Universal Health Coverage (UHC) is a goal for health systems where everyone can access healthcare services regardless of their ability to pay and while avoiding the incurrence of catastrophic costs. Many countries in the Asia Pacific, as well a globally, are experiencing rising healthcare costs driven by increasing raw material costs, increases in the proportion of older people in the population, technological advances, health system inefficiencies, income growth, the transition from infectious to chronic diseases in lower income countries and the disproportionate rise of labour costs compared to productivity growth. Furthermore, health systems generally have insufficient government funding for health and UHC and out-of-pocket (OOP) spending remains high. Aging populations also have consequences for the value of funds raised from the working population due to a shrinking taxable workforce. The ability to raise sufficient funds for UHC in light of these issues is a major challenge. A key aim should be the creation of fiscal space – the creation of capacity in their (national) budgets that can be used for specific purposes without compromising their financial stability and sustainability.
This study analyses the health financing challenges facing six ASEAN counties – Indonesia, Malaysia, the Philippines, Singapore, Thailand and Viet Nam and explores a number of traditional and innovative health financing methods that may be beneficial for ASEAN health systems to achieve UHC.
We aimed to answer four underlying research questions: 1). What progress has been made toward Sustainable Development Goal 3 in ASEAN-6? 2). What are the key organisational and financial challenges in each healthcare system? 3). How large is the fiscal gap in the countries of interest? And 4). What financing mechanisms are acceptable to increase fiscal space for healthcare?