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Enrollment of firms in social security in Lao P.D.R. : perspectives from the private sector : Main report (Inglês)

Social Health Insurance (SHI), which is part of a broader social security system, is one of the main risk-protection schemes operating in Lao People's Democratic Republic (PDR) and is expected to play an important role in moving the country toward universal coverage in the health sector. Although the scheme is mandatory, enrollment among the target population is low due a variety of reasons that are only partially understood. This study was conducted to better understand the factors affecting enrollment in SHI, to document employers' experiences with and perceptions of the scheme, and to identify opportunities and challenges of expanding coverage in the future. A survey was administered to 130 employers (including 65 member firms and 65 non-member firms) in Vientiane Capital. The study reveals opportunities for strengthening SHI and expanding enrollment, but also highlights the challenges of achieving high coverage rates. Expansion will require increased formalization of the labour market, effective enforcement mechanisms and effective and efficient tax collection systems. Stronger enforcement also increases incentives for evasion and informality of the labour market, while voluntary enrollment within firms makes the scheme prone to adverse selection. As the government finalizes the new health financing strategy, the costs and benefits of various approaches should be considered. However, regardless of the financing arrangement taken, increased public spending in the health sector and improved coordination The study reveals opportunities for strengthening SHI and expanding enrollment, but also highlights the challenges of achieving high coverage rates. Expansion will require increased formalization of the labour market, effective enforcement mechanisms and effective and efficient tax collection systems. Stronger enforcement also increases incentives for evasion and informality of the labor market, while voluntary enrollment within firms makes the scheme prone to adverse selection. As the government finalizes the new health financing strategy, the costs and benefits of various approaches should be considered. However, regardless of the financing arrangement taken, increased public spending in the health sector and improved coordination across schemes can help to strengthen the health system and build up the foundation on which universal coverage can be achieved.

Detalhes

  • Data do documento

    2010/11/01

  • TIpo de documento

    Outro estudo sobre saúde

  • No. do relatório

    58580

  • Nº do volume

    1

  • Total Volume(s)

    2

  • País

    República Democrática Popular do Laos,

  • Região

    Leste Asiático e Pacífico,

  • Data de divulgação

    2010/12/21

  • Disclosure Status

    Disclosed

  • Nome do documento

    Main report

  • Palavras-chave

    natural resource policy;social security;financing need;scheme will;access to health care;quality of health services;access to health service;tax identification number;social security benefit;social security scheme;social security payment;health financing strategy;quality of care;social security system;social security contribution;health care benefit;lack of knowledge;health financing reform;mandatory health insurance;private health insurance;income generating activity;international social security;participation in health;private insurance market;social security financing;formal sector worker;higher education level;expansion of enrollment;social security pension;social health insurance;form of tax;provincial tax;number of beneficiaries;lump sum tax;incentive for employer;contribution to health care;health health;challenges in mind;private sector worker;general tax revenues;health insurance benefits;health care system;social security program;types of firms;temporary worker;odds ratio;sick leave;benefit package;coverage rate;adverse selection;tax payment;universal coverage;retirement benefit;health protection;enrollment rate;direct payment;confidence interval;informal sector;government hospital;informant interviews;annual leave;operational change;personal communication;permanent worker;Labor Market;university education;maternity benefit;secondary data;pay taxes;smaller enterprise;statistical term;quality improvement;waiting time;employee turnover;small sample;tax registration;diminishing return;policy question;international body;reporting procedure;employee benefit;hospital staff;local research;government staff;financial protection;occupational disease;inspection unit;field work;health equity;capitation payment;fiscal space;health finance;labour law;expanding enrollment;hotel sector;national assembly;positive impact;information strategy;risk pool;gradual decline;employers attitude;social insurance;tax base;informal firms;age distribution;company revenue;Population Growth;consensus building;license requirement;baseline scenario;international standard;large enterprise;daily wage;formal tax;government spending;government expenditure;average risk;administrative cost;world development;business information;domestic company;financial resource;firm level;employee contributions;cooperative arrangement;construction company;tax group;regulatory structure;benefit structure;foreign owner;negative effect;documentation process;voluntary scheme;financial incentive;geographic reach;employee health;mandatory insurance;primary source;trade registration;limited capacity;financial status;multivariate analysis;seasonal basis;promotion activity;extreme poverty;business entity;death benefit;maternity leave;perceived risk;regulatory procedure;cross-sectional nature;causal relationship;public provider;retirement pension;employment injuries;business association;membership organizations;employment contract;firm survey;unenrolled population;sample bias;foreign ownership;inpatient care;response rate;risk profile;Tax Administration;reduced expenditure;Business Registration;international security;employment injury;income ceiling;public health;monitoring data;economic census;road access;advance account;administrative efficiency;international insurance;study period;government subsidy;logistic regression;disability insurance;average cost;Public Spending;population level;enforcement mechanism;population increase;geographic area;financing arrangement;efficient tax;tax system;general revenues;sampling error;cost escalation;sampling frame;construction industry;

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