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About the Asian Development Bank

ADB’s vision is an Asia and Pacific region free of poverty. Its mission is to help its developing member countries reduce poverty and improve the quality of life of their people. Despite the region’s many successes, it remains home to the majority of the world’s poor. ADB is committed to reducing poverty through inclusive economic growth, environmentally sustainable growth, and regional integration.

Based in Manila, ADB is owned by 67 members, including 48 from the region. Its main instruments for helping its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and technical assistance.

ASIAN DEVELOPMENT BANK6 ADB Avenue, Mandaluyong City1550 Metro Manila. Philippineswww.adb.org

NATIONAL HEALTH INSURANCE FOR

27-30 September 2016ADB Headquarters, Manila, Philippines

UNIVERSAL HEALTH COVERAGE

ii NatioNal HealtH iNsuraNce for uNiversal HealtH coveraGe

Background

National Health Insurance (NHI) systems are not new. Many developed countries have made significant progresses toward Universal Health Coverage (UHC) by using these systems or elements of them.

In Asia and the Pacific, Japan implements an NHI system funded by payroll taxes, income-based premiums, and government subsidies. The system has effectively reduced out-of-pocket payments for health to only 14% of total health expenditures in 2014.

Among the middle- and low-income countries in Asia and the Pacific, Thailand moved closer to UHC by implementing its own version in 2002, called the Universal Coverage Scheme (UCS). UCS insures the population that falls outside of the Social Health Insurance system for the formal sector and the Civil Servants Medical Benefit Scheme for government personnel. The scheme now covers 75% of the entire population, and is funded through government taxes. How did the Thai UCS become one of the most successful health financing models for middle-income countries? Aside from commitment from politicians, civil society, and technocrats to move toward UHC, several reforms were implemented. These included changes in pooling and purchasing mechanisms, which led to efficiency. Costs were controlled through fixed budget caps, which also improved efficiency and financial sustainability.

Thailand’s success proves that developing member countries (DMCs) are capable of making progresses toward UHC—and that some of the most effective interventions use elements of social health insurance as instruments for improving health outcomes and coverage.

The same is true for many countries that are on their way toward UHC. This meeting then demonstrates why these successes are not out of the reach of DMCs and shares examples of how NHI as a tool for moving closer to the objective of UHC.

NatioNal HealtH iNsuraNce for uNiversal HealtH coveraGe

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objective

The Asian Development Bank (ADB) in partnership with the ADB Institute (ADBi) will convene this meeting to learn from Thailand as well as other country experiences on maximizing the use of a national health insurance system to move toward UHC. Key components and bottlenecks of UHC will be explored: providing effective population coverage; selecting what goods and services to purchase; and improving pooling mechanisms, governance issues, and more. Several country-specific experiences from Organisation for Economic Co-operation and Development (OECD) countries and DMCs will also be retold. The meeting is expected to support the ongoing efforts of DMCs, and to inform ADB’s financing and technical support to DMCs as these strive to make progresses UHC.

2 NatioNal HealtH iNsuraNce for uNiversal HealtH coveraGe

NHI4UHC: Leveraging NHI and its Elements to Achieve UHC27–30 September 2016 Auditoriums C & D (27 Sept), Auditoriums A to D (28-30 Sept)

DAY 1: Tuesday, 27 September 2016

Opening Session9 a.m.–9:10 a.m. Welcome Address9:10 a.m.–9:25 a.m. ADB, National Health Insurance, and Universal Health Coverage9:25 a.m.–9:50 a.m. Universal Health Coverage: Key Issues and Challenges

SESSION 1 National Health Insurance as an Instrument for UHC9:50 a.m.–10:15 a.m. NHI as an Instrument for UHC: Lessons from Thailand and

Non-DMCsUniversal Coverage in Thailand

10:15 a.m.–10:25 a.m. Open Forum10:25 a.m.–10:35 a.m. House rules

Group picture-taking

NETWORKING BREAK

11 a.m.–12 noon Panel Discussion: NHI as an Instrument for Achieving UHC in Non-DMCs

LUNCH BREAK

SESSION 2 Covering the Whole Population1:30 p.m.–2:25 p.m. Panel Discussion: Challenges in Population Coverage2:25 p.m.–3:45 p.m. Addressing Population Coverage Challenges

Sin Taxes and Scaling Up Population Coverage in the Philippines: Lessons for Asia and the Pacific (1425-1445)Covering People Across the Pacific (1445-1505)Covering People Across Borders for People from Asia and the Pacific (1505-1525)Open Forum (1525-1545)

NETWORKING BREAK

4:15 p.m.–5:30 p.m. Digital Health, Member Management, and UHCUnique Identifiers and Interoperability Labs to drive UHCLeveraging Country Networks for Scaling Up Digital Management of Population CoverageMonitoring NHI and UHC: Lessons from the Field

summary agenda


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DAY 2: Wednesday, 28 September 2016

SESSION 2 Covering the Whole Population9 a.m.–9:10 a.m. Keynote Address: ADB and the Sustainable Development Goals9:10 a.m.–9:30 a.m. Scaling up Population Coverage in India: The RSBY Story9:30 a.m.–9:50 a.m. Scaling up Population Coverage in China: The NRCMS Story9:50 a.m.–10:05 a.m. Open Forum

SESSION 3 Purchasing Needed Health Services10:05 a.m.–11 a.m. Panel Discussion: Determining which needed services should be

covered

NETWORKING BREAK

11:30 a.m.–12:25 p.m. Panel Discussion: Determining how service providers and goods will be paid

LUNCH BREAK

1:50 p.m.–3:10 p.m. Future Challenges on Covering Needed Health ServicesAgeing and UHC (1350 – 1405)Malaria Elimination, Health Security, and UHC (1405 – 1420)Obesity and UHC (1420 – 1435)Cancer and UHC (1435 – 1450)Open Forum (1450 – 1510)

NETWORKING BREAK

SESSION 4 Increasing and Pooling Pre-Payments3:40 p.m.–5 p.m. Increasing and Pooling Pre-Payments: Challenges and Responses

Mobilizing Government Revenues for NHI: Challenges in DMCs (1540-1555)Mobilizing VAT, Re-allocated Subsidies, and Other Sources for NHI: Global Lessons (1555-1610)Challenges of State Governments in Implementing National Health Insurance (1610-1625)Evolving a Single Fund in the Philippines (1625-1640)Open Forum (1640-1700)

ADB recognizes “China” as the People’s Republic of China


DAY 3: Thursday, 29 September 2016

SESSION 5 Governance: Holding It All Together9 a.m.–9:10 a.m. Keynote Address: ADB on Building Institutions to Sustain NHI

and UHCGoverning NHI and UHC

9:10 a.m.–9:35 a.m. Governing UHC Efforts: Global Lessons9:35 a.m.–9:55 a.m. The Republic of Korea’s Big Data Initiative and UHC9:55 a.m.–10:15 a.m. Governance Challenges in Moving Towards UHC in Indonesia10:15 a.m.–10:25 a.m. Open Forum

NETWORKING BREAK

10:55 a.m.–12 noon Panel Discussion: Research for Informing Governance in NHI4UHC

LUNCH BREAK

SESSION 6 Implementing and Sustaining NHI4UHC1:30 p.m.–2:30 p.m. Panel Discussion: Implementation Challenges for “New” National

Health Insurance Systems

NETWORKING BREAK

3 p.m.–4:05 p.m. Sustaining UHC effortsContinuous Re-invention: UHC in Singapore (1500-1520)The Virtuous Cycle of UHC: Increased Prepayments and Enhanced Service Delivery (1520-1535)Aspirational Goals and Building Alliances: Lessons for UHC from APLMA (1535-1550)Open Forum (1550-1605)

4:05 p.m.–5 p.m. Dialogue with Finance Ministry Officials5 p.m.–5:15 p.m. Bringing It All Together

DAY 4: Friday, 30 September 2016

SESSION 7 Advancing National Health Insurance as a cornerstone of UH: What is the role for the Private Sector

9 a.m.–9:10 a.m. Keynote Address: ADB and the Private Health Sector9:10 a.m.–9:15 a.m. Introductions9:15 a.m.–9:45 a.m. Structuring financing in NHI4UHC: Speakers9:45 a.m.–10:05 a.m. Structuring financing in NHI4UHC: Reactors

NETWORKING BREAK

10:30 a.m.–11 a.m. Implementing Services in NHI4UHC: Speakers11 a.m.–11:20 a.m. Implementing Services in NHI4UHC: Reactors11:30 a.m.–11:50 a.m. Open Forum11:50 a.m.–12 noon Summary and Closing


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Detailed agenda

DAY 1: Tuesday, 27 September 2016

OpENING SESSION

ADB’s Operational Plan for Health (OPH) from 2015-2020 recognized the efforts of countries all over Asia and the Pacific in pursuing Universal Health Coverage (UHC) in order to ensure that their people can access needed health services without risk of financial ruin. Clearly, there is a need for increased financing, particularly pre-payments, for health and the strategic use of this health funds to drive quality, efficiency and equity. This needs to be complemented by increased investments in health service delivery, including investments in health infrastructure that would respond to the increased demand for needed quality health care services. Progressing toward UHC requires efficient management of health systems in order to maximize quality outcomes from the resources invested in health. This session will discuss the rationale for ADB’s commitment to support developing member countries (DMCs) in their efforts to move toward UHC. It will look at the key issues and challenges for pursuing UHC and describe the various instruments that can help DMCs move toward UHC, with emphasis on the use of national health insurance as an instrument for achieving and sustaining UHC. It will set the stage for the next four days and describe ADB’s commitment to support DMC efforts to meet the sustainable development goals (SDGs), particularly SDG 3 and universal health coverage targets.

Key takeaway

▪Understanding of ADB’s operational plan for Health (OPH) 2015-2020 and the OPH support for UHC efforts▪General overview of the role of NHI in UHC efforts▪Key supply-side and demand-side issues and challenges for countries pursuing UHC

9 a.m.–9:10 a.m. Welcome addressby Bambang SusantonoVice President, Knowledge Management and Sustainable Development Group, ADB

9:10 a.m.–9:25 a.m. aDB, National Health insurance, and universal Health coverageby Eduardo BanzonPrincipal Health Specialist, Sustainable Development and Climate Change Department, ADB

9:25 a.m.–9:50 a.m. universal Health coverage: Key issues and challengesby Soonman KwonTechnical Advisor (Health), Sustainable Development and Climate Change Department, ADB

NHI4UHC: Leveraging NHI and its Elements to Achieve UHC27–30 September 2016 Auditoriums C & D (27 Sept), Auditoriums A to D (28-30 Sept)


SESSION 1 NATIONAL HEALTH INSURANCE AS AN INSTRUmENT fOR UHC

National health insurance schemes are not new—developed countries are successful in providing comprehensive health coverage to their populations. Japan boasts of (universal) health coverage funded mainly by payroll taxes and income-based premium with government subsidies for the poor. Thailand has declared universal population coverage in 2002 with the implementation of Universal Coverage Scheme (UCS), which provides insurance to the population outside of the Social Health Insurance for the formal sector and the Civil Servants Medical Benefit Scheme for government personnel. The UCS covers 75% of the entire population, and is funded through government taxes. Clearly, health insurance has insurance has evolved from paying for adverse health events to using it as an instrument for reaching the overall targets of UHC—population coverage, provision of needed health services, and financial risk protection. This session will look into the experiences of Thailand; Japan; the Republic of Korea; and Taipei,China in how they have evolved health insurance into an instrument for achieving UHC.

Key takeaway

▪Understanding of Thailand’s UC and its decision to subsidize or cover all informal sector (or nonmember of its SHI and CSMBS) into UC using government revenues.

▪ Lessons from Japan; the Republic of Korea; and Taipei,China on how their respective national health insurance systems were used to ensure UHC. Focus will be on how the MoH used NHI in the delivery of health services that traditionally was considered to be public health services that must be provided by MOH/government providers.

NHi as an instrument for uHc: lessons from thailand and Non-DMcs

ModeratorAzusa Sato, Health Specialist, Southeast Asia Regional Department, ADB

9:50 a.m.–10:15 a.m. universal coverage in thailandby Walaiporn PatcharanarumolInternational Health Policy Program, Thailand

10:15 a.m.–10:25 a.m. Open Forum10:25 a.m.–10:35 a.m. House rules

Group picture-takingNETWORKING BREAK

11 a.m.–12 noon Panel Discussion: NHi as an instrument for achieving uHc in Non-DMcsModerated by Azusa Sato, Health Specialist, Southeast Asia Regional Department, ADB

PanelistsNaoki Ikegami, St. Luke’s International University, JapanTae-jin Lee, Seoul National University, Republic of KoreaYue-Chune Lee, National Yangming University, Taipei,China

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SESSION 2 COvERING THE WHOLE pOpULATION

Providing effective population coverage in UHC terms entails several things: Identifying the poor and vulnerable groups, making sure that they are empowered and informed regarding their benefits, and ensuring that they have physical and financial access to services—assuming that countries already have a working system for insuring the formally employed. The four sub-sessions will highlight country challenges and responses in ensuring population coverage given the geographical expanse and population mobility of Asia and the Pacific. The sessions will also discuss specific population concerns on proper identification of those who will be subsidized, member empowerment efforts, and the value digital health brings in to sustaining effective population coverage. It will also go deep in the population coverage experiences in India and the People’s Republic of China, the two largest countries in terms of population, in Asia and the Pacific.

About this sub-session

The sub-session will highlight the challenges faced by DMCs in ensuring population coverage. It will include discussions on specific population coverage concerns from proper identification of those who will be subsidized and member empowerment efforts.

Key takeaway

▪The different policy and implementation challenges DMCs face in expanding population coverage, particularly the coverage of the informal sector.

1:30 p.m.–2:25 p.m. Panel Discussion: challenges in Population coverage

Moderated by Beverly Lorraine Ho, Chief, Research Division, Health Policy Development and Planning Bureau, Department of Health, Philippines

PanelistsTran Thi Mai Oanh, Director, Health Strategy and Policy Institute, Viet NamTsolmon Tsilaajav, Former Director of Planning, Ministry of Health, MongoliaJaidev Singh Anand, Senior Technical Specialist, ACCESS Health, South Asia


This sub-session will discuss how the Philippines and Palau came out with innovative solutions in expanding population coverage. It will then discuss how countries from both the sending countries in Asia and Pacific, and the receiving countries in the Gulf (or the Gulf Cooperation Council or GCC countries) are ensuring population coverage to “migrant workers” from Asia and the Pacific.

Key takeaway

▪Use of incremental sin taxes or excise taxes on alcohol and tobacco products has enabled the coverage of the poor and near poor in the Philippines.

▪ Learnings on how Palau designed its health insurance scheme to ensure population coverage and access to needed out of country health services

▪Current mechanisms used by sending and receiving countries to provide coverage for migrant workers from Asia and Pacific who are working in the Gulf Cooperation Council (GCC) countries

2:25 p.m.–3:45 p.m. addressing Population coverage challenges

ModeratorHayman Win, Senior Health Specialist, South Asia Regional Department, ADB

2:25 p.m.–2:45 p.m. sin taxes and scaling up Population coverage in the Philippines: lessons for asia and the PacificJeremias Paul, Coordinator, Tobacco Control Economics, World Health Organization

2:45 p.m.–3:05 p.m. covering People across the PacificGregorio Ngirmang, Minister of Health, Palau

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3:05 p.m.–3:25 p.m. covering People across Borders for People from asia and the PacificAzusa Sato, Health Specialist, Southeast Asia Department, ADBAwad Mataria (by Skype), Regional Adviser, Health Financing, WHO-EMRO

3:25 p.m.–3:45 p.m. Open Forum

NETWORKING BREAK


This sub-session will look into a number of digital health initiatives which if adopted in DMCs and across the region will enable the expansion of population coverage and the appropriate management of covered individuals.

Key takeaway

▪The concept of unique identifiers and implementation approaches for the design and adoption of these identifiers, and how they can contribute to UHC efforts

▪What interoperability labs mean and how a lab in Asia and Pacific can facilitate health information systems to talk to each other and enable portability of population coverage

▪How country network and collaboration, and learning from each other can accelerate the use of digital health interventions to support UHC and population coverage interventions

▪An innovative UHC dashboard is empowering and informing government health officials achieve and sustain universal population coverage in their catchment geographical area.

4:15 p.m.–5:30 p.m. Digital Health, Member Management, and uHc

ModeratorSusann Roth, Senior Social Development Specialist, Sustainable Development and Climate Change Department, ADB

unique identifiers and interoperability labs to drive uHcDerek Ritz, Principal Consultant, ecGroup Inc

leveraging country Networks for scaling up Digital Management of Population coverageAlvin Marcelo, AeHIN and University of the Philippines College of Medicine

Monitoring NHi and uHc: lessons from the field Rosebelle Azcuna, independent consultant

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DAY 2: Wednesday, 28 September 2016


In this sub-session, we will go deep in the population coverage experiences in India and the People’s Republic of China, the two largest countries in terms of population, in Asia and the Pacific.

Key takeaway

▪ India’s approach in expanding population coverage▪The Republic of China’s approach in expanding population coverage

ModeratorArup Chatterjee, Principal Financial Services Specialist, Sustainable Development and Climate Change Department, ADB

9 a.m.–9:10 a.m. Keynote address: aDB and the sustainable Development GoalsMa. Carmela LocsinDirector General, Sustainable Development and Climate Change Department, ADB

9:10 a.m.–9:30 a.m. scaling up Population coverage in india: the rsBY storyNishant Jain, Deputy Program Director, Social Security Program, GIZ – India

9:30 a.m.–9:50 a.m. scaling up Population coverage in china: the NrcMs storyQingyue Meng, Dean, Peking University School of Public Health

9:50 a.m.–10:05 a.m. Open Forum

SESSION 3 pURCHASING NEEdEd HEALTH SERvICES

Given resource constraints, a challenge for health systems is to be able to identify the health needs to be covered—what these should be, where they will be covered, and how these services are to be provided. These will help address supply side issues but another aspect that needs to be resolved is the demand side—are there factors that members have difficulty with and aren’t being addressed? These include the indirect costs of accessing health services, such as transportation, travel time, home care, among others. After determining what services should be covered, then a second question of how these services shall be purchased and the providers paid arises. Two panels will tackle these interrelated strategic purchasing components of determining what needs have to be covered, who shall provide the needed services and how the providers shall be paid. And with changing demographics, burden of diseases and other issues affecting health systems, the challenge of addressing these new and emerging concerns and consider what actions can help DMCs address will be tackled in another session.


This sub-session is the first part of related panels which will tackle these interrelated strategic purchasing components of determining what needs have to be covered, who shall provide the needed services and how the providers shall be paid, with this focusing on global, regional and country experiences in determining which needed health services shall be prioritized. It will look at tools and criteria that are being developed and adopted, and the processes including the political processes used for priority setting.

Key takeaway

▪Different priority setting tools used for determining which needed health services should be covered▪Use of health (intervention) technology assessment to inform priority setting and coverage decisions▪Global, regional and country level experiences and lessons in determining which health services should be covered

10:05 a.m.–11 a.m. Panel Discussion: Determining which needed services should be covered

ModeratorsMegan Counahan, Health Specialist, Central and West Asia Regional Department, ADB Sean Donato, Health Specialist, Sustainable Development and Climate Change Department, ADB

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PanelistsAlia Luz, Health Intervention Technology Assessment of ThailandInez-Mikkelsen Lopez, Health Specialist, Pacific Regional Department, ADBYogesh Rajkotia, Thinkwell Global Naoki Ikegami, St. Luke’s International University, Japan

NETWORKING BREAK


This second of the sub-sessions will focus on global, regional and country trends on how provider payment mechanisms are being transformed to better support the move toward UHC.

Key takeaway

▪ Prerequisite for strategic purchasing in the framework of NHI systems is the split between providers and purchasers. ▪Countries are adopting payment systems that are aimed at aligning provider incentives, such as performance-based

payments over and above the salaries and budgets for government health care providers, and close-ended bundled payments (i.e. case rates, capitation, global budget) for private health care providers

▪Ongoing shift in many countries from input-based financing toward output- and results-based approaches▪Demand-side output-based payments are being leveraged to supplement and complement existing supply-side budgets

11:30 a.m.– 12:25 p.m. Panel Discussion: Determining how service providers and goods will be paid

ModeratorsGerard Servais, Senior Health Specialist, South East Asia Regional Department, ADB Mathilde Mailfert, Health Financing Consultant, ADB

PanelistsYue-Chune Lee, National Yangming University, Taipei,ChinaWalaiporn Patcharanarumol, International Health Policy Program, ThailandBernard Couttelenc, Instituto PerformaClaude Meyer, P4H (Providing for Health)

LUNCH BREAK


With resource constraints, a challenge for health systems is to be able to identify the health needs to be covered—what these should be, where they will be covered, and how these services are to be provided. A challenge compounded by changing demographics, burden of diseases and other issues affecting health system, and had become the challenge of addressing these new and emerging concerns is a growing concerns for DMCs. This sub-session will look into a number of these future challenges for DMCs in Asia and the Pacific and explore actions that can help DMCs address them in the soonest time.

Key takeaway

▪Ageing, obesity and cancer are among the new health related concerns and health conditions faced by DMCs. They need new and innovative interventions different from those that have effectively addressed communicable diseases.

▪ Even as countries address the above new challenges, they need to continue to invest in eliminating diseases including malaria and in strengthening national and regional health security. How these interventions help ensure UHC will be discussed.

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1:50 p.m.–3:10 p.m. future challenges on covering Needed Health services

ModeratorsKirthi Ramesh, Social Development Specialist, Sustainable Development Climate Change Department, ADBBrian Chin, Health Specialist, South Asia Regional Department, ADB

1:50 p.m.–2:05 p.m. ageing and uHcSoonman Kwon, Technical Advisor (Health), Sustainable Development and Climate Change Department, ADB

2:05 p.m.–2:20 p.m. Malaria elimination, Health security, and uHcSandii Lwin, Managing Director, Myanmar Health and Development Consortium

2:20 p.m.–2:35 p.m. obesity and uHcMatthias Helble, Research Economist, ADB Institute

2:35 p.m.–2:50 p.m. cancer and uHcPrabhat Jha, Professor, University of Toronto

2:50 p.m.–3:10 p.m. Open Forum

NETWORKING BREAK

SESSION 4 INCREASING ANd pOOLING pRE-pAymENTS

The original intent of insurance was to make sure that the patient is protect from catastrophic spending in case of adverse health events through prepayment of insurance premiums. The idea now is to expand this concept to make sure that pre-payments are increased and pooled in an autonomous and independent health fund that covers even regular health services. An essential step to making this happen is increasing prepayments through mandatory contributions from the formal sector, subsidies financed by government revenues and other types of pre-payments, and to pool all these pre-payments into the least number of health funds as possible. This session will explore how to increase pre-payments while consolidating the health funds into a single pool of funds.

Key takeaway

▪The traditional distinction that government revenues are allocated through the budgetary process to fund the direct government provision of health services while mandatory insurance is managed through an independent or quasi-independent fund which purchases defined entitlements/rights for members from both government and private providers has blurred.

▪Many DMCs are pooling both government revenues and health insurance contributions in an independent or quasi-independent “health insurance” funds with government revenues subsidizing the poor and near poor informal sector population into the fund.

▪ International experience indicates that countries that have made good progress on UHC have used mixed systems of financing to creating a single, large pool of funding managed by a single fund.

3:40 p.m.–5 p.m. increasing and Pooling Pre-Payments: challenges and responses

ModeratorYogesh Rajkotia, CEO, Thinkwell Global

3:40 p.m.–3:55 p.m. Mobilizing Government revenues for NHi: challenges in DMcsVera Siesjo, Country Manager, ACCESS Health

3:55 p.m.–4:10 p.m. Mobilizing vat, re-allocated subsidies, and other sources for NHi: Global lessons Lluis Vinyals-Torres, Regional Adviser for Health Financing, WHO-SEARO

4:10 p.m.–4:25 p.m. challenges of state Governments in implementing National Health insuranceSunil Nandraj, Advisor, Health Reforms, State Government of Delhi

4:25 p.m.–4:40 p.m. evolving a single fund in the PhilippinesRuben John Basa, Senior Vice President, Philippine Health Insurance Corporation, Philippines

4:40 p.m.–5 p.m. Open Forum

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DAY 3: Thursday, 29 September 2016

SESSION 5 GOvERNANCE: HOLdING IT ALL TOGETHER

The enabling platform for UHC is critical in this process. Areas such as the policy and regulatory environment, decision points for quality standards, and stakeholder roles and participation will define the success of UHC. The incentive mechanisms for a successful health system should therefore be in place. This first sub-session explores global lessons on UHC governance efforts and two best practices in creating an enabling platform for UHC: the Republic of Korea’s Big Data Initiative, which has become the ultimate source of evidence for policy-making; and Indonesia’s stepwise JKN governance reforms which highlights transparency and encourages stakeholder engagement and participation in UHC. The second sub-session looks at the value of investing in research to inform the governance of UHC efforts.


This first sub-session explores global lessons on UHC governance efforts and two best practices in creating an enabling platform for UHC: the Republic of Korea’s Big Data Initiative and Indonesia’s JKN governance reforms.

Key takeaway

▪UHC schemes are not just “more of the same” (more people, benefits, money or supply) but are instead designed with changes in health system structures such as a purchaser-provider split, the establishment of health purchasing agencies, more autonomy for public hospitals, explicit benefit packages, and formal agreements between national and subnational governments.

▪All these changes are geared toward improving accountability of health care providers and health purchasers, and driving innovative governance measures such as the extensive use of data for governance and the creation of governing boards and bodies.

▪ Information and governance structures empower people and patients.

ModeratorSoonman Kwon, Technical Advisor (Health), Sustainable Development & Climate Change Department, ADB

9 a.m.–9:10 a.m. Keynote address: aDB on Building institutions to sustain NHi and uHcStephen GroffVice-President for Operations 1, ADBGoverning NHi and uHc

9:10 a.m.–9:35 a.m. Governing uHc efforts: Global lessons Toomas Palu, Global Practice Manager, Health Nutrition and Population, World Bank

9:35 a.m.–9:55 a.m. the republic of Korea’s Big Data initiative and uHcYoon Kim, Professor, Seoul National University

9:55 a.m.–10:15 a.m. Governance challenges in Moving towards uHc in indonesia Teguh Dartanto, Head of Poverty and Social Protection Research Group, Institute for Economic and Social Research, University of Indonesia

10:15 a.m.–10:25 a.m. Open Forum

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This second sub-session will look at the value of investing in research to inform the governance of UHC efforts.

Key takeaway

▪UHC schemes need to be informed by research.▪Appropriate types of information and research studies for advancing UHC▪ Experiences on how research findings are used to inform policies▪Recommended roles of development banks, other development partners, government, and the private sector in research▪ Proposed actions that can drive investment in research and adoption of research findings▪ Examples of regional research collaborations for UHC that can be considered by DMCs

10:55 a.m.–12 noon Panel Discussion: research for informing Governance in NHi4uHc

ModeratorLluis Vinyals-Torres, Regional Adviser for Health Financing, WHO-SEARO

PanelistsKatherine Villegas-Reyes, AIHO, PhilippinesJuan Carlos Negrette, University of UtahAnderson Stanicole, United Nations Population Fund Tae-jin Lee, Seoul National University, Republic of KoreaRos Chung Eang, Ministry of Health, Cambodia

LUNCH BREAKSESSION 6 ImpLEmENTING ANd SUSTAINING NHI4UHC

The three sub-sessions will discuss the different implementation challenges of DMCs. A number of DMCs that are implementing “new” NHI for UHC are tackling birthing pains which they may be able to address better by building upon the experiences of other DMCs. Stories on sustaining NHI4UHC in the face of changing disease burden, population demands, political bottlenecks, and adverse patient and provider behavior are expected to provide insights to DMCs. Finally, a deeper understanding of the mindset of Finance Ministry officials regarding NHI4UHC is critical step sustaining all these UHC efforts.


The first of the three sub-sessions will focus on implementation concerns and barriers of new NHI4UHC, and discuss how other DMCs have previously addressed or currently addressing their respective implementation issues.

Key takeaway

▪An understanding of the challenges of the faced by three DMCs that have started or are about to establish NHI4UHC▪Despite differences in context and the number of years of implementation, there are similarities in the implementation

challenges faced by the DMCs establishing NHI4UHC▪Tips on how to deal with these implementation challenges, based on country experiences

1:30 p.m.–2:30 p.m. Panel Discussion: implementation challenges for “New” National Health insurance systems

ModeratorsEduardo Banzon, Principal Health Specialist, Sustainable Development and Climate Change Department, ADBAnna Mae dela Cruz, Health System Implementation consultant, ADB

PanelistsSuleman Khan, Director, Health Economics Unit, Ministry of Health and Family Welfare, Bangladesh Bouphat Phonvisay, Director, National Health Insurance Bureau, Ministry of Health, Lao PDRFaisal Rifaq, Acting CEO / Director - Technical, Prime Minister’s National Health Insurance Program, Pakistan

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The second sub-session will discuss the different implementation challenges of DMCs. It will focus on the stories on sustaining NHI4UHC in the face of changing disease burden, population demands, political bottlenecks, and adverse patient and provider behavior.

Key takeaway

▪ Sustaining the move toward UHC requires addressing continuing and new challenges. UHC is not a finish line that once can reach and then rest. It demands continuous refinements and building on insights and lessons, and then building again on new insights and lessons.

3 p.m.–4:05 p.m. sustaining uHc efforts

Moderators Raushan Mamatkulov, Senior Health Specialist, East Asia Regional Department, ADBYe Xu, Health Specialist, Southeast Asia Regional Department, ADB

3 p.m.–3:20 p.m. continuous re-invention: uHc in singaporeLim Yee Wei, Associate Professor, National University of Singapore

the virtuous cycle of uHc: increased Prepayments and enhanced service Delivery Ma. Elena Herrera, Professor, Asian Institute of Management

aspirational Goals and Building alliances: lessons for uHc from aPlMaBenjamin Rolfe, Executive Secretary, APLMA

Open Forum

3:20 p.m.–3:35 p.m.

3:35 p.m.–3:50 p.m.

3:50 p.m.–4:05 p.m.


This is the third of three sub-sessions that will discuss the different implementation challenges of DMCs. This will be a dialogue with Ministry of Finance officials on ensuring sustained government financing of NHI4UHC.

Key takeaway

▪ Insights from Finance Ministry officials as to how they understand the value and need for sustained financing of NHI4UHC

4:05 p.m.–5 p.m. Dialogue with finance Ministry officials

ModeratorSusann Roth, Senior Social Development Specialist, Sustainable Development and Climate Change Department, ADB

SESSION 7 BRINGING IT ALL TOGETHER

The session will summarize the previous three days of how NHI can use used as an instrument for moving toward UHC

5 p.m.–5:20 p.m. Bringing it all together Soonman Kwon, Technical Advisor (Health), Sustainable Development and Climate Change Department, ADB

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DAY 4: Friday, 30 September 2016

SESSION 7 AdvANCING NATIONAL HEALTH INSURANCE AS A CORNERSTONE Of UH: WHAT IS THE ROLE fOR THE pRIvATE SECTOR

In emerging and developing markets alike, tensions exist on the role of the private sector vis-à-vis NHI systems for UHC (NHI-4-UHC). These tensions have arisen from differences between public and private sectors on appropriate policy, provision of financing, and health service implementation. Issues have ranged from the ‘correct’ mix of public and private health financing, ‘appropriate’ recipients of funds, and the impact of private sector on health insurance. Arguably, in many countries these issues have divided stakeholders to the detriment of UHC progress.

In recent times, a gradual policy consensus has emerged on using NHI as a tool to achieve UHC, and in partnership with private sectors. The consensus has developed based on the success of NHI as a cornerstone of UHC, through coordinated public and private interventions and investments. It has also developed as the private sector increasingly demonstrates their complementary role as health providers or insurers to public services.

However, despite progress, the role of the private sector has yet to be fully realized with two critical areas requiring further dialogue: Structuring financing: the role of government health insurance subsidization or schemes to support private health care and reduce overall out of pocket payments; and Implementing services: using health insurance as a tool to support health care service delivery and access.

Key takeaway

▪ Increased understanding of the role of government health insurance subsidization or schemes to support private health care and reduce overall out of pocket payments

▪ Increased awareness of possible private sector collaboration with government health insurance systems to further reduce out of pocket health spending, and improve private health sector service delivery

Moderators Eduardo BanzonPrincipal Health Specialist, Sustainable Development and Climate Change Department, ADBSaumya Kailasapthy, Health Specialist, SDCC, ADB

9 a.m.–9:10 a.m. Keynote address: aDB and the Private Health sectorDiwakar Gupta, Vice-President for Private Sector and Cofinancing Operations, ADB

9:10 a.m.–9:15 a.m. introductionsEduardo Banzon and Saumya Kailasapathy

9:15 a.m.–9:45 a.m. structuring financing in NHi4uHc: speakersPartnering for Health insurance “the abu Dhabi experience”: Jan schmitz-Huebsch, Munich HealthPharmaceuticals financing: Ben Kamarck, Gilead sciences, inc.

9:45 a.m.– 10:05 a.m. structuring financing in NHi4uHc: reactorsJudith Won Pat, Speaker of the Guam LegislatureGregorio Ngirmang, Minister of Health, PalauDale Huntington, Johnson & Johnson

NETWORKING BREAK10:30 a.m.–11 a.m. implementing services in NHi4uHc: speakers

Hospitals: Bhavdeep Singh, Fortis HospitalsDelivery Innovation: Farouk Meralli, mClinica

11 a.m.–11:20 a.m. implementing services in NHi4uHc: reactorsAlice Sabino, Clinton Health Access InitiativeMargaret Bengzon, The Medical City Scott Roberts, Private Sector Operations Department, ADB

11:30 a.m.–11:50 a.m. Open Forum11:50 a.m.–12 noon Summary and Closing

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Profiles of speakers and Moderators

Jaidev Singh Anandis Senior Technical Specialist for Health Financing in ACCES Health International India. His current field of engagement includes formulation of health financing policy through engaging relevant stakeholders from the public, private & academic spheres. He is involved in developing the framework for an integrated care model under the ongoing UHC initiatives in India. He previously worked with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) in Dhaka, Bangladesh where he provided technical support and helped build capacity within the government with regard to UHC efforts being undertaken there.

Rosebelle May Azcunais a Health Information Specialist focused in health system performance monitoring which tracks country progress toward national and global targets. Her work includes improving access to quality data through the application of global data and indicator standards and use of data analytics and visualization. In WHO and ADB, she was involved in monitoring efforts in transitioning from MDGs to the sustainable development agenda through development of Universal Health Care monitoring tools including a monitoring framework, core indicator set and a customizable dashboard which promote better data-informed decision-making and accountability.

Ruben John A. Basais Senior Vice President of the Health Finance Policy Sector of the state-run Philippine Health Insurance Corporation (PhilHealth). His office is in charge of the development of policies in benefits planning, standards development and monitoring, and provider engagement. In his19 years with PhilHealth, he was involved in corporate planning and communications, international relations, organizational development, human resources, and information technology. Prior to PhilHealth, he was with the Department of Health and the Philippine Senate’s Committee on Health and Demography. Mr. Basa holds a Bachelor’s Degree in Political Science and a Master’s in Development Studies.


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Margaret Bengzonis the President and CEO of the Guam Regional Medical City and a member of The Medical City’s senior management who has been responsible for a number of successful strategic acquisitions and partnerships in the Philippines and abroad, in line with the hospital’s network development thrust, most recently, the Guam Regional Medical City. She led the hospital’s bid for prestigious Joint Commission International Accreditation in 2006 and again in 2009. She likewise directed the hospital’s Process Reengineering and Organizational Transformation Project, which positioned the hospital for national and international sector leadership.

Bernard Couttolencis a health financing consultant in the Sustainable Development and Climate Change Department. He has a PhD in Health Economics and has been an international consultant for the World Bank and other international organizations for many years. He has extensive experience in health sector reform projects in over 20 developing countries of Latin America, Africa and Asia. His main areas of expertise include Health System Assessment and Performance, Health Financing and Payment Mechanisms, Hospital Governance and Autonomy, and UHC sustainability.

Teguh Dartantois Director of the Undergraduate Program in Economics, Faculty of Economics and Business, University of Indonesia and Head of Poverty and Social Protection Research Group in Universitas Indonesia. His current research areas include universal health coverage in the presence of informality, a sustainability of premium payment, financial analysis of social security in Indonesia and the digital divide and socio-economic impacts of broadband development in Indonesia. His work has been published in Energy Policy, Bulletin of Indonesian Economic Studies, the Singapore Economic Review, and Margin-Journal of Applied Economic Research. He received his master of Economics at Hitotsubashi University, Japan and his PhD in the International Development at Nagoya University, Japan.


Anna Mae D. Dela Cruzis a health system implementation consultant in the Sustainable Development and Climate Change Department. She is also a full-time faculty member of the Development Studies Program of the Ateneo de Manila University, a public health and management consultant and researcher, and an entrepreneur. She has worked for government and various private corporations. She graduated from the Ateneo de Manila University with a Bachelor of Science degree in Health Sciences, and finished her Master of Business Administration at the Ateneo Graduate School of Business.

Ros Chhung Eangis the Head of Bureau of Health Economics and Financing, Department of Planning and Health Information, of the Ministry of Health (MoH) of Cambodia. He has worked with the MOH for 20 years in health planning and policy development. He has a Master of Business Administration from the Central Queensland University, Australia, and a Diploma in Economic Statistic from School of Planning, Cambodia. He is the author of the MOH Annual Health Sector Financing Report and has contributed to numerous reports, strategies and publications on the health system in Cambodia.

Matthias Helbleis a research economist at the Asian Development Bank Institute in Tokyo. His research interests include international trade, health and climate change. His work has been published in the Review of World Economics, Kyklos, Journal of World Trade, World Economy, Japan and the World Economy Health Policy & Planning, and the Bulletin of the World Health Organization. Matthias worked in the Development Research Group of the World Bank in Washington, DC, the World Health Organization in Geneva, Switzerland, and the World Trade Organization. He holds degrees in economics from the University of Tübingen (BA, MSc) in Germany, the University of Wisconsin-Madison (MA) in the United States, and the Graduate Institute of International and Development Studies (MSc, PhD) in Geneva.

Maya Herrerais a fellow and former president of the Actuarial Society of the Philippines. She provides training and advice on health policy and finance in the Asia and Eastern Mediterranean Region. She teaches for the Asia Network for Capacity Building in Health Systems Strengthening. Maya is also the Director and Senior Consultant for Solutions Incorporated and is chairman of the Strategic Management Department of Asian Institute of Management. She holds a PhD in Organizational Development from the Southeast Asia Interdisciplinary Development Institute and a Master’s degree in Actuarial Mathematics from the University of Michigan. She has held the post of CFO for Manulife Philippines and AIM and President of Solutions Incorporated.

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Beverly Lorraine Hois Chief of the Health Research Division of the Department of Health’s Health Policy Development and Planning Bureau. Prior to this, she was a consultant for the Asian Development Bank’s Health Sector Group working on health financing, health security and health impact assessment in the Greater Mekong sub-region. Bev has worked for the Philippine Health Insurance Corporation (PhilHealth) and Qualimed Health Network. She has provided technical assistance to government through WHO and UNICEF. Bev holds a Doctor of Medicine degree from the University of the Philippines and a Master of Public Health in Health Policy and Management from the Harvard T.H. Chan School of Public Health.

Dale Huntingtonis Senior Director, Health Care Systems for Emerging Markets with Johnson and Johnson, where he serves as the primary Global Health Policy lead in Asia and the Pacific. He is responsible for developing and implementing a strategy to advance Johnson & Johnson’s Enterprise objectives and Government Affairs & Policy platform priorities – with a particular focus on shaping healthcare systems to expand access to quality healthcare in key emerging markets globally. With WHO, he was Director of the Asia Pacific Observatory on Health Policy and Systems, based in the WHO Western Pacific Regional Office, Manila, and as a Scientist with the Department of Reproductive Health and Research in Geneva. He holds a Doctorate in Science degree from the Johns Hopkins University School of Hygiene and Public Health.

Naoki Ikegami is Professor at St Luke’s International University and Professor Emeritus at Keio University, Tokyo. He was Chair of the Department of Health Policy and Management at the Keio School of Medicine, from which he received his MD and PhD. He also received a Master of Arts degree in health services studies with Distinction from Leeds University (UK). He was a visiting professor at the University of Pennsylvania’s Wharton School and Medical School and has continued to be a Senior Fellow at Wharton. He is a founding member of interRAI (a nonprofit international consortium of researchers and clinicians focused on care planning instruments), and served as a consultant to the WHO and the World Bank. He has been President of the Japan Society of Healthcare Administration and of the Japan Health Economics Association.

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Nishant Jainis Deputy Programme Director with Social Security Programme of German Development Cooperation (GIZ) in India. His field of expertise includes health systems, health financing and health insurance. He provides technical advice to the Ministry of Health and Family Welfare on the design of restructured new Health Protection Scheme of Government of India. Dr. Jain was Advisor to Ministry of Labor and Employment of India specifically in the design and implementation of Rashtriya Swasthya Bima Yojana the existing National Health Scheme of India. Dr. Nishant Jain has a PhD in Health Finance from the Indian Institute of Management, Ahmedabad, MBA in Finance and MSc in Chemistry and MA in music.

Suleman Khanis the Director of the Health Economics Unit of the Ministry of Health and Family Welfare in Bangladesh. He has Masters degrees in both Commerce (major in Accounting) and Economics. He is currently responsible for health expenditure tracking and public health expenditure reviews. He is also part of a team responsible for promoting UHC in Bangladesh.

Prabhat Jhais the University of Toronto Endowed Professor in Disease Control and Canada Research Chair at the Dalla Lana School of Public Health, and the founding Director of the Centre for Global Health Research at St. Michael’s Hospital. Professor Jha is a lead investigator of the Million Death Study in India, lead scientist for the Statistical Alliance for Vital Events and co-investigator of the Disease Control Priorities Network. He is the author of several influential books on tobacco control. Professor Jha served as Senior Scientist for the World Health Organization, where he co-led the work on health and poverty for the Commission on Macroeconomics and Health. Professor Jha holds an MD from the University of Manitoba and a DPhil from Oxford University, where he studied as a Canadian Rhodes Scholar.

Ben Kamarckis the Southeast Asia regional director for Gilead’s access and operations in emerging markets program. In this role, he manages Gilead’s access work in Mongolia, the Philippines, Viet Nam, Cambodia, the Lao People’s Democratic Republic, Myanmar, and Indonesia. Ben has also worked with the Clinton Health Access Initiative, first as deputy country director in Viet Nam and then launching its global viral hepatitis program, covering work in Africa and Asia. Prior to this role, Ben worked for Roche pharma, first in the People’s Republic of China, then in the Philippines, Viet Nam, Cambodia and and the Lao People’s Democratic Republic, with a significant focus on viral hepatitis. Ben has an MBA from INSEAD and an undergraduate degree in international politics from Georgetown University.

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Yoon Kimis a professor in Health Policy and Management, Seoul National University College of Medicine (SNUMC). He also serves as the associate dean for planning in SNUMC and the director for planning of the Republic of Korea’s Academy of Medical Science. He was the Executive Director of the Research Institute at Health Insurance Review and Assessment Service. His research focuses on Healthcare Performance Management, Mental Health, Emergency Medical Services, and Medical Informatics.

Tae-Jin Leeis professor of health economics at the Graduate School of Public Health in Seoul National University. His research areas are economic analysis of health care systems focusing on health financing, financial protection, and economic evaluation of various interventions in the health care sector. He is President of the Republic of Korea’s Association of Health Economics and Policy. He completed his degree in economics and public health at SNU and received his PhD in health services management from the University of Manchester in the United Kingdom.

Yue-Chune Leeis professor at the Institute of Health and Welfare Policy (IHWP), National Yang-Ming University in Taipei,China. She has been Founder and Director of IHWP, Director of Research Center of Health and Welfare Policy, Director of Research Center of Value-Added Health Data of NYMU and President of Taipei,China’s Public Health Association. She has been Deputy Minister of Ministry of Health and Welfare, supervising National Long-Term Care Insurance (LTCI) Planning, National Health Insurance (NHI) administration, National Pension System, long-term care delivery and social welfare policy. Previously, she was chief advisor of LTCI Task Force of Ministry of Health for 7 years to plan for the legislation and implementation of LTCI. She has served as Director of Payment system of NHI Task Force for 12 years.

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Yee Wei Limis Associate Professor of the National University of Singapore Saw Swee Hock School of Public Health. He is a physician and health systems researcher. His areas of interest include the design and evaluation of integrated health systems in developed and developing countries and the role of social innovation in health. His projects include the evaluation of Regional Health Systems in Singapore and the examination of a multi-sectoral integrated care system in the Philippines. Professor Lim co-led the NUS Improvement of Healthcare in Asia Leadership Development Program for the past four years. A/Prof Lim was also a health policy researcher at The RAND Corporation.


Mathilde Mailfertis a health financing consultant in the Sustainable Development and Climate Change Department. Prior to this assignment, she has been working on health financing in West Africa for Save the Children. She also worked as a social protection and health financing consultant for several international organizations and consulting firms, including the World Health Organization (WHO) and the International Labor Organization (ILO). Ms. Mailfert holds a master of arts degree in Public Affairs from Sciences Po (France) and an MSc in Health Policy, Planning and Financing from the LSE/LSHTM (UK).

Alia Cynthia Luzgraduated from Bryn Mawr College in 2013 with a degree in economics. She studied and worked with local and international development NGOs in various countries in North America, Europe, and Asia. Post-graduation, she worked in Liberia on renewable energy economics for a USAID-funded project. Now part of HITAP’s international unit, Alia works as a Project Associate with the project management and research team. She also provides administrative coordination for the organization’s regional projects. Alia is the primary point person for the HIU-iDSI project in Indonesia.

Sandii Lwinis a public health specialist with over 20 years of regional and cross-regional experience in international health and development in more than 20 countries in 6 regions. She is the Founder and current Managing Director of Myanmar Health and Development Consortium. She worked as WB Operations Unit Chief in Cambodia managing the first World Bank health project in 1995. She also worked for UNDP, International Monetary Fund, and National Network of Asian and Pacific Women. She is currently a member on the Board of Myanmar Business Coalition for AID; the Board of PATH’s Executive Working Committee for Myanmar; and the Asia Pacific Leaders Malaria Alliance Regional Financing Task Force.

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Alvin B. Marcelois a general and trauma surgeon by training and currently executive director of the Asia eHealth Information Network. He served as senior vice-president and chief information officer of the PhilHealth. Dr. Marcelo established the Master of Science in Health Informatics program in the University of the Philippines Manila. Dr Marcelo also manages the International Open Source Network for ASEAN+3, advises the Community Health Information Tracking System, and a Stockholm Challenge finalist in the health category in 2006. He took his postdoctoral fellowship in medical informatics at the National Library of Medicine in Bethesda, Maryland.


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Claude Meyeris one of the coordinators of the P4H network, a network of development partners jointly supporting countries on their way toward universal health coverage and social health protection. He is based in the WHO headquarters, Department of Health Systems Governance and Financing. He has worked in numerous assignments for NGOs in Sub-Saharan Africa including DR Congo, Guinea, Benin, Kenya, Uganda working at decentralized level in the area of health systems management and financing and for consulting firms serving national policy makers. He holds a Master in International Affairs and Economics from the Institut d’Etudes Politiques de Paris (Sciences-Po).

Juan Carlos Negrettehas more than 25 years of extensive international experience in health programs design, implementation and management. He has successfully directed health service delivery programs and commercial healthcare activities, and has structured and developed productive partnerships of strategic importance with relevant private sector companies and government entities, resulting in tangible improvement of the health and social conditions of communities and populations served. Mr. Negrette has effectively adopted and adapted commercial tools, techniques and approaches to child and maternal health interventions, and to family planning programs in different parts of the world.

Awad Matariais the Regional Adviser for Health Economics and Financing of the World Health Organization Eastern Mediterranean Regional Office (WHO-EMRO). Prior to being Regional Adviser, he was Health Economist in WHO-EMRO, a Senior Researcher at the Palestine Economic Policy Research Institute, and a Health Economist in Birzeit University. He completed his PhD in Health Economics in the Universite de la Mediterranee and his MSc in Health Systems Analysis in the University de Rennes I.

Qingyue Mengis Professor in Health Economics and Policy in Peking University. He is currently the Dean of Peking University School of Public Health and Executive Director of Peking University China Center for Health Development Studies. He was Professor and Director of Center for Health Management and Policy at Shandong University. He is the lead author of Health System Review (People’s Republic of China) published by the WHO. He serves the National Health and Family Planning Commission as the Policy Advisory Committee and Board of Health Systems Global. He got his Bachelor of Medicine from Shandong Medical University, Master of Public Health from Shanghai Medical University, Master of Economics from University of the Philippines, and PhD from Karolinska Institute.

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Farouk Meralli is Chief Executive Officer of mClinica Inc. Prior to founding mClinica, Farouk held senior roles at Sanofi-Aventis, Johnson & Johnson, Pfizer, and Roche, where he focused on product pricing, retail distribution, and patient programs in the emerging markets. He serves as an advisor and Board member to several companies and organizations including the Kairos Society and Borderless World Volunteers, an international nonprofit which he founded. Farouk holds a Bachelor in Biomedical Sciences and International Development Studies from McGill University and a Masters in Health Policy and Management from Harvard University.

Sunil Nandrajis advisor to the central government for the implementation of the Clinical Establishment Act, Government of Delhi for Health Sector Reforms including the Aam Admi Mohalla Clinics, Regulation of Health Sector, and Health Insurance. He is a senior advisor at the Public Health Foundation of India for providing technical assistance to the states of Karnataka and Kerala for operationalizing Universal Health Coverage. Previously, he was the Cluster Head for Health Systems Development in WHO India Country Office. He served as a technical expert in various national committees on issues of health systems development and published more than 50 articles and reports in national and international journals. He is co-founder of a website called medileaks, like wikileaks, documents irrational practices and irregularities in the health sector in India.

Gregorio Ngirmangis Minister of Health at the Republic of Palau Ministry of Health where he oversees operations at the Ministry of Health. He ensures all policies, procedures, and guidelines are being followed and the Ministry’s Vision and Mission are being upheld. As Minister, he ensures that patient care and healthcare services are the top priority of the Ministry from 2013-Present. He chaired the National Steering Committee that worked with international experts to establish a social health insurance program or the Health Care Financing Act. After the enactment of the Law, he led efforts to promulgate implementing rules and regulations, as well as administrative policies and procedures, and standards for administering the Health Care Fund program.

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Tran Thi Mai Oanhis the Director of the Health Strategy and Policy Institute. She has worked in all aspects of health care policy analysis and health system strengthening. Working at HSPI for over 25 years, she has worked on hospital autonomy, health structure operational reviews to strengthen health care at grassroots level, development and implementation of health manpower strategies, design and implementation of health financing mechanisms, assessment of health insurance policy and development of benefit health service package to support the implementation of universal health coverage. Dr. Oanh was trained as a General Practitioner at the Hanoi Medical University. She obtained her Master Degree in Public Health at Karolinska Institute, Sweden and her PhD degree in public health at National Institute of Hygiene and Epidemiology in Viet Nam.

Toomas Paluis Health Sector Manager for the World Bank’s South East Asia and Pacific Region. During the past 6 years, he has led World Bank health programs in Viet Nam, Cambodia, Thailand, and the Lao People’s Democratic Republic, and previously, in several countries in Eastern Europe and the former Soviet Union. He has also served as a Director in the Estonia Social Health Insurance Fund Management Board and as a Deputy Director of the Tallinn Emergency Care Hospital in Estonia. Toomas has an MD from the Tartu University in Estonia and an MPA from Harvard University. He has also studied medical anthropology at Oxford University and health economics at York University in the United Kingdom.

Walaiporn Patcharanarumolis a senior researcher for the International Health Policy Program (IHPP), Ministry of Public Health Thailand. A former hospital pharmacist, her main research areas include health financing, universal health coverage, health insurance and health policy and systems. She worked extensively on the National Health Account, National Drug Account, National AIDS Spending Assessment, long-term projection of national health expenditure, health care financing for the poor and capitation rate estimation for the public health insurance scheme. She also provides capacity strengthening to a number of countries in the region.

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Jeremias N. Paul, Jr.recently joined the World Health Organization (WHO) as Coordinator of the Tobacco Control Economics Unit in the Department of the Prevention of Non-Communicable Diseases. He was formerly Undersecretary of the Domestic Finance Group of the Department of Finance in the Philippines where he led initiatives to reform the country’s fiscal and tax systems, including the “Sin Tax Reform” law. He has held various positions in the Department of Finance since 1990 including Assistant Secretary of the International Finance Group. In 2005-2006, he served as Alternate Executive Director of the World Bank Group in Washington D.C. He holds a Master’s degree in International Affairs (Major in Economic Policy Management) from Columbia University in New York and a Master of Science in Industrial Economics and Bachelor of Science in Industrial Engineering degrees.

Yogesh Rajkotiais Founder and CEO of ThinkWell, a globally recognized health financing expert, and has supported the development of major health financing programs in over 25 countries. He has served in high-profile political roles to enact major reforms, such as Special Advisor to the Minister of Health in Rwanda and Health Systems Advisor to the Secretary of Health in Bangladesh. Dr. Rajkotia has managed large-scale health development programs, such as USAID’s $45 million health portfolio in Rwanda and its $125 global flagship program, Health Systems 20/20. Dr Rajkotia holds an MSc in Health Policy, Planning, and Financing from the London School of Economics and a PhD in health economics from Johns Hopkins Bloomberg School of Public Health.

Faisal Rifaqis the Acting CEO / Director – Technical of the Prime Minister’s National Health Insurance Program of Pakistan. He previously worked with the Child Advocacy International Pakistan as In-country head, Greenstar Social Marketing, Ministry of Health, and World Health Organization among others. He completed his MPH in The Johns Hopkins University and holds both MBBS and MBA degrees.

Bouphat Phonvisay is Director of the National Health Insurance Bureau of the Ministry of Health of the Lao People’s Democratic Republic which is among those tasked to work on the integration of existing health protection schemes including Health Equity Funds into a single payer system.

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Derek Ritzis the principal consultant at ecGroup Inc., a digital health consultancy based in Toronto, Canada. Mr. Ritz is a senior advisor to international public and private sector clients regarding health enterprise architecture, digital health strategy, informatics standards and national-scale systems implementation. Mr. Ritz is a registered professional engineer and an internationally certified health informatics professional. Mr. Ritz was instrumental in launching Canada’s national digital health reference implementation lab at Mohawk College in Hamilton, Ontario. He is presently involved in launching the first node of the AeHIN Community of Interoperability Labs (COIL) in Manila, Philippines.

Benjamin Rolfeis Executive Secretary of the Asia Pacific Leaders Malaria Alliance, the secretariat of which is hosted by the Asian Development Bank. Formerly Pacific Lead Health Advisor at the Australian Department of Foreign Affairs and Trade, Ben has more than twenty years’ experience in supporting health initiatives across 30 countries. Ben is currently based in Manila, having previously lived and worked for long periods in Cambodia, Nepal, India, Tanzania, Australia, Nigeria and Eritrea. Dr Rolfe holds a PhD from the University of Wales and is a Fellow of the UK Faculty of Public Health Medicine.

Alice Sabino is Global Program Manager – Health Financing at Clinton Health Access Initiative (CHAI). She has previously worked with the International Federation of Red Cross and Red Crescent societies (IFRC) and Doctors with Africa. She completed in MSc in Public Health in Developing Countries in the London School of Hygiene and Tropical Medicine and MA in International Relations in the University of Florence

Jan Schmitz-Huebschis a Director in Munich Re’s health insurance division. He is responsible for leading growth and strategy projects in emerging markets, with a focus on the Middle East and Africa. Based in Dubai / Abu Dhabi, Jan Schmitz-Huebsch is also heavily involved in the Joint Venture which Munich Re has formed with Abu Dhabi’s Government a decade ago to jointly launch and operate the National Health Insurance system. Prior to his current position, Jan was in strategy and management consulting for close to 10 years, most of it with Booz Allen Hamilton / Booz & Company. Here, he focused on healthcare finance projects for large governmental and private sector clients, such as reforming national health finance, introduction of health insurance, but also across the healthcare provider and technology sectors.

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Vera Siesjöserves as Country Director of ACCESS Health International in the Philippines. She currently manages projects on health financing, healthcare quality improvement and healthcare delivery systems. She supports ACCESS Health’s work with the Joint Learning Network for Universal Health Coverage, an innovative, country driven network of practitioners and policymakers from 22 countries around the globe. The network co develop global knowledge products that give guidance on how to address challenges related to the implementation of Universal Health Coverage though the expansion of national health insurances in low- and middle-income countries.

Bhavdeep Singhis the CEO of Fortis Healthcare, a publicly listed company on the Mumbai Stock Exchange and a globally recognized hospital operator with over 4000 beds across India. Mr. Singh is an acknowledged business leader and a seasoned professional with over 20 years of leadership experience across several continents. He has held senior executive roles in HR, Retail and Healthcare, and has worked across multiple geographies with a strong track record of leading great teams whilst delivering exceptional results. Mr. Singh attended Pace University and completed several certified courses in Leadership and Executive Management.

Anderson Stancioleis Health Economics Advisor at the UNFPA Asia-Pacific Regional Office, responsible for providing technical assistance on health financing to promote equitable and efficient SRHR service delivery. Before that, Mr. Stanciole led the development of a portfolio management system to provide visibility to the Gates Foundation product development portfolio, as well as played a key role in managing the relationship with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Before joining the Gates Foundation, Anderson worked as a health economist at the World Bank in Washington, DC. He holds a PhD in Health Economics from the University of York, UK.

Tsolmongerel Tsilaajavis a health economist from Mongolia and the former Director of Policy Planning in the Ministry of Health. She has been extensively engaged in the reforms of health care financing and social health insurance in Mongolia. Ms. Tsolmongerel undertook several policy studies including distribution of catastrophic and impoverishing health payments and hospital services costing in Mongolia and the Philippines. Ms. Tsolmongerel currently works as a consultant for the Ministry of Labor and Social Welfare in Mongolia. She holds a Master’s degree from the University of Manchester, United Kingdom.

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Katherine Ann Villegas-Reyesis the Executive Director and a Founding Partner of the Alliance for Improving Health Outcomes, Inc. (AIHO), a Philippine-based health NGO that provides advising, development and implementation services to government and development partners. She finished her medical degree from the University of the Philippines College of Medicine and her masters at the Lee Kuan Yew School of Public Policy, National University of Singapore. She has provided consulting services to the Philippine Department of Health, PhilHealth, World Health Organization, UNICEF, UNDP, ADB, Medicines Transparency Alliance (MeTA) Philippines, among others.

Lluis Vinyals Torresis a health financing expert with more than 18 years of experience in low- and middle-income countries. He has worked with several multilateral and bilateral aid agencies. His exposure to all health systems levels, from facility to Ministry and social health insurance schemes, has given him a wide understanding of how to analyze performance at all these levels. He has an MSc degree on Health Policy from the London School of Economics. Mr. Torres recently joined WHO as Health Planning and Financing Regional Adviser for the South East Asia Regional Office (SEARO).

Judith Won Pat is the Speaker of the Guam Legislature since March 2008, during the 29th Guam Legislature and continues to be the Speaker in the 33rd Guam Legislature. She attained her Master of Education from the University of Guam.

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Profiles of the aDB team

Eduardo P. Banzonis Principal Health Specialist in the Sustainable Development and Climate Change Department. Dr. Banzon champions UHC and has long provided technical support to countries in Asia and the Pacific in their pursuit of this goal. Before joining ADB, he was President and CEO of the Philippine Health Insurance Corporation, WHO regional adviser for health financing, World Bank senior health specialist, and a faculty member of the University of the Philippines’ College of Medicine and the Ateneo Graduate School of Business.

Arup Chatterjeeis Principal Financial Sector Specialist in the Sustainable Development and Climate Change Department, and is responsible for leading financial sector development initiatives and providing operational support in the areas of insurance, contractual savings, and financial inclusion. He has earlier served as Principal Administrator of the International Association of Insurance Supervisors (IAIS) at the Bank for International Settlements in Basel, Switzerland; Joint Director of Insurance Regulatory and Development Authority of India; and Officer on Special Duty of the Ministry of Finance, Government of India.

Brian Chinis Social Sector Economist in the South Asia Department. Mr. Chin is responsible for designing and implementing projects in health, education, and skills development sectors and facilitating knowledge management. He holds a PhD in demography from the University of Pennsylvania and a master’s degree from the Harvard School of Public Health.

Megan Counahanis Health Specialist in the Central and West Asia Department. She is a public health specialist with more than 20 years’ experience in health systems strengthening, disease control, and policy and program management. She has worked as a policy advisor, program lead, donor representative and field researcher for governments, the World Health Organization, Australian Aid and ADB. Working now in Central and West Asia she has previously worked in both South East Asia and the Pacific. Megan holds a Doctorate in Public Health and a Masters in Public Health and Tropical Medicine.


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Sean Donatois Health Specialist in the Sustainable Development and Climate Change Department, seconded from the Clinton Health Access Initiative. He is a health commodity supply chain management specialist and has worked on various procurement, information management, process improvement and strategy development projects in his career. Sean studied at the University of Michigan and Columbia University, and has a certificate in Organizational Performance Management.

Stephen P. Groffis Vice-President for Operations (VPO2), and is responsible for the full range of ADB’s operations in East Asia, Southeast Asia, and the Pacific. Prior to joining ADB, Mr. Groff was Deputy Director for Development Cooperation at the Organisation for Economic Co-operation and Development (OECD). Mr. Groff has worked across Asia, Africa, and Latin America and writes regularly on development issues. He also serves on a number of advisory boards for development-related organizations. Mr. Groff holds a Master’s degree in Public Administration from Harvard University and a Bachelor of Science degree in Environmental Biology from Yale University.

Diwakar Guptais Vice-President for Private Sector and Cofinancing Operations, and oversees ADB’s assistance to private sector projects. He is also responsible for building and maintaining cofinancing partnerships with various organizations and financial institutions. Before joining ADB, Mr. Gupta was Managing Director and Chief Financial Officer of the State Bank of India. He holds a Master of Science degree in Physics from the University of Delhi, and a Bachelor of Science degree in Physics (with Honors) from St. Stephen’s College in Delhi.


Soonman KwonSoonman Kwon is the Chief of Health Sector Group (Technical Advisor on Health) in ADB. Prior to ADB, Soonman was the Dean of the School of Public Health, Seoul National University (SNU), South Korea. After he received his Ph.D. from the Wharton School of the University of Pennsylvania, he was assistant professor of public policy at the University of Southern California in 1993-1996. Prof. Kwon has held visiting positions at the Harvard School of Public Health, London School of Economics, University of Toronto, and University of Bremen. He is the associate editor of Health Policy (Elsevier) and was the editor of Korean Journal of Public Health and Korean Journal of Health Economics. He has occasionally worked as a short-term consultant of WHO, World Bank, GIZ, and ADB on health financing and system in Algeria, Bhutan, Cambodia, the People’s Republic of China, Egypt, Fiji, Ghana, India, Indonesia, Iran, Kenya, Lao PDR, Malaysia, Maldives, Mongolia, Myanmar, Nepal, Pakistan, Philippines, South Africa, Uganda, and Vietnam.

Ma. Carmela Locsinis Director General of the Sustainable Development and Climate Change Department. Prior to this, Ms. Locsin assumed various positions including Head of the Office of Cofinancing Operations (OCO), Deputy Director General, South Asia Department; Deputy Director General, Regional and Sustainable Development Department; and Director, OCO. Before joining ADB in 1997, Ms. Locsin worked at the International Finance Corporation, and the World Bank. She has a Master’s degree in Business Administration from Georgetown University, and a Bachelor’s degree in Economics from the University of the Philippines.

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am Saumya Kailasapathyis Health Specialist in the Sustainable Development and Climate Change Department, seconded from the Clinton Health Access Initiative. She supports ADB’s operational plan for health, focusing on implementing innovative financing for health infrastructure, developing investment frameworks in public and private healthcare, and supporting private sector health investment opportunities. Her professional experience includes a global career in Financial Services, but more recently on increasing access to health care and private sector development for health in emerging markets.

Inez-Mikkelsen Lopez is Health Specialist in the Pacific Regional Department. Prior to joining ADB, she was a monitoring and evaluation adviser for a health program in Papua New Guinea funded by the Government of Australia. She also has private sector sector experience as part of the Access to Medicines team with Merck. She started her career at the World Bank and completed her PhD in Health Systems from the Swiss Tropical and Public Health Institute.


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Raushanbek (Raushan) Mamatkulovis Senior Health Specialist in the East Asia Department. He is a medical doctor, and has a Master of Public Health degree from the George Washington University, as well as a Master of Business Administration degree from the University of Chicago. Dr. Mamatkulov has more than 15 years’ experience in economic development, including work on infrastructure development projects in health, urban and transport sectors in the People’s Republic of China, Mongolia, and Central and Southeast Asia.

Kirthi Rameshis Social Development Specialist in the Sustainable Development and Climate Change Department. She focuses on health governance and accountability, as well as in information and communication technology solutions for health systems strengthening. Prior to joining ADB, she worked with the Ministry of Health in Malawi on financial management for the Global Fund. Ms. Ramesh’s experience also includes working with the Global Fund and GIZ across Asia in the areas of social protection, health systems strengthening and urban governance. She has further supported the German Ministry of Health in the preparation of Germany’s National Global Health Strategy.

Scott Roberts is Senior Investment Specialist in the Private Sector Operations Department, and focuses on nonsovereign infrastructure finance in East and Southeast Asia. He was previously a VP of GE Capital’s emerging markets energy investment group and PRC Director for consultancy Cambridge Energy Research Associates. Mr. Roberts is a graduate of Tufts University, the Harvard Kennedy School of Government, and the MIT Sloan School of Management.

Susann Rothis Senior Social Development Specialist in the Sustainable Development and Climate Change Department. She focuses on private sector health investments, regulatory convergence and capacity development of regulatory agencies, and digital health. She is a medical doctor, and holds a PhD in medical science from the University of Heidelberg, and a Master of Public Health degree from the University of the Philippines. She was recently appointed as Adjunct Associate Professor at National University of Singapore, LKY School of Public Policy.

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Gerard Servaisis Senior Health Specialist in the Southeast Asia Department. He is a medical doctor with 30 years of working experience as a public health specialist in Africa and Asia. His interest includes health financing, health sector governance and health system strengthening.

Bambang Susantonois Vice-President for Knowledge Management and Sustainable Development, and is responsible for managing the Sustainable Development and Climate Change Department, Economic Research and Regional Cooperation Department, and Department of External Relations. Prior to this, Mr. Susantono was the Vice-Minister of Indonesia’s Ministry of Transportation, and Deputy Minister for Infrastructure and Regional Development. He chaired several research institutes and taught in universities. Mr. Susantono holds a PhD in Infrastructure Planning and Master’s degrees in Transportation Engineering, and City and Regional Planning from the University of California Berkeley.

Hayman Winis Senior Health Specialist in the South Asia Department, and is primarily responsible for the design and implementation of health sector operations. She joined ADB as a Young Professional and has covered social sector operations South Asia, Southeast Asia, and the Pacific. Prior to ADB, she worked with the Gates Foundation’s HIV/AIDS Program in India, UNESCAP in Thailand, and UNICEF in Myanmar. She has degrees in economics, international relations, and public health from Johns Hopkins School of Advanced International Studies and Johns Hopkins School of Public Health (United States).

Ye Xuis a health economist (Young Professional) in the Southeast Asia Department, and supports health sector lending projects and technical assistance in Viet Nam and the Greater Mekong Subregion. She was a lead author for the World Bank’s Deepening Health Sector Reform in China Study (2014-2016). She was a guest lecturer at Tsinghua University and visiting scholar at the Ministry of Health of the People’s Republic of China. Ms. Xu received her doctoral degree from the Harvard School of Public Health.

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am Azusa Satois Health Specialist in the Southeast Asia Department. She currently works in the areas of health financing, insurance, governance, security and human resource development in Viet Nam, Cambodia, the Lao People’s Democratic Republic and Myanmar. Prior to joining ADB, she worked with the London School of Economics, and was consultant for DFID, Oxfam, World Bank, and the WHO. She has a PhD in Health Policy, and a Master’s degree in Population and Development, both from the London School of Economics.


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About the Asian Development Bank

ADB’s vision is an Asia and Pacific region free of poverty. Its mission is to help its developing member countries reduce poverty and improve the quality of life of their people. Despite the region’s many successes, it remains home to the majority of the world’s poor. ADB is committed to reducing poverty through inclusive economic growth, environmentally sustainable growth, and regional integration.

Based in Manila, ADB is owned by 67 members, including 48 from the region. Its main instruments for helping its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and technical assistance.

ASIAN DEVELOPMENT BANK6 ADB Avenue, Mandaluyong City1550 Metro Manila. Philippineswww.adb.org

NATIONAL HEALTH INSURANCE FOR

27-30 September 2016ADB Headquarters, Manila, Philippines

UNIVERSAL HEALTH COVERAGE

growth, environmentally sustainable growth, and regional ... · 9:10 a.m.–9:30 a.m. Scaling up...

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