Developing countries

Developing countries

Region type
Not official

Substitution of Insurance Booklets with E-prescription

Due to growth of heath costs, especially cost of medicine and in order to promote quality of health services, it is highly necessary to consider solutions such as strategic purchasing of health services aiming at cost control and shortening fiscal burden as well as preventing medical errors. In line with high level targets of the ISSO and facilitation and expedition of the processes, increasing system efficiency and meet the e-government goals, planning and implementing the “electronic prescription” scheme came on the agenda.

Tongzhou Program for the Chinese Work Injury Insurance

Aiming to resolve the problems in construction industry, such as high work-related injury risks, flexible employment and high mobility of construction workers, China has implemented the “Tongzhou Program”, i.e. the specific social insurance expansion program for the construction industry workers. The program requires the construction industry to join the social insurance coverage in terms of each building project, exploring a new coverage pattern of dynamic real-name registration management.

“Running Errand, at Most Once”——Reform on Chinese Social Security Operation

In December 2016, Zhejiang Provincial Government made the decision to push forward the reform of “Running Errand, at Most Once”, actively forging a province with “least examination and approval matters, highest efficiency, optimal government environment and strongest sense of gains for the masses and enterprises”. Aiming at reducing the running errands of the insured, based on the “Internet+ E-government Service” and big data, Zhejiang province launched the reform from the aspects and matters closest to the production and livelihood of the enterprises and masses.

The Universal Social Security Enrolment Programme Begins from Registration

Targeting at building a social security system that covers the urban and rural residents in an all-round way, the Chinese government has formulated and implemented a universal social security enrolment programme focusing on the old-age insurance and medical insurance. By the end of 2017, the registration of all the targeted groups across China has been basically completed through the measures of policy optimizing, publicity, strict law enforcement, service improvement and registration at every address.

Creating a Nationwide Network for Chinese Basic Health Insurance and Achieving Direct Settlement of Hospitalization

To fundamentally solve the two problems of “running errands for reimbursement” and “full prepayment by the patients”, in 2016 the Chinese government made the commitment that within two years, the direct settlements of hospitalization expenses will be fully portable across provinces. A nationwide network for basic health insurance and direct settlement network across provinces will be set up to achieve direct settlement of hospitalization expenses across provinces.

ENFORCEMENT TRANSFORMATION INITIATIVE

As part of the Social Security establishment, it is a statutory requirement that every qualified employee is to be registered by a registered and qualified employer. Apparently, there are still employers who fail to register their employees. The failure by employers to register their employees will result in the non-coverage of the employees. The unregistered qualified employees are unfairly deprived of any coverage of social security schemes and benefits in the event they become unfit to work or even worst if they are suffering from permanent disability or invalidity.

Administrative solutions for coverage extension

India has a federal structure of Governance, where Health is a provincial subject and the Social Security and Labour fall in the concurrent list. Healthcare, Cash Compensation for Employment Injury in the formal sector is provided by the Employees State Insurance Corporation (ESIC) whereas the Pension and Provident Fund by Employees Provident Fund. The employees of factories & establishments in the formal sector are entitled to benefits of Social Security through ESI Scheme.

VSS IT application on health insurance management, medical review and payment

Vietnam has about 80.9 million citizen participate in Healthcare Insurance that makes the coverage of over 86% of the population. VSS now faces big challenges in HI payment inspection: how to manage the huge amount of HI participant data (hundreds of million HI payment requests need inspection annually and increasing) as well as to provide timely resolutions for all HI policies and ensure the quality of social security. It was in this situation that VSS decide to build the HI Inspection Information System to connect with over 12,000 hospitals nationwide.