The burden of health care expenditure and the feasibility of health insurance reform in Myanmar

Background: Millions of people fall into “extreme poverty” each year due to payments for health care. To protect against this problem, United Nation Members States, including Myanmar, have agreed to assure universal health coverage (UHC) by 2030. Financial protection is one of the strategies to achieve UHC because a high share of out-of-pocket payments for health care may lead to financial catastrophe or impoverishment, or patients may forgo essential treatments. Aim: The principal aim of this dissertation is to provide knowledge and insight relevant for the health insurance reform in Myanmar. Methods: Various methods such as systematic review of health financing mechanisms; estimating catastrophic health care expenditure; regression analysis of cross-sectional primary survey data, and qualitative study such as focus group discussions and in-depth interview were carried out. Policy implications: Health insurance reform is urgently needed in Myanmar. To assure financial sustainability, the government of Myanmar should invest in improving its tax and insurance contribution collection process, as well as in building population trust in the new health insurance arrangements