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Decision time: Cost estimations and policy implications to advance Universal Health Coverage in Cambodia

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  • Kolesar, Robert John
  • Pheakdey, Sambo
  • Jacobs, Bart
  • Phay, Sokchegn

Abstract

Cambodia aims to expand social health protection to move toward Universal Health Coverage. We developed a modeling tool to facilitate the simple, interactive estimation of cost and coverage for three policy alternatives, enabling decision-makers to simultaneously adjust for scenario options currently under consideration. Assuming the adoption of all scenario options, the projected cost of expanding social health protection to all is US$42 million, to vulnerable individuals is US$32.1 million, and to uncovered 1st–3rd wealth quintile people is US$30.4 million. These policy alternatives are projected to increase population coverage to 100%, 89.1%, and 92.5% by 2025, respectively. The results have multiple policy implications. First, given the similar costs and coverage estimates for the targeted approaches, and other considerations, expansion to the 1st–3rd wealth quintiles is recommended. Second, the model quantifies the potential impacts for policy changes relating to each scenario option. The inclusion of dependents under the contributory schemes significantly shifts costs; reversing the policy of non-payment for priority public health services increases public health facility revenue; and, alignment of reimbursement rates leverages demand-side financing which can increase value for money. Finally, the cost estimates provide a basis for economic planning. Revenue raising options include increasing the contribution ceiling for the private employees’ scheme and the progressive adoption of strategic purchasing.

Suggested Citation

  • Kolesar, Robert John & Pheakdey, Sambo & Jacobs, Bart & Phay, Sokchegn, 2021. "Decision time: Cost estimations and policy implications to advance Universal Health Coverage in Cambodia," Journal of Policy Modeling, Elsevier, vol. 43(1), pages 127-145.
    • Handle: RePEc:eee:jpolmo:v:43:y:2021:i:1:p:127-145
    DOI: 10.1016/j.jpolmod.2020.04.009
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    References listed on IDEAS

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    1. Robert Kolesar & Sambo Pheakdey & Bart Jacobs & Narith Chan & Samedy Yok & Martine Audibert, 2020. "Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations," Post-Print hal-02545747, HAL.
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    7. Robert Kolesar & Sambo Pheakdey & Bart Jacobs & Narith Chan & Samedy Yok & Martine Audibert, 2020. "Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations," Post-Print hal-02545471, HAL.
    8. Mcintyre, Di & Meheus, Filip & Røttingen, John-Arne, 2017. "What level of domestic government health expenditure should we aspire to for universal health coverage?," Health Economics, Policy and Law, Cambridge University Press, vol. 12(2), pages 125-137, April.
    9. Alwang, Jeffrey & Siegel, Paul B. & Jorgensen, Steen L., 2001. "Vulnerability : a view from different disciplines," Social Protection Discussion Papers and Notes 23304, The World Bank.
    10. Bart Jacobs & Kelvin Hui & Veasnakiry Lo & Michael Thiede & Bernd Appelt & Steffen Flessa, 2019. "Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia," Health Economics Review, Springer, vol. 9(1), pages 1-14, December.
    11. Knut Lönnroth & Philippe Glaziou & Diana Weil & Katherine Floyd & Mukund Uplekar & Mario Raviglione, 2014. "Beyond UHC: Monitoring Health and Social Protection Coverage in the Context of Tuberculosis Care and Prevention," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-10, September.
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    Cited by:

    1. Robert John Kolesar & Guido Erreygers & Wim van Dam & Vanara Chea & Theany Choeurng & Soklong Leng, 2021. "Hardship Financing, Productivity Loss, and the Economic Cost of Illness and Injury in Cambodia," Working Papers hal-03437399, HAL.
    2. Robert John Kolesar & Peter Bogetoft & Vanara Chea & Guido Erreygers & Sambo Pheakdey, 2022. "Advancing universal health coverage in the COVID-19 era: an assessment of public health services technical efficiency and applied cost allocation in Cambodia," Health Economics Review, Springer, vol. 12(1), pages 1-20, December.

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    More about this item

    Keywords

    Social health protection; Universal health coverage; Policy options; Cost modeling; Cambodia;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • C6 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling

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