Abrejo Farina Gul, Shaikh Babar Tasneem
Department of Community Health Sciences, Aga Khan University, Karachi.
J Pak Med Assoc. 2008 May;58(5):267-70.
Social Health Insurance has been used as an approach to increase efficiency of healthcare system and consumer satisfaction in provision of healthcare services. Many developed countries have successfully planned and implemented insurance models which provide almost universal coverage and addresses issues of equity. The phenomenon is established however, developing countries especially Eastern Mediterranean region is still struggling to present one successful model of social health insurance which can be compared with European or Scandinavian countries. Pakistan likewise faces huge challenges in public sector healthcare provision and considerable proportion of population prefers to go to private sector. Quality of care, access and rising costs make healthcare, somehow, a luxury. Rising national economy, political will to carry out health sector reforms and the creation of district health system after devolution presents an opportunity to launch at least some pilot initiatives of social health insurance. This will give us some food for thought to further up scale and replicate the model all over the country.
社会医疗保险已被用作提高医疗保健系统效率和提升医疗服务消费者满意度的一种方式。许多发达国家已成功规划并实施了保险模式，这些模式几乎提供全民覆盖并解决公平问题。然而，这种现象已存在，发展中国家尤其是东地中海地区仍在努力推出一个能与欧洲或斯堪的纳维亚国家相媲美的社会医疗保险成功模式。巴基斯坦在公共部门提供医疗服务方面同样面临巨大挑战，相当一部分人口更倾向于前往私营部门就医。医疗服务质量、可及性以及成本上升在某种程度上使医疗保健成为一种奢侈品。国民经济的增长、开展卫生部门改革的政治意愿以及权力下放后建立的地区卫生系统为至少开展一些社会医疗保险试点举措提供了契机。这将为我们进一步扩大规模并在全国复制该模式提供一些思考。
