Is health insurance an option for Sri Lanka?

In the face of rising health care costs and the reductions imposedby budgetary cuts many governments in developing countries areconsidering options other than general tax revenue to financetheir health services. Health insurance models that introducethe concept of ‘risk sharing’, and which are currentlybeing used by developed countries, are critically reviewed inthe light of some of the experiences of developing countriesin Asia. Factors to be considered when selecting options are: the existinghealth system, the state of economic development, the availabilityof facilities and manpower, the demand for quality care, thetechnical and managerial knowledge of insurance and the existingresource gap for health services. In the case of Sri Lanka, if health insurance is to be a viableoption certain changes to the existing comprehensive healthservice, provided by the government free to all citizens, wouldfirst need to be introduced. It is argued that, in terms ofinsurance options, Sri Lanka would most benefit from a socialinsurance model where a health insurance fund would be establishedwith contributions made statutory by law. This fund should remaina financial source separate from general tax revenue, and servicesshould be supplied utilizing the existing infrastructure - withsufficient control vested in the ministry of health to safeguardthe poor and to control cost escalation.