Promoting Universal Healthcare Coverage (UHC) has become a common goal of ASEAN member states as it grants people access to healthcare without any barriers and hence improves their health conditions and wellbeing, according to Deputy Permanent Secretary of Public Health Ministry Dr Supakit Sirilak.
“However, each nation is at a different stage of establishing UHC. For example, [governments of] some countries have yet to provide health coverage to civil servants. It would be difficult for them to implement UHC in the near future,” Supakit, who oversees ministerial collaboration on the health agenda in ASEAN, said this week.
He classifies ASEAN countries into three groups based on their progress in UHC development.
First, the countries that have succeeded in setting up UHC, namely Brunei, Malaysia, Singapore and Thailand. The entire populations of these countries are covered by healthcare insurance.
Second, the countries that are moving closer to UHC, namely Indonesia, Philippines and Vietnam. Their governments have passed laws to guarantee healthcare access to citizens but their health insurance programmes do not cover every citizen at this stage.
Finally, the countries with limited resources, namely Cambodia, Laos and Myanmar. The governments of these countries lack financial resources to fund free healthcare for citizens.
According to data collected by the International Health Policy Programme (IHPP), each ASEAN nation has a different level of health expenditure, showing the gap in health access among citizens in the region.
In 2016, a Singaporean spent approximately Bt74,400 per person on health. A person in Brunei, Indonesia, Malaysia and Thailand spent from Bt3,400 to Bt19,000, while health expenditure per capita in Cambodia, Laos and Myanmar was less than Bt3,000 per person.
Noting that Thailand was a middle-income country that could achieve UHC without getting rich first, Supakit put the success of introducing UHC down to two main factors: infrastructure readiness and long-term commitment from the government.
Prior to the introduction of UHC in 2002, the Thai government allocated large budgets to improve health facilities including building hospitals in every district and increasing the numbers of rural doctors. The government, though led by different political parties in each term, made a strong commitment to improve UHC and expand its benefits. “But we don’t want just a few countries to achieve UHC. We want to see our neighbours, ASEAN members and the world do it,” said Supakit.
Achieving UHC is one of the main targets in the Sustainable Development Goals (SDGs) and the United Nations is strongly encouraging the leaders of every country to introduce UHC for the good health and wellbeing of their citizens.
ASEAN nations have recognised the SDGs’ target and put every effort into addressing health issues across all dimensions. In August, representatives and policymakers met at the 14th ASEAN Health Ministers Meeting in Siem Reap where the ministers of all ASEAN nations promised to deliver and improve UHC. They declared a commitment to strengthen primary health care in order to facilitate UHC, while ensuring the availability of essential medicines and cost-effective health interventions.
“Among ASEAN countries, we have a mechanism to progress our regional health agenda. We set up four clusters specialized in different health issues – health promotion, disease prevention, health system development and safe food. UHC is in the third cluster,” said Supakit.
“Thailand is trying to convince the other nations to co-found the ASEAN Centre for Active Ageing and Innovation (ACAI) where all health-relevant parties can share data, collaborate on research and exchange knowledge on the ageing society. Ageing is a common challenge among us. If we don’t plan well, UHC may find itself in trouble with too heavy a financial burden. However, some country representatives will need further consultation with their parliaments. Hopefully, we can establish the centre and work together soon.”