“Continue free health,” SLMA urges
View(s):Sri Lanka should continue its free, tax-funded health scheme while any new health insurance scheme must only be a complementary strategy to free medical care, the country’s main body of medical professionals has said.
The Sri Lanka Medical Association (SLMA), the apex medical association in the country, offered this piece of advice to the Government in presenting its proposals for the November Budget.
SLMA President Prof. Chandrika Wijeyaratne, in a media release titled “Recommendations for budget proposals 2018 for the health sector”, said experts in health policy, medical practitioners, medical administrators, and economists met to discuss relevant health policy issues that needed to be included in the budget.
Most recent data from the Household Income and Expenditure Survey, National Health Accounts, and other research studies were analysed and discussed, she said.
In its budget recommendations which were for health in the broadest sense, the SLMA said Sri Lanka continues to be a model in the world in terms of its health system and most of these achievements are possible because of a tax-funded, state healthcare system. “This is performing relatively well and should be maintained. The WHO and many eminent health economists too have promoted such a tax-funded system as the best option to deliver universal health coverage,” the SLMA said.
It pointed out that a Social Health Insurance (SHI) scheme should be implemented only as a complementary strategy to the existing tax funded system.
Further, SHI should be mainly employer-funded insurance schemes. “Though there are advocates for private health insurance, there is limited space in the system for this. Furthermore, the experiences from other countries show that private insurance increases the costs of healthcare,” according to the recommendation.
The SLMA called for an increase in the health sector budget saying it should be invested in a productive manner (e.g. strengthening primary curative care services).
The association pointed out that primary curative care services (state sector clinics and outpatient departments where doctors provide simple curative care to a pre-defined population) provides clear benefits to the poorer segments of the population in Sri Lanka who currently access private clinics at extra cost.
Strengthening primary curative care services (PCCS), it said, should be made a priority in the next two decades.
Budgetary allocations should focus more on developing these PCCS, their infrastructure, and human resources to support the initiative, it said.
Among other proposals to be considered are extending of service hours for greater access and making available a basic package of essential drugs and investigative services at all primary care levels. The SLMA also urged the Government to consider retention policies that may require incentives for health workers in primary care and in rural settings.
On costly private medical care, the SLMA said the existing legal framework for regulating private sector should be adequately utilized to ensure that the “private sector delivers quality and affordable care to a segment of population who is willing to access care in private sector. It should be closely monitored and the regulatory mechanisms should be further strengthened”.