UNIVERSAL SOCIAL HEALTH INSURANCE

Summary

This presentation explores the concept of Universal Social Health Insurance (USHI) and its global significance. It traces the historical evolution of Universal Health Coverage (UHC) from the WHO Constitution in 1946 to the 2018 Astana Declaration. The speaker emphasizes that UHC ensures everyone, regardless of financial status, can access quality health services without facing financial hardship. Several countries' healthcare systems, such as those in the UK, Canada, and Indonesia, are examined to highlight UHC models. The goal is to make healthcare equitable and affordable for all, with a focus on primary care and financial protection against health-related costs.

Takeaways

• 😀 Universal Health Coverage (UHC) aims to provide accessible, high-quality health services to all people without financial hardship.
• 😀 The WHO's 1946 constitution recognized the right to health, which later led to significant agreements such as Alma-Ata (1975) and Astana (2018) that shaped UHC goals.
• 😀 UHC includes comprehensive health services, such as promotive, preventive, treatment, rehabilitative, and palliative care, ensuring financial protection for everyone.
• 😀 A key principle of UHC is to eliminate financial barriers to healthcare, preventing people from having to sell assets to afford treatment.
• 😀 The three main dimensions of UHC are: equitable access to health services, high-quality healthcare, and financial protection against high medical costs.
• 😀 Countries like the UK, Canada, and Germany have different UHC models funded through taxes and employer contributions, with varying levels of coverage and services.
• 😀 Japan employs a co-payment system where citizens pay 20-30% of healthcare costs, aiming to balance affordability with personal responsibility for healthcare.
• 😀 Taiwan’s National Health Insurance system also includes traditional Chinese medicine in its services, highlighting cultural health practices alongside modern care.
• 😀 South Korea and Thailand have national health systems funded by contributions, with Thailand managing separate schemes for formal and informal sector workers.
• 😀 In Indonesia, Jaminan Kesehatan Nasional (JKN) was established in 2004, but by 2020, only 82.83% of the population was covered, with a goal of achieving 100% coverage.
• 😀 Achieving full UHC requires prioritizing primary healthcare, as it prevents the overburdening of secondary and tertiary care services, especially in low-income populations.

Q & A

What is the main concept behind Universal Social Health Insurance?

Universal Social Health Insurance aims to provide healthcare access to everyone, ensuring financial protection against healthcare costs, without barriers or discrimination. It is rooted in the idea that all individuals have a right to affordable and quality healthcare.

What is Universal Health Coverage (UHC) and why is it important?

Universal Health Coverage (UHC) ensures that everyone has access to needed healthcare services, including preventive, promotive, curative, rehabilitative, and palliative care, without facing financial hardship. It is vital for equitable health systems that protect people from health-related financial risks.

What are the key dimensions of Universal Health Coverage?

The three key dimensions of UHC are: 1) Access to health services, ensuring fairness in access across all populations; 2) Quality of health services, guaranteeing effective healthcare that improves people's health; 3) Financial protection, preventing individuals from experiencing financial hardship due to health costs.

How does Universal Health Coverage aim to prevent financial difficulties for individuals?

UHC helps by ensuring that no one has to sell assets like homes or land to afford healthcare. It emphasizes financial protection, preventing people from being forced into poverty or losing property due to healthcare expenses.

What is the difference between private insurance and Universal Social Health Insurance?

Private insurance is typically based on individual or employer contributions, often providing coverage to a select group, while Universal Social Health Insurance is a government-mandated system aimed at covering the entire population, regardless of income or employment status.

What are some examples of Universal Health Insurance systems in different countries?

Examples include: 1) The UK's National Health Service, funded by taxes from employers and workers; 2) Canada's Medicare, which also relies on taxes and government subsidies; 3) Germany's Sickness Fund, based on worker contributions; 4) Japan's system with co-payment options for citizens.

What challenges are associated with achieving Universal Health Coverage in Indonesia?

Despite the implementation of JKN (National Health Insurance), Indonesia still faces challenges in covering the entire population. As of 2020, approximately 82.83% of the population was covered, leaving around 17% uninsured, hindering the goal of 100% coverage.

What is the significance of the Astana Declaration (2018) in relation to Universal Health Coverage?

The Astana Declaration emphasized the importance of primary healthcare as the foundation for Universal Health Coverage. It reaffirms the commitment to achieving UHC by integrating primary healthcare as a core component of health systems globally.

What role does primary healthcare play in Universal Health Coverage?

Primary healthcare plays a critical role by providing basic health services at the community level, which can reduce the need for more expensive secondary or tertiary care. This approach aims to improve health outcomes and reduce overall healthcare costs.

Why are high taxes in some countries like Germany and Japan often linked to successful Universal Health Coverage systems?

High taxes in countries like Germany and Japan fund comprehensive healthcare systems that provide universal access to medical services. These systems ensure financial protection and equitable healthcare for all citizens, regardless of their income.