The struggle for universal healthcare in Asia

Abstract

These efforts have contributed to improving health outcomes, better access to health services, and importantly lowering out-of-pocket (OOP) spending on healthcare. OOP expenditure on healthcare—the amount that individuals have to pay (for which they are not reimbursed) in accessing health services—is a metric to measure financial protection that health systems offer. High OOP spending can reduce access to needed services, and in some cases pushes vulnerable households into poverty or force families to borrow or sell assets to pay for medical expenses. China and Singapore, for example, have reduced OOP spending on healthcare by more than 50 percent, and Thailand from 30 percent to less than 10 percent over the past two decades. India has made similar gains in reducing maternal mortality rates in line to meet United Nations Sustainable Development Goals by 2030.