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Health Financing Country Profiles in the Western Pacific Region

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Health Financing Country Profiles in the Western Pacific Region Health financing country profiles in the Western Pacific Region 1995–2011 Health financing country profiles in the Western Pacific Region 1995–2011 WHO Library Cataloguing-in-Publication Data Health financing country profiles in the Western Pacific Region: 1995-2011 1. Delivery of health care – economics. 2. Health expenditures. 3. Healthcare financing. I. World Health Organization Regional Office for the Western Pacific. ISBN 978 92 9061 674 0 (NLM Classification: W74) © World Health Organization 2014 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html). For WHO Western Pacific Regional Publications, request for permission to reproduce should be addressed to Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, fax: +632 521 1036, e-mail: [email protected] The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Contents FOREWORD . V ACKNOWLEDGEMENT . VI INTRODUCTION . 1 AUSTRALIA . 6 BRUNEI DaRUSSALAM . 11 CAMBODIA . 15 CHINA . 20 COOK ISLANDS . 26 FIJI . 30 FEDERATED STATES OF MICRONESIA . 34 JAPAN . 38 KIRIbaTI . 43 LAO PEople’s DEMOCRATIC REPUBLIC . 47 MALAYSIA . 53 MARSHALL ISLANDS . 57 MONGOLIA . 61 NAURU . 66 NEW ZEALAND . 70 NIUE . 74 PaLAU . 78 PaPUA NEW GUINEA . 82 PHILIPPINES . 87 REPUBLIC OF KOREA . 93 SaMOA . 98 SINGAPORE . 102 SOLOMON ISLANDS . 107 TONGA . 111 TUVALU . 115 VaNUATU . 119 VIET NAM . 123 iii iv HEALTH FINANCING COUNTRY PROFILES IN THE WESTERN PACIFIC REGION, 1995–2011 Foreword he WHO Western Pacific Region continues to face many challenges in ensuring that millions Tof people, particularly poor and vulnerable populations, have financial protection against illness to prevent financial hardship from out-of-pocket payments or a decision not to seek health services . The development and improvement of health financing policies and their monitoring and evaluation are important to a country’s journey towards universal health coverage, which is defined as all people having access to quality health services that are needed without enduring financial hardship paying for these services . WHO supports countries as they move closer towards universal health coverage through the development of their health financing systems . The third edition of the Health Financing Country Profiles for the Western Pacific Regionprovides summary descriptions of the health financing systems of 27 countries in the WHO Western Pacific Region . A cross-country comparison and individual country profiles of health expenditure trends from 1995–2011 are analysed in the context of each country’s health financing system, current issues and developments in health financing reform . Shin Young-soo, MD, Ph .d . Regional Director FOREWORD v Acknowledgement he third edition of Health financing country profiles for the Western Pacific Region provides an T update to the second edition with new health financing developments in the Western Pacific Region and more recently available data on health expenditures . Health financing country profiles for the Western Pacific Region is a product of the Health Care Financing unit of the WHO Regional Office for the Western Pacific, led by Ke Xu, within the Division of Health Sector Development under Division Director Vivian Lin . Annie Chu, Ding Yan and Ke Xu contributed to the technical updating of the report . Chris James and Nouria Brikci provided technical input to each profile . Marc Lerner edited the report . The Health Care Financing unit would like to thank the following for their valuable comments: Henrik Axelson, Valeria De Oliveira Cruz, Enkhee Erdenchimeg, Chandika Indikadahena, Ben Lane, Clement Malau, Thi Kim Phuong Nguyen, Lucille Nievera, Ann Robins, Paulinus Sikosana, Paul Chun Soo, and Thongleck Xiong . The unit would like to also give special thanks to Henk Bekedam who initiated the Health Financing Country Profiles for the Western Pacific Region project and supported the production of each edition during his tenure as the previous Director of the Division of Health Sector Development . Financial support from the Australia Government, Department of Foreign Affairs and Trade, formally the Australian Agency for International Development; Japan, Ministry of Health, Labour and Welfare; the Republic of Korea, Ministry of Health and Welfare; and the United Kingdom of Great Britain and Northern Ireland, Department for International Development, contributed to this publication . vi HEALTH FINANCING COUNTRY PROFILES IN THE WESTERN PACIFIC REGION, 1995–2011 Introduction s countries in the WHO Western Pacific Region undergo rapid economic development, health A financing plays an increasingly important role in efforts to progress towards universal health coverage, a vision of health sector development in which everyone has access to quality health services with financial protection . Experiences can be shared and lessons can be learnt from countries that are diverse in their geographic, economic and socio-demographic backgrounds as other countries, regardless of their backgrounds, undertake their own paths towards universal health coverage . The WHO Health Financing Strategy for the Asia Pacific Region 2010–2015 provides eight strategic areas to help countries move towards universal health coverage, including raising more money for health and gaining more health for the money . The strategy outlines four target indicators to monitor and evaluate progress towards universal health coverage: 1 . ut-of-pocketO (OOP) spending should not exceed 30%–40% of total health expenditure (THE) . 2 . otalT health expenditure should be at least 4%–5% of gross domestic product (GDP) . 3 . Over 90% of the population should be covered by prepayment and risk-pooling schemes . 4 . Close to 100% of vulnerable populations should be covered by social assistance and safety net programmes . The Health financing country profiles for the Western Pacific Region provides concise overviews of the health financing systems of Member States of the Western Pacific Region . The third edition of Health financing country profiles for the Western Pacific Region covers 1995 to 2011 . Health expenditure trends across and by countries are analysed using WHO National Health Account data, country health financing systems and policies, and recent developments . DATA The health expenditure and associated macroeconomic data used in these profiles come from the WHO Global Health Expenditure Database (http://www.who.int/nha/database). The standardized system of health accounts ensures accurate cross-country comparisons of health expenditures over time . It is important to note that in a few cases the data may differ from country-generated data due to methodological differences, although WHO works closely with governments to ensure consistency whenever possible . Note also that data are aggregated at the national level . INTRODUCTION 1 Health expenditure: cross-country comparisons As an introduction to the more detailed country-by-country profiles, the figures below provide simple cross-country comparisons in relation to some key health expenditure percentages in 2011 . The first figure shows health expenditures as a percentage of GDP, disaggregating total health expenditures into general government and private health expenditures . Few low-income countries have health expenditures of less than 4–5% of GDP . Health expenditure as % of gross domestic product (GDP) 18 16 14 12 10 as % of GDP 8 6 4 2 0 FJI KIR NIU JPN SOL PHL SGP NZL VUT TUV BRN AUS KOR LAO FSM COK PNG MYS NRU TON PLW CHN MHL KHM VNM MNG WSM GGHE as % of GDP PvtHE as % of GDP AUS Australia KHM Cambodia NZL New Zealand SLB Solomon Islands BRN Brunei Darussalam KIR Kiribati NIU Niue TON Tonga CHN China KOR Republic of Korea NRU Nauru TUV Tuvalu LAO Lao People’s COK Cook Islands PHL Philippines VNM Viet Nam Democratic Republic FJI Fiji MHL Marshall Islands PLW Palau VUT Vanuatu FSM Federated State
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