20013131716107587107587313171600

EUR Total31117140741150153608161243181814002993934118133280741875

SEARBangladeshBGD2001753363695245988874285753363665313

SEARBhutanBTN2001171242132131712400

SEARDemocratic People's Republic of KoreaPRK200136472813226413226436472800

SEARIndiaIND2001444214718204216767020421676704442147180-0

SEARIndonesiaIDN20016430985741322563123602091008235411352793382300

SEARMaldivesMDV2001256651351325660-0

SEARMyanmarMMR2001304169022478101036777810321660220334

SEARNepalNPL20018445319910721851000844531372

SEARSri LankaLKA200127711182901169313275111127711181245

SEARThailandTHA200165123962428893918256717175645155157091777654399363

SEARTimor-LesteTLS2001

SEAR Total7452709387166633590924491019231429221797

WPRAustraliaAUS2001229423335010865157942631382564729408229423335017622561

WPRBrunei DarussalamBRN20011231733245324512317300

WPRCambodiaKHM200160369343211429017896036953325

WPRChinaCHN20011194954261235891071223976618058515168637936172273116405286116797626

WPRCook IslandsCOK20012714142700

WPRFijiFJI200144124216121614412400

WPRJapanJPN200121727217630426005021101673892599591024831553644492542778347121750414203

WPRKiribatiKIR20013120003120-0

WPRLao People's Democratic RepublicLAO20013015424124199930154525

WPRMalaysiaMYS200119461804434715583755112271144634841785430100

WPRMarshall IslandsMHL200161136366110-0

WPRMicronesia, Federated States ofFSM2001132551023132537

WPRMongoliaMNG20011890452231785136327133522

WPRNauruNRU200171111117110-0

WPRNew ZealandNZL20013196513696715542564126971120319651361422

WPRNiueNIU200112000120-0

WPRPalauPLW200181611118160-0

WPRPapua New GuineaPNG2001117702148618127211770216

WPRPhilippinesPHL200118210141059590912837162254141510035599877489526148

WPRRepublic of KoreaKOR2001863715404111851995013989249512401428310400185492548454611882119

WPRSamoaWSM200111292625112901

WPRSingaporeSGP200127533411241367222727082159262584910336883

WPRSolomon IslandsSLB200117561412175612

WPRTongaTON2001514393951400

WPRTuvaluTUV200140303040-0

WPRVanuatuVUT2001513393951300

WPRViet NamVNM2001523304803028120275795132110536639428269898619

WPR Total238404247783688112052116933266793875221453872240827770

Grand Total7865329184525835536331855740859234129291101210637133997153786

int$

Territorial governmentPrivate InsuranceSocial InsuranceOtherOut-of-Pocket

AFR2583913442151029431707560809

AMR557983541874248826778563196441746183

EMR38166333510213254546051100310

EUR41181360816407411418751814001103315

SEAR314301666270979792449129051

WPR1453871205224778327770266793699785

12106186331859184521537869234123839453

xrate

Territorial governmentPrivate InsuranceSocial InsuranceOtherOut-of-Pocket

AFR88394562652924604621023

AMR500602519868229816761022678461594234

EMR225621884574415352535157076

EUR2993935015331117132807124318817842

SEAR101923877452213359045135

WPR87522688123840422408116933472148

9291105837357865321339975740843007458

World shares-pie

World Total (without Timor Leste) based on international dollar dataWorld Total (without Timor Leste) based on exchange rate data

Taxes1210575Territorial Government929213

Social health insurance917574Social Insurance785907

Private health insurance633142Private Insurance583470

Other private expenditure154527Other private134814

Out-of-pocket spending923839Out-of-Pocket573945

38396593007349

World shares-pie

0

0

0

0

0

Health expenditure in the world: 3.8 trillions of $ int.Timor Leste not includedSource: NHA Unit, EIP/FER/RER, WHO

Shares per region-data

0

0

0

0

0

In 2001, the world spent 3.0 trillion dollar on health Timor Leste not included - Data estimated using average annual exchange rateSource: NHA Unit, EIP/FER/RER, World Health Organization

Shares per region-OECD not sep

RegionCountryCodeYearSS inUS$SS inInt$GGHE in USDGGHE in Int $Pvt HE in USDPvt HE in Int $Prepd inUS$Prepaid in Int$OOPS in USDOOPS in Int $Terr Gov /US$Terr Gov /Int$Other Pvt /US$Other Pvt /Int$

OECDAustraliaAUS2001229423335010865157942631382564729408229423335017622561

OECDAustriaAUT200164887855105151273046535634108313112855345640274875715867

OECDBelgiumBEL20011134714199146141828857827235394493340042553267408919882487

OECDCanadaCAN2001950122647678615371961725319771699581026613250467286031116352111

OECDCzech RepublicCZE20013286912438151059136010013601001529146700

OECDDenmarkDNK200111239110572397235822121721762141112391105700

OECDFinlandFIN20011333150863967235206523361711931707193150635727187212

OECDFranceFRA200191557111454948841155042993536440159021935712758155313327405012751552

OECDGermanyDEU200113661315969114883817398249822582381671319537211382470912225142911197113992

OECDGreeceGRC2001214832656142933948307344215327357054293994607410451588

OECDHungaryHUN200121905810263369858772326113075019894431175116307

OECDIcelandISL200116217657762511912911912941544900

OECDIrelandIRL20015158502056671587179245150987698949695609260294

OECDItalyITA20011832546906196110226353150181411331858425863688789585632374505

OECDJapanJPN200121727217630426005021101673892599591024831553644492542778347121750414203

OECDLuxembourgLUX200180189510331154116130171987972322591214

OECDMexicoMEX200111111163211670724542209823082110261508193912848455968221565829

OECDNetherlandsNLD200120381248922173426544125801536453356516303437061353165242115142

OECDNew ZealandNZL20013196513696715542564126971120319651361422

OECDNorwayNOR20011151011274194619061884184611510112746260

OECDPolandPOL200161551340480221746831356827238519289763081867406400

OECDPortugalPRT2001472779697411496313751711342211834302465021071711691926

OECDRepublic of KoreaKOR2001863715404111851995013989249512401428310400185492548454611882119

OECDSlovakiaSVK20019863117103732791243931243935116200

OECDSpainESP200128884263313074621712516184771760259810368153052841941954388574

OECDSwedenSWE200116299172142823298228232982162991721400

OECDSwitzerlandCHE200110991966015614137241172010302278524488661761346234064274241

OECDTurkeyTUR20011519410653041433221675856266921425788378510226-1-1

OECDUnited KingdomGBR200188732961651924920861331135881065211544887329616552865729

OECD Total53752158376564635799022153892617654055374987465486361334

AFRAlgeriaDZA2001633145616933895563129529665061165106024392864

AFRAngolaAGO200124956114532714532724956100

AFRBeninBEN20014911856134561334911801

AFRBotswanaBWA20012214421132252346407922144250100

AFRBurkina FasoBFA20014319928132281284319904

AFRBurundiBDI2001147110501050147100

AFRCameroonCMR20011172411984091613331172413776

AFRCape VerdeCPV20018222161412412133900

AFRCentral African RepublicCAF20012311222107211022311215

AFRChadTCD2001291059338272910516

AFRComorosCOM2001413383841300

AFRCongoCOG2001415023282328415000

AFRCte d'IvoireCIV2001106326558171157176501153510632600

AFRDemocratic Republic of the CongoCOD200111626514533214533211626500

AFREquatorial GuineaGNQ2001213014207102130710

AFREritreaERI2001259013481348259000

AFREthiopiaETH20011390371133544112461893682183

AFRGabonGAB20017812185131851317812100

AFRGambiaGMB2001125213541148125226

AFRGhanaGHA200114871110048210048214871100

AFRGuineaGIN20015627248231482315627200

AFRGuinea-BissauGNB200162852452462800

AFRKenyaKEN20011917557022777672654741878191755161634

AFRLesothoLSO2001331439389383314300

AFRLiberiaLBR200133001951803300015

AFRMadagascarMDG20016121931113517279661219-10

AFRMalawiMWI2001511599529625421295115951162

AFRMaliMLI2001501448022915435816550144721

AFRMauritaniaMRT20012489934934248900

AFRMauritiusMUS20017199223062157621578521100

AFRMozambiqueMOZ20011375836628222611113758340169

AFRNamibiaNAM2001391494477121355166133814643839

AFRNigerNER200125973915114331292597518

AFRNigeriaNGA2001401844132627891326278940184400

AFRRwandaRWA20011511984115927105511971454

AFRSao Tome and PrincipeSTP200112111200

AFRSenegalSEN2001127358892517218223012735800

AFRSeychellesSYC200124421119915244224

AFRSierra LeoneSLE2001207313471347207300

AFRSouth AfricaZAF200140821197257901697941811226112783747408211972331971

AFRSwazilandSWZ200130121145614563012100

AFRTogoTGO20011910320109201091910300

AFRUgandaUGA2001198788146583137831119878867269

AFRUnited Republic of TanzaniaTZA200119143621849710221814131914362762

AFRZambiaZMB200110929096256691841092902772

AFRZimbabweZWE200126082231499210934516451726082241130

AFR Total65215104562134426047170738839258399222945

AMRAntigua and BarbudaATG2001232715171517232700

AMRArgentinaARG20017969132681360622653118751977136936149741312342563793857691280

AMRBahamasBHS200115121311416111416115121300

AMRBarbadosBRB200110916756851320436510916700

AMRBelizeBLZ2001193123372337193100

AMRBoliviaBOL2001185466278702141356112712130593236924

AMRBrazilBRA20011608741458226105826881062089114500373671608741458410

AMRChileCHL20011474385320535366261768411055275815614080579151313

AMRColombiaCOL20017382501295310003154452295361817100734102215750212

AMRCosta RicaCRI200173014028051545370711510341655751432446

AMRCubaCUB200117972221287354220272179722216782

AMRDominicaDMA200111175757111700

AMRDominican RepublicDOM20011062444681079830191337734169136283593215

AMREcuadorECU2001218510480112547511124510535082026261580187

AMREl SalvadorSLV2001228493513110758512642962555120028561412

AMRGrenadaGRD20011526610610152600

AMRGuatemalaGTM2001263609485112451912042864445103222251546108

AMRGuyanaGUY2001301318338333013100

AMRHaitiHTI2001942428221137969424245115

AMRHondurasHND200136932065381824761436162423170445617

AMRJamaicaJAM200120927628838165862122792092761116

AMRNicaraguaNIC200148125152399161423617150394104274512

AMRPanamaPAN2001310551535950240427458019534622539901

AMRParaguayPRY200110134320971233711499532624182310836910

AMRPeruPER200172817341405334411512741185441940223967716102661

AMRSaint Kitts and NevisKNA200111166868111600

AMRSaint LuciaLCA200157192610141014141900

AMRSaint Vincent and the GrenadinesVCT20011327815815132700

AMRSurinameSUR2001923401032668153931801129

AMRTrinidad and TobagoTTO200115621820428415201772461562181218

AMRUruguayURY2001336542941151510901755758122133253460597300

AMRUnited States of AmericaUSA20012033182033186174336174337742887742884961034961032054972054974141154141157268872688

AMRVenezuela, Bolivarian Republic ofVEN200195311974727593628843621134168275034533774473900

AMR Total2177552312795109445304082381932779104482784894517390074916

EMRAfghanistanAFG20019140082360823609140000

EMRBahrainBHR2001112393181071432939749923831745

EMRDjiboutiDJI2001233616259142336711

EMREgyptEGY2001458153415435164161353988271487497710853630118394

EMRIran, Islamic Republic ofIRN20014172502710233123321329816024342412125271509660617305429516

EMRIraqIRQ200117107333668157436681574171073300

EMRJordanJOR20013739610034471133338433083739399684212

EMRKuwaitKWT20019961135267305267305996113500

EMRLebanonLBN200129940259079415112033249335122716512913923547

EMRLibyan Arab JamahiriyaLBY200142871633756233756242871600

EMRMoroccoMAR2001401356812312105135662398117792643641217733112

EMROmanOMN2001487744117178507748774467101

EMRPakistanPAK2001250130657830131792935017929350328170700

EMRQatarQAT200138534013912347413853409282

EMRSaudi ArabiaSAU20016382100602176343080112638281305638210060547862

EMRSomaliaSOM2001266232773277266200

EMRSudanSDN200181232353100835110018123227

EMRSyrian Arab RepublicSYR2001485318461940666194066485318400

EMRTunisiaTUN200152118019753370313108270242243840454156900

EMRUnited Arab EmiratesARE200118522010590641113122387420185220109099

EMRYemenYEM20011254412418532137571254412896

EMR Total574410213188433352534946052225623818615362544

EURAlbaniaALB2001195898303531661856351087924502

EURAndorraAND2001517559872436223381223

EURArmeniaARM20016834797496974966834700

EURAzerbaijanAZE2001622663113213301296226600

EURBelarusBLR2001145996586401490618290616441301800

EURBosnia and HerzegovinaBIH200112840221969021969012840200

EURBulgariaBGR20011967315351996117436114427339126539

EURCroatiaHRV200113572501143026373195883195887313600

EURCyprusCYP20011691713513553853898837738118218400

EUREstoniaEST20012045092385926816938571433483818

EURGeorgiaGEO2001188843213713511713502512500

EURIsraelISR2001259829137005785431233501312335014407494100

EURKazakhstanKAZ2001415191127312542731254415191100

EURKyrgyzstanKGZ20013273026231276312762723500

EURLatviaLVA2001135328259628234568122335671243000-1

EURLithuaniaLTU200144810385071175212491195451591371740

EURMaltaMLT20011271282172189910099100909000

EURMonacoMCO200130373138253025301100

EURRepublic of MoldovaMDA20014223843242432424223800

EURRomaniaROU20011837722720808184545214643169502197724395700

EURRussian FederationRUS20012468979111313448755280209422409524457176788845350845832312

EURSan MarinoSMR200113192636710710131700

EURSerbia-MontenegroYUG200162837537034200185110218511027544700

EURSloveniaSVN200194717831222230140977023944917032127551800

EURTajikistanTJK200110762518825188107600

EURThe former Yugoslav Republic of MacedoniaMKD20011745011985733510235102247200

EURTurkmenistanTKM2001532271978487230919815322714462101

EURUkraineUKR200110985899521279952127991098589900

EURUzbekistanUZB20013131716107587107587313171600

EUR Total11620329015721731115153537317644593436132384

SEARBangladeshBGD2001753363695245988874285753363665313

SEARBhutanBTN2001171242132131712400

SEARDemocratic People's Republic of KoreaPRK200136472813226413226436472800

SEARIndiaIND20014442147182042167670204216767044421471800

SEARIndonesiaIDN20016430985741322563123602091008235411352793382300

SEARMaldivesMDV20012566513513256600

SEARMyanmarMMR2001304169022478101036777810321660220324

SEARNepalNPL20018445319910721851000844531472

SEARSri LankaLKA200127711182901169313275111127711181245

SEARThailandTHA200165123962428893918256717175645155157091777654399363

SEARTimor-LesteTLS2001

SEAR Total7452709387166633590924491019231429222797

WPRBrunei DarussalamBRN20011231733245324512317300

WPRCambodiaKHM200160369343211429017896036953325

WPRChinaCHN20011194954261235891071223976618058515168637936172273116405286116797626

WPRCook IslandsCOK20012714142700

WPRFijiFJI200144124216121614412400

WPRKiribatiKIR200131231200

WPRLao People's Democratic RepublicLAO20013015424124199930154525

WPRMalaysiaMYS200119461804434715583755112271144634841785430100

WPRMarshall IslandsMHL2001611363661100

WPRMicronesia, Federated States ofFSM2001132551023132537

WPRMongoliaMNG20011890452231785136327133422

WPRNauruNRU2001711111171100

WPRNiueNIU2001121200

WPRPalauPLW2001816111181600

WPRPapua New GuineaPNG2001117702148618127211770216

WPRPhilippinesPHL200118210141059590912837162254141510035599877489526148

WPRSamoaWSM200111292625112901

WPRSingaporeSGP200127533411241367222727082159262584910336883

WPRSolomon IslandsSLB200117561412175602

WPRTongaTON2001514393951400

WPRTuvaluTUV20014330400

WPRVanuatuVUT2001513393951300

WPRViet NamVNM2001523304803028120275795132110536639428269898619

WPR Total1249556075569270144001192792160586764319378864

Grand Total7865329184525835536331855740849234149291101210637133993153784

int$

Territorial governmentSocial InsurancePrivate InsuranceOut-of-PocketOther

AFR2583915101344217073294557864

AMR489451231279530408277910749161529048

EMR3818610213333546052254497786

EUR59343329011731353732384129348

SEAR314292709166692449797128253

WPR676435607527011927928864319211

OECD less USA4987465837657990226176361334261763

12106379184526331859234121537842523273

xrate


AFR88396524562604692220099

AMR448278217755510944238193739001415170

EMR225635743188425347153655537

EUR17644116205721151361341349

SEAR101927453873359022244914

WPR160581249556944001193773123

OECD less USA40553753752164635215389548631223082

9291117865315835535740791339932873274

AMR less USA

int$


AFR2583915101344217075294357866

AMR557983248826541874319644778561668327

EMR3816610213333546051254597765.2508549491

EUR41181340741160816181400418751061440

SEAR314302709166692449797128254.150449637

WPR1453872477831205226679327770672015

12106186331859184521537869234123685667.40130459

xrate


AFR88396524562604692420099

AMR500602229816519868267846761021518132

EMR225625744188425351153555541

EUR2993933111715015312431832807785035

SEAR101927453873359022144914

WPR87522238404688111693322408449740

9291105837357865321339975740842873461

AMR less USA

00000

00000

00000

00000

00000

00000

Territorial government

Social Insurance

Private Insurance

Out-of-Pocket

Other

Composition of health spending - 2001Data estimated in international $ - Timor Leste not includedSource: NHA Unit, EIP/FER/RER, World Health Organization

00000

00000

00000

00000

00000

00000

Territorial government

Social Insurance

Private Insurance

Out-of-Pocket

Other

Composition of health spending - 2001Data estimated unsing average annual exchange rate - Timor Leste not includedSource: NHA Unit, EIP/FER/RER, World Health Organization

int$SS inUS$SS inInt$GGHE in USDGGHE in Int $Pvt HE in USDPvt HE in Int $Prepd inUS$Prepaid in Int$OOPS in USDOOPS in Int $Terr Gov /US$Terr Gov /Int$Other Pvt /US$Other Pvt /Int$

ImptsAss.obligatoireAss.privePaiements directsAutres dp.priv.

AFR25839151013442170732945608092033182033186174336174337742887742884961034961032054972054974141154141157268872688

AMR - USA753362796134305724132228212243

EMR38186102133335460522544100330

EUR59343329011731353732384131732

SEAR314292709166692449797129050

WPR676435607527011927928864328075

OCDE - USA49874658376579902261763613341485510

USA414115203318496103205497726881391721

Monde12106379184526331859234121537843839470

xrate

TaxesSocial health insurancePrivate health insuranceOut-of-pocket spendingOther private expenditure

AFR88396524562604692220099

AMR - USA34163144371484132696121296137

EMR225635743188425347153655537

EUR17644116205721151361341349

SEAR101927453873359022244914

WPR160581249556944001193773123

OCDE - USA40553753752164635215389548631223082

USA41411520331849610320549772688

Monde9291117865315835535740791339931554241

00000

00000

00000

00000

00000

00000

00000

00000

Impts

Ass.obligatoire

Ass.prive

Paiements directs

Autres dp.priv.

Structure des dpenses de sant- 2001 $ internationaux - Timor Leste non incluSource: Unit CNS, EIP/FER/RER,OMS

00000

00000

00000

00000

00000

00000

00000

00000

Taxes

Social health insurance

Private health insurance

Out-of-pocket spending

Other private expenditure

Composition of health spending - 2001Data estimated unsing average annual exchange rate - Timor Leste not includedSource: NHA Unit, EIP/FER/RER, World Health Organization

World Health Organization

Cambodia IndiaViet NamIndonesiaChinaPhilippinesSri LankaThailand100.0100.0100.0100.0100.0100.0100.0100.082.978.770.8 64.066.360.951.330.317.121.3 29.236.033.739.148.769.7Total HE, % Private HE,% Public HE, %Private out of pocket spendingSource: WHO/NHA 2005


World Health Organisation

Health care costs lead to poverty

Poverty Line

Health Expenditure

Income Distribution in Viet Nam (VLSS 1998)


Poverty and ill health Poor people more likely to become sick. Ill health contributes to poverty:- loss of earning, and employment- low chances of productive life- high financial burden


Facts Medical costs rise far faster than incomes in developing countries, creating heavy burden n individual families. Out of pocket payment for health care became a major reason for poverty among rural population. Increasing number of people borrow money or sell family assets to cover cost of health care.


Low financial protection The rapid increase in health care expenditure has not been accompanied by a similar trend in financial protection for everyone against health care costs.



II. Issues and challengesMajority of the population in Asia and the Pacific inadequately covered by social safety nets such as SHI.Few countries achieved near universal SHI coverage.HI coverage in many developing countries is still low.Excluded population: rural and self-employed population poor and vulnerable family defendants


What does the low coverage mean?Heavy financial burden on individualsUndesirable financial barrier in seeking care Unmet health needs and demand affecting healthIncreasing incidence of povertyInefficient and ineffective use of resourcesImpeding economic and social development


Challenges in extending coverage Socioeconomic factors Policy consensus and political commitment Policy and strategy development and plans Supporting legislation and regulations Technical and administrative capacity Health service and system infrastructure


Main causes Low awareness about social health insurance Lack of political commitment Limited evidence, data and information Vested interest versus needs Weak human resource development and management Poor coordination among partners


III. Recent and future reformsRecent and future reforms aimed to enhance SHI coverage in Asia and the Pacific need to answer:1. Whether SHI is feasible in low-income developing countries?2. Whether universal coverage is achievable if labour force has a large informal sector?3. Whether specific provider payment methods have any impact on increasing coverage?


Is SHI is feasible for low-income countries?

Regional experiences show that social health insurance is feasible with given policy consensus, political commitment and funding support for the poor and vulnerable. http://www.wpro.who.int/sites/hcf/documents/


Is universal coverage achievable ?

Regional experiences show that universal coverage is achievable with appropriately developed policy and design that covers both formal and informal sectors through a single or well coordinated multiple schemes, such as cooperative and community based health insurance (Thailand, China, Philippines)


Does payment methods have impact on coverage?

Regional experience and pilot projects show that provider payment methods such as capitation and case mix payments have some positive impacts on extension of coverage versus fee for service methods. (Mongolia, Lao DPR, Philippines)


Important features of successful reform Political commitment Affordable premiums Comprehensive benefits Family coverage Risk shared payment such as capitation Separate administration


IV. Conclusion Stable and equitable health care financing is needed for all countries. Paying for health care has become an issue for equity, access and family impoverishment. Problems may seem similar but solutions will be country specific. Social health insurance is one feasible option. Challenges in delivering SHI exist but solvable.


Regional strategy on health financingTo provide operational and practical guidance to the Member States in improving overall health financing arrangements that will mobilize adequate, and stable revenues provide effective financial protection, and ensure equitable access by all, to good quality health services.


Sharing experiences in SHIAsia and the Pacific have a wide range of experience on SHI development.Opportunities in sharing these experiences were limited for some reasons, but there is now increasing interest and demand in SHI. In collaboration with MOHW and NHIC of the R.O.Korea, a regional SHI training course was launched in 2004, Seoul.SHI development experience examined in 12 countries in Asia and the Pacific and lessons learnt published in a book.


Thank you

Documents

Current challenges in delivering social health insurance in Asia and the Pacific