Trong tuần này, Việt Nam sẽ chủ trì tổ chức Hội nghị các Bộ trưởng Y tế ASEAN lần thứ 12 tại Hà Nội. Bảo hiểm y tế toàn dân (BHYTTD) sẽ là một trong những chủ đề chính của hội nghị, cả trong các diễn đàn chính thức và không chính thức, giữa các nhà hoạch định chính sách của khu vực. Dù thế nào thì mục tiêu tiến tới BHYTTD, được hỗ trợ bởi việc tăng chi tiêu của nhà nước để trợ cấp cho các đối tượng tham gia bảo hiểm, cũng là một trong những nội dung có sự thống nhất cao nhất trong chính sách y tế của khu vực ASEAN hiện nay.
Có thể nói, Việt Nam đã phần nào đi trước khu vực nhờ tăng đều độ phủ bảo hiểm y tế trong suốt những năm 1990. Với Luật Bảo hiểm Y tế ban hành năm 2008, Việt Nam đã hợp nhất các chương trình bảo hiểm y tế hiện hành, áp dụng chính sách một bên chi trả duy nhất, trước cả một số nước lớn trong ASEAN khác như Inđônêxia và Philipin. Hiện nay, không những có tới 68% dân số đã tham gia bảo hiểm y tế mà nhà nước cũng đã đầu tư đáng kể vào cơ sở hạ tầng bên cung và nâng cao năng lực nguồn nhân lực y tế trong nước để đáp ứng nhu cầu khám chữa bệnh ngày càng tăng của người dân.
This week, Vietnam will host the twelfth ASEAN Health Minister’s Meeting in Hanoi. Universal Health Coverage (UHC) is likely to take center-stage in discussions, both formal and informal, among the region’s policymakers. After all, the drive for UHC, backed by large increases in public spending to subsidize coverage, is one of the most uniting features of health policy in the ASEAN region today.
Vietnam is somewhat forerunner in the region, having steadily expanded health insurance coverage through the 1990s. Through the Law of Social Health Insurance in 2008, Vietnam consolidated existing health insurance programs and adopted a single payer design ahead of some other larger ASEAN countries such as Indonesia and the Philippines. Today, not only is 68% of the population enrolled in health insurance but significant public sector investments have also been made to the supply side infrastructure and health human resource capacity of Vietnam in order to meet the growing demand for health care.
A picture can tell a thousand words but the stunning photos we usually associate with the Pacific Islands often overlook the reality for many who live there. Faced with natural hazards such as cyclones, droughts and earthquakes alongside geographical remoteness and isolation, Pacific Island countries, which make up over a third of small island developing states (SIDS), are some of the most vulnerable nations in the world.
Already this year the Pacific region has been hit by two major disasters; Tropical Cyclone Ian in Tonga in January, followed by flash flooding in Solomon Islands in April. Both disasters had devastating impacts on the economy and livelihoods of local communities. Situated within the cyclone belt and Pacific Ring of Fire, earthquakes, tsunamis and cyclones are frequent. Around 41 tropical cyclones occur each year across the region as well as numerous earthquakes and floods.
Last month I was interviewing participants in the World Bank’s Urban Youth Employment Project in Port Moresby, talking about the challenges that PNG’s young people face in finding work.
One issue that came up repeatedly was mobility – or the lack of it: the basic ability to travel to and from the workplace. It is no secret that parts of Port Moresby are dangerous and crime is high. There are regular stories of carjacking but public transport is also a huge risk – an issue which disproportionately affects workers coming from poorer parts of the city.
The HR Manager told me casually how she was stabbed at a bus-stop and her billum (bag) stolen; one of the reception staff was stabbed twice on a bus getting home from work. The young woman we were profiling was held up on a bus at gunpoint in the area of Two Mile.
“How you can live and adapt to climate change… How you can together tackle the issue of carbon intensity of Vietnam?” – World Bank Group President Jim Yong Kim challenged 22 young Vietnamese environmentalists, including myself, at a roundtable discussion on the impacts of climate change to Vietnam during his visit to the country. Around that time, Vietnam and some neighboring countries were hit by typhoon Rammasun. It could have been a coincidence, but it gave us a sense of urgency and how serious the issue of climate change is.
In my 10 years of working in the World Bank, I have seen remarkable changes around me. In 2004, Emerald Avenue in Ortigas Center, where the old World Bank office was located, started to wind down after 9 PM. Finding a place to buy a midnight snack whenever I did overtime was hard. It was also hard to find a taxi after work.
Today, even at 3 AM, the street is bustling with 24-hour restaurants, coffee shops, and convenience stores, hundreds of BPO (Business Process Outsourcing) employees taking their break, and a line of taxis waiting to bring these new middle class earners home. Living in Ortigas Center today means that I also benefit from these changes.
Pada tahun 2005, saya merasa beruntung berada di Indonesia saat upaya reformasi guru dimulai. Parlemen Indonesia menetapkan sebuah undang-undang komprehensif mengenai guru disertai agenda yang besar. Program utamanya adalah sertifikasi yang bertujuan meningkatkan kesejahteraan sekaligus kualitas guru secara signifikan. Guru yang telah menerima sertifikasi akan menerima gaji dua kali lipat. Syarat sertifikasi adalah memiliki gelar S1 serta kompetensi untuk memberikan pendidikan yang berkualitas.
Semua bahan untuk melakukan perubahan besar sepertinya tersedia. Regulasi yang bagus, dan upaya yang dipimpin seseorang yang mengepalai sebuah direktorat baru di Kementerian Pendidikan dengan mandat khusus untuk meningkatkan kualitas guru dan staf pendidik.
In 2005, I had the great fortune of being in Indonesia just as its major teacher reform effort was beginning to take off. Indonesia’s parliament had passed a comprehensive law on teachers, along with its ambitious agenda. Its signature program of certification intended to dramatically improve both teacher welfare and quality. Certified teachers would receive a doubling of salary, and certification was to require that teachers hold a four-year degree and demonstrate possession of competencies necessary to provide good quality education.
The key ingredients for major change seemed in place. Good legislation, and an effort led by a dynamic champion who headed a newly established directorate in the Education Ministry, with the specific mandate of improving the quality of teachers and of educational staff.
Our response to climate change at the global level clearly needs improving. While some governments are managing to set and enforce limits on the emission of greenhouse gases, an international agreement that is both enforceable and meaningful remains elusive. Measures undertaken by private individuals and organizations, though plentiful, largely fail to connect to the political process and continue to fall short in aggregate. Is there a way to combine these public and private efforts? We think there is, as we’ve explored in a recent NZZ article and ETH blog post: a new type of liability insurance.
Looking to the insurance industry for addressing climate change is not new (see, for example, Nobel Laureate Robert Shiller’s column; the Geneva Association’s statement; and the climate change and insurance links discussed at the World Bank’s recent Understanding Risk conference). What has been lacking, however, are ideas for employing insurance instruments at scale, across national boundaries, and in a way that maximizes existing capacities and market mechanisms.