scholarly journals Health Insurance in Myanmar: The Views and Perception of Healthcare Consumers and Health System Informants on the Establishment of a Nationwide Health Insurance System

Risks ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 81
Author(s):  
Marjolein van Rooijen ◽  
Chaw-Yin Myint ◽  
Milena Pavlova ◽  
Wim Groot
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Rural Areas ◽  
Social Protection ◽  
Vulnerable Groups ◽  
Health Insurance System ◽  
Structured Interviews ◽  
Insurance System ◽  
Supplementary Health Insurance ◽  
Insurance Model

(1) Background: Health insurance and social protection in Myanmar are negligible, which leaves many citizens at risk of financial hardship in case of a serious illness. The aim of this study is to explore the views of healthcare consumers and compare them to the views of key informants on the design and implementation of a nationwide health insurance system in Myanmar. (2) Method: Data were collected through nine focus group discussions with healthcare consumers and six semi-structured interviews with key health system informants. (3) Results: The consumers supported a mandatory basic health insurance and voluntary supplementary health insurance. Tax-based funding was suggested as an option that can help to enhance healthcare utilization among the poor and vulnerable groups. However, a fully tax-based funding was perceived to have limited chances of success given the low level of government resources available. Community-based insurance, where community members pool money in a healthcare fund, was seen as more appropriate for the rural areas. (4) Conclusion: This study suggests a healthcare financing mechanism based on a mixed insurance model for the creation of nationwide health insurance. Further inquiry into the feasibility of the vital aspects of the nationwide health insurance is needed.

scholarly journals Trade-off between Efficiency and Equity on the Rationing in Health Insurance System: the Burden on the Poor

2019 ◽  
Author(s):  
Manal Etemadi ◽  
HasanAbolghasem Gorji
Keyword(s):  
Health Insurance ◽  
Vulnerable Groups ◽  
Service Access ◽  
Health Insurance System ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Financing System ◽  
Insurance System ◽  
The Poor ◽  
Main Challenge

Background: Nearly all of the rationing mechanisms have negative impacts on the poor. If the fair service access is not set as the top priority in the rationing choices, the poor will experience service limitation and scarcity. This study aims at investigating the effects of rationing policies on the poor covered by Iran Health Insurance System. Methods: This article is based on a qualitative study conducted in 2017. In total, 32 experts of health system financing participated in the study. A purposeful sampling method was applied till reaching knowledge saturation. Data were collected using semi-structured interviews. Afterwards, data was analyzed by framework analysis based on Bennet and Gilson pro-poor health financing system framework using MAXQDA10 software.        Results: The main challenge of rationing through the insurance system in Iran is the rationing only for the poor. As a result of rationing decisions, the poor are mostly the first group affected by service limitation only because they exempted from paying the premium. The current implicit or explicit health services rationing policies in each dimension has jeopardized the access of the poor to the services. Conclusion: Every resource allocation and negotiation of service purchaser on the budgets should be aligned with the focus on vulnerable groups and their needs. The access of deprived groups should not be reduced for limited budgets or income prioritization. Every decision about the constraints on the usage of the services should be accompanied by the analysis of potential effects on the poor and preventive policies should be implemented so that the burden of service rationing could not be imposed on the poor

Ethical Reflections on the Equity of the Current Basic Health Insurance System Reform in China: A Case Study in Hunan Province

2018 ◽  
Vol 27 (3) ◽  
pp. 447-458 ◽  
Author(s):  
JUNXIANG LIU ◽  
JINGZI XU ◽  
TIANYU ZHANG ◽  
YONGHUI MA
Keyword(s):  
Health Insurance ◽  
Hunan Province ◽  
Vulnerable Groups ◽  
System Reform ◽  
Health Insurance System ◽  
Basic Health Insurance ◽  
Basic Health ◽  
Insurance System ◽  
Insurance Reform ◽  
Health Insurance Reform

Abstract:China’s current basic health insurance reform aims at promoting equity in the economic accessibility of health services for all citizens, to better ensure healthcare justice. Therefore, it is important to assess equity not only from a socioeconomic perspective but also from an ethical angle. This article investigates the basic health insurance system of Hunan Province in China by focusing on insurance types as well as their classification standards, mechanisms, and utilization according to local policy documents and data. This study demonstrates the reforming achievements and the inequity of institutional design according to two interrelated dimensions: equal opportunity of access to healthcare insurance and reducing inequality in insurance benefits. The article concludes that to achieve opportunity equity and outcome fairness, the reform should focus on designing the system to promote equity with respect to procedures and rules and to be more attentive to the interests of vulnerable groups and especially to rural residents.

scholarly journals Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamidreza Khankeh ◽  
Mehrdad Farrokhi ◽  
Juliet Roudini ◽  
Negar Pourvakhshoori ◽  
Shokoufeh Ahmadi ◽  
...  
Keyword(s):  
Health System ◽  
Social Protection ◽  
Social Inequalities ◽  
Mental Health Problems ◽  
Patient Flow ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Cultural Issues ◽  
Structured Interviews

Abstract Background With the unprecedented expansion of COVID-19 in the world since December 2019, Iran’s health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. Methods The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. Results Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. Conclusions According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.

THE ROLE OF SELF-HELP IN PATIENTS SOLIDAR RESPONSIBILITY TO OWN HEALTH

Vestnik ◽  
2021 ◽  
pp. 328-331
Author(s):  
С.К. Молдабаев ◽  
С.А. Мамырбекова ◽  
Д.Н. Маханбеткулова
Keyword(s):  
Health Insurance ◽  
The State ◽  
Shared Responsibility ◽  
Self Management ◽  
Health Insurance System ◽  
Insurance System ◽  
Self Help ◽  
Compulsory Health Insurance ◽  
The Republic

Согласно Концепции Государственной программы улучшения здоровья населения на 2020-2025 годы в рамках дальнейшего внедрения системы ОСМС в РК одним из основных задач госудаства является повышение солидарной ответственности граждан за свое здоровье. Существующая солидарная ответственность должна побуждать пациентов развивать навыки самопомощи/самоменеджмента с целью лучшего управления собственным здоровьем. Цель исследования. Анализ роли самоменеджмента пациентов в системе солидарной ответственности за свое здоровье. Материал и методы. Данный обзор основывается на материалах ВОЗ и статей зарубежных и отечественных исследователей. Выводы. На сегодняшний день, в системе здравоохранения Казахстана одним из основных моментов является солидарная ответственность государства, пациента и работодателя. Ведь каждый гражданин должен принимать важные решения, которые оказывают существенное влияние на состояние его здоровья. Поэтому стратегии по повышению грамотности пациентов, их вовлеченность в процесс принятия решений и развитие самоменеджмента должны быть одними из фундаментальных стержней существующей системы ОСМС и политики здравоохранения. According to the Concept of the State Program for improving the health of the population for 2020-2025, as part of the further implementation of the compulsory health insurance system in the Republic of Kazakhstan, one of the main tasks of the state is to increase the joint responsibility of citizens for their health. The existing shared responsibility should encourage patients to develop self-help / self-management skills in order to better manage their own health. Purpose of the study. Analysis of the role of patients' self-management in the system of joint responsibility for their health. Material and methods. This review is based on WHO materials and articles of foreign and domestic researchers. Findings. Today, in the health care system of Kazakhstan, one of the main points is the joint responsibility of the state, the patient and the employer. After all, every citizen must make important decisions that have a significant impact on his health. Therefore, strategies to improve patient literacy, their involvement in the decision-making process and the development of self-management should be one of the fundamental pillars of the existing compulsory health insurance system and health policy.

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