Is health insurance an option for Sri Lanka?

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Abstract
In the face of rising health care costs and the reductions imposed by budgetary cuts many governments in developing countries are considering options other than general tax revenue to finance their health services. Health insurance models that introduce the concept of ‘risk sharing’, and which are currently being used by developed countries, are critically reviewed in the light of some of the experiences of developing countries in Asia. Factors to be considered when selecting options are: the existing health system, the state of economic development, the availability of facilities and manpower, the demand for quality care, the technical and managerial knowledge of insurance and the existing resource gap for health services. In the case of Sri Lanka, if health insurance is to be a viable option certain changes to the existing comprehensive health service, provided by the government free to all citizens, would first need to be introduced. It is argued that, in terms of insurance options, Sri Lanka would most benefit from a social insurance model where a health insurance fund would be established with contributions made statutory by law. This fund should remain a financial source separate from general tax revenue, and services should be supplied utilizing the existing infrastructure - with sufficient control vested in the ministry of health to safeguard the poor and to control cost escalation.

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