The rocky road to universal health coverage in Egypt: A political economy of health insurance reform from 2005-15

2018 ◽  
Vol 71 (2) ◽  
pp. 79-101 ◽  
Author(s):  
Sharif A. Ismail
Author(s):  
Sabrina Ching Yuen Luk

This article uses a refined version of historical institutionalism to critically examine the complex interplay of forces that shape the health insurance reform trajectory in China since the mid-1980s, problems that plague the current multi-layered social medical insurance system and solutions to these problems. It shows that achieving universal health coverage (UHC) requires the government to ensure financing equity between urban and rural insured participants, access to affordable health care and the financial sustainability of medical insurance funds. Facing the challenges of rapidly aging population, the government implements a pilot scheme that integrates medical and nursing care for the elderly and a pilot long-term care insurance scheme for disabled elderly. It is expected that these two pilot schemes can provide better financial protection and quality of medical services for the elderly.


Author(s):  
Muhammad Arief Hasan ◽  
Puput Oktamianti ◽  
Dumilah Ayuningtyas

Abstract. JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the premium size. From the organization structure, all the stakeholders have been well coordinated. We conclude that we are not ready to implement the JKN. We recommend that mass and effective socialization program to be performed using various methods of communication and involve the community. To reduce the disparity of healthcare services, we recommend that the regional government to establish various healthcare facilities to accelerate health development. There should also be regulations that allocates healthcare staff in every corner of the country to achieve Universal Health Coverage in 2019, as stated in the National Health Insurance Road Map. Keywords: policy analysis, national health insurance, universal health coverage


2021 ◽  
Author(s):  
Hasbullah Thabrany ◽  
Ryan R. Nugraha ◽  
Ery Setiawan ◽  
Farah Purwaningrum

Abstract Background. Indonesia is nearing its 7-year implementation of its national health insurance scheme, or the Jaminan Kesehatan Nasional (JKN), as a facilitator for achieving universal health coverage (UHC). Despite its long-running system, it is contentious as to whether JKN has been narrowing the gap of inequity in its delivery. This paper aims to explore on whether the national health insurance scheme in Indonesia have been promoting equity of access towards health services.Methods. This study analyzes findings from JKN statistic data of 2014-2018 published by Government of Indonesia. Using a retrospective design, this study identified membership and utilization of health services within JKN, based on different membership enrollment groups as proxy for income.Results. JKN has been expanding its enrollment significantly within 5 years, during year 2014 to 2018. Moreover, the study concludes that there was increased access for outpatient in all membership groups. Inpatient care was increased in low-income group, but not in high-income group. Result also showed inpatient access was correlated with adequate supply side intervention, particularly hospital beds.Conclusion. JKN has been successful in narrowing the inequity gap, particularly by serving the low-income group better in terms of access. Going forward, equity needs to be incorporated into JKN achievement indicator, particularly to accelerate Indonesia’s effort to realize universal health coverage.


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