Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations

Robert Kolesar, Sambo Pheakdey, Bart Jacobs (), Narith Chan, Samedy Yok and Martine Audibert ()
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Robert Kolesar: Health Policy Plus/The Palladium Group
Sambo Pheakdey: General Secretariat for the National Social Protection Council
Bart Jacobs: Radboud University [Nijmegen]
Narith Chan: General Secretariat for the National Social Protection Council
Samedy Yok: General Secretariat for the National Social Protection Council
Martine Audibert: CERDI - Centre d'Études et de Recherches sur le Développement International - UCA [2017-2020] - Université Clermont Auvergne [2017-2020] - CNRS - Centre National de la Recherche Scientifique

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Abstract: The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio‐economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out‐of‐pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.

Date: 2020-01
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Published in International Social Security Review, 2020, 73 (1), pp.35-63. ⟨10.1111/issr.12227⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02545471

DOI: 10.1111/issr.12227

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