univer­sal con­cern

De­spite health­care suc­cesses, nearly half of South­east Asians lack ac­cess to ad­e­quate health­care

Southeast Asia Globe - - Health -

Hy­per­ten­sion had in­creased by 43%, di­a­betes by 88% and obe­sity by 250% in 2012 com­pared to 2002

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.” – Tom O'Con­nell

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

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