The role of the private sector in Asia: challenges and opportunities for achieving universal health coverage
The role of the private sector in Asia
Overview
How do public
sector insurance companies deal with contracting private providers? How are the
contracts managed? How do they ensure quality? How do they tackle corruption
and over billing?
The role of the private sector in Asia:
challenges and opportunities for achieving universal health coverage
is a new comparative country study published by the Asia Pacific
Observatory on Health Systems and Policies (APO) to highlight experiences
in three different Asian setting at various levels of maturity and
context to show how they tackle these issues.
Japan has a
nationally agreed fee for service package that is applicable across a plethora
of different insurance schemes and all providers, irrespective of their status.
In effect a purchasing monopoly where the negotiation for fee for service rates
are the key factor in determining how much private providers make.
Thailand, on
the other hand, has a very small private sector outside of Bangkok, hence
contracting with the private sector is an important policy issue only in the
Capital. Even there, the focus is on hospital services. The model, although
offers coverage, is challenged regarding provision of Primary Health Care
services in Bangkok, as there is neither enough providers nor patient demand
for them.
Philippines,
as a country that has recently started providing universal health coverage
through the national health insurance corporation still needs to iron out
technical challenges of managing different providers while ensuring quality and
tackling fraud. Simultaneously, the corporation, that was established many
decades ago also needs to reform internally to manage its much more universal
mandate and shift its focus towards providing equitable healthcare services for
the masses.
The detailed analysis of this book allows comparison of the systems and highlights challenges and solutions that although are context specific, can be used as learning process for other countries as we move towards achieving UHC across the globe.
How to Cite this publication
Sakamoto H, Aya I, Tangcharoensathien V, Witthayapipopsakul W, Dayrit MM, Dayrit E at al. The role of the private sector: challenges and opportunities in Asia for achieving universal health coverage. New Delhi: World Health Organization Regional Office for South-East Asia; 2023