Seeking universal health coverage of social health insurance in three Asian countries: China, Thailand, and Viet Nam

Abstract

While social health insurance (SHI) schemes vary according to country circumstances, they remain the chief means to achieving widest inclusion of people who are in dire need of Healthcare. SHI schemes in various countries initiated by governments—and sometimes by private entities—are meant as an alternative to tax payments and out-of-pocket (OOP) expenditures in times of medical needs. They are expected to reduce OOP by pooling members’ contributions into a fund where payments for health-care services will be drawn. Such pooled money, which constitutes the bulk of SHI funds, is in the hands of the government. SHI is generally supported by different forms of state subsidy, sometimes foreign funded as in the case of Viet Nam, or by taxes on alcohol and tobacco products. Recently, SHIs are employed to achieve universal health coverage (UHC) so that no person is left without the means to access or even pay for Healthcare. While advanced economies have achieved UHC, SHIs in developing countries are “typically characterized by large-scale exclusion”