Universal health coverage (UHC) isn’t simply about bringing everyone into a health insurance or ‘financial protection’ scheme, and giving everyone legal guarantees to health care. Ultimately it is about ensuring that everyone – irrespective of their ability to pay – can access the health services they need without suffering undue financial hardship in the process. This seminar presented the results of a study of UHC covering six Asian countries (Cambodia, China, Indonesia, the Philippines, Thailand and Vietnam) conducted by researchers from these countries, and from several European universities and the World Bank. The project – known as the ‘Health Equity and Financial Protection in Asia’ or HEFPA project – set out to explore the effectiveness of a number of strategies these countries have used to try to achieve UHC, including both demand-side interventions such as subsidized health insurance, as well as supply-side interventions such as pay-for-performance. The project reached three major and somewhat counterintuitive conclusions: subsidized health insurance is not the panacea many policymakers appear to think it is; health insurance coverage doesn’t always improve financial protection, and when it does, it doesn’t necessarily eliminate financial protection concerns; and tackling health care provider incentives may be just as – if not more – important in the UHC agenda as demand-side initiatives.

Adam Wagstaff, Research Manager of the Human Development and Public Services team in the World Bank’s Development Research Group, who coordinated the HEFPA project, presented the key results of this multi-country study. Simultaneous translation at the World Bank seminar in Tokyo on Oct 16, 2014.

Presentation

ON THE ROAD TO UNIVERSAL HEALTH COVERAGE: LESSONS FROM A MULTI-COUNTRY STUDY IN EAST ASIA (PDF)

Adam Wagstaff Research Manager, Human Development and Public Service,Development Research Group, World Bank	Professor Hideki Hashimoto Graduate School of Medicine, University of Tokyo

Speaker

Adam Wagstaff is Research Manager of the Human Development and Public Services team in the World Bank’s Development Research Group. He holds a DPhil in Economics from the University of York (UK) and before joining the Bank was Professor of Economics at the University of Sussex (UK).

He is President-Elect of the International Health Economics Association, was Associate Editor of the Journal of Health Economics for 20 years, and has published extensively in many areas of health economics but especially on equity, financial protection, and health system reform.
Website

Commentator

Professor Hideki Hashimoto
Graduate School of Medicine, University of Tokyo

Hideki Hashimoto, MD DPH, received MD from the University of Tokyo Medical School. After clinical training as a cardiologist, he finished his master degree in health policy and management and doctoral degree in health communication at Harvard School of Public Health. His research interests covers performance of healthcare systems, effectiveness of healthcare both in micro-situation and nation-scale, and socio-economic context of health. He contributed to the Lancet’s Japan Series in 2011 featuring Japan’s achievement of universal health coverage over 50 years.