Universal healthcare

Despite gains, almost half of Southeast Asians lack basic healthcare

Despite healthcare successes, nearly half of Southeast Asians lack access to adequate healthcare and many are falling into crippling debt due to medical bills

Tom O'Connell
June 1, 2018
Despite gains, almost half of Southeast Asians lack basic healthcare
A doctor in Vietnam examines scans of a boy suspected of having bird flu. Corporatisation of health schemes could pave the way to universal healthcare Photo: Hoang Dinh Nam / AFP

The push for universal healthcare in Southeast Asia is seeing successes in some countries, but an estimated 65 million people in the region are pushed into poverty each year due to paying their own healthcare bills.

The World Health Organisation (WHO) cited that figure, and also said nearly half of Southeast Asians lack basic care, when it reiterated its call for universal healthcare in the region on World Health Day, 7 April.

As the region continues to develop and incomes rise, so do conditions such as obesity and diabetes, according to Dr Lee Poh Onn, a senior fellow at Singapore’s Institute of Southeast Asian Studies – Yusof Ishak Institute. “Such non-communicable diseases are becoming a serious issue [in Malaysia] partly caused by rising affluence,” he says. “Hypertension had increased by 43%, diabetes by 88% and obesity by 250% in 2012 compared to 2002.”

Indonesia, which has the world’s fourth-largest population, set off on a mission in 2014 to provide healthcare to all of its 260 million citizens with its single-payer healthcare system. The nation hopes to have universal cover by 2019.

The Philippines and Vietnam, meanwhile, are closing the gap on universal healthcare. The Philippines’ national health policy, launched in 2010, now covers 90% of citizens, according to the Philippine Canadian Inquirer. In Vietnam, the WHO estimates that 73% of citizens have health coverage.

Indonesia, the Philippines and Vietnam “serve as good examples” for the rest of Southeast Asia to follow, “but there are vast economic differences between these and other Southeast Asian countries”, and it all comes down to governments’ budget priorities, says Lee.

Among the things that need to happen in order for universal healthcare to take root, says Lee, is the corporatisation of health schemes, at least for the more developed countries. This could be in the form of a compulsory social health insurance scheme, he says, but with government assistance for those who can’t afford it.

The doctor cites the success of Singapore’s corporatising of its public hospitals, which he says “has resulted in better delivery of medical services to all segments of society”.

Lee recommends a tiered system, with private costs for those who can afford them and government subsidies for those who cannot: “Free healthcare can then be provided to those who cannot afford to pay at all.”

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