Page 24 - The Insurance Times June 2020

point of service from the current level of 64% to 32% Essential roles of a National Health
by the year 2032.
Insurance mechanism revenue collection
X The strategy further aims to ensure efficiency in
Collecting revenue in health insurance can vary from being
resource allocation within the MoHFW in order to attain
financed by the client as well as the employer like Thailand
maximum value for money and an equitable and started co-payment on health service and later resulted fully
sustainable financing mechanism.
subsidizing the premium by virtue of which currently has
X Indeed, the success of any health financing strategy achieved universal coverage for health.
depends not only how the resources are accumulated
but also on how the collected revenues are spent and India has a wonderful revenue collection strategy varying
allocated. from full subsidization from government to combined
contribution from employer, employee and government.
X Risk pooling through an insurance mechanism has
Revenue of Ghana comes from VAT on goods and services
proved to be an efficient health financing mechanism,
(70%) followed by compulsory contribution from formal
which possesses the ability to ensure higher value for
sector workers in the form of social security tax (23%) where
money for healthcare.
premium from the members is only 5% of the total revenue.
X The government of Bangladesh is also inclined towards If Bangladesh could follow the revenue collection strategy
testing social health insurance schemes in this regard. of these countries, it would be more helpful for the nation.
The current strategy plans to combine funds from tax- Due to lot of people in informal sector in Bangladesh it
based budgets with the social health protection becomes difficult to collect.
scheme, existing community-based and other
prepayment schemes, and donor funding to ensure Bangladesh government is currently following India to fully
financial protection against health expenditures for all subsidize the premium for the population below the poverty
segments of the population. line (BPL) to ensure universal coverage for all though it's
required further investigating. The example of Ghana could
X The importance and interest in testing social health
protection schemes was also highlighted in the country's also prove to be useful in Bangladesh to include people from
all spare. Bangladesh however can mix several methods that
health sector Strategic Investment Plan (SIP) of 2003-
2010. could be also useful.
X The current health financing strategy of Bangladesh In the developing and under developed countries financing
further elaborates on the path towards universal health reforms followed a path where health insurance schemes
coverage where it includes small scale health insurance are solely introduced for the formal workforce. In this
schemes like micro health insurance or community system better quality health and resources can be focused
health insurance as an intermediary step towards to already an advantaged and organized group, which in
establishing a social health insurance mechanism to another form exacerbates inequities in societies and leads
cover the risks of ill-health nationwide. to a two-tier system of healthcare provision.

There are some organizations have launched micro health The Choice between Formal vs. Informal
insurance in the country. In order to make it more successful Care
and effective operational system should be designed and
developed. We have found that the majority (about 60%) of those
interviewed who have sought some form of health care
followed by private providers (about 26%) and government
In this regard, prepayment for health, diversifying source
providers (about 11%). More than two-thirds (about 68%)
of funding, monitoring of dynamics of health insurance of those who went to informal providers, visited quacks
market and ensuring easy access to health service for the
(followed by drugstore salesman (about 22%).
poor demand deeper understanding should be ensured. For
this the country needs to accumulate findings from the This report has revealed that the main reason for selecting
existing trials and or programs to build a system that would the type of provider by about 42 per cent of those who
allow efficient risk pooling and fund allocation under a well- sought 'informal' care followed by the 'low cost of
managed national insurance scheme. treatment' (about 31%).

24 The Insurance Times, June 2020