Although there were many contributing factors — political, economic, social and
health-system related — the most significant was an ambitious reform known as
the Universal Coverage Scheme (UCS). Launched in 2001 and financed through
general tax revenues, the scheme rapidly expanded and within a year was
providing coverage to 47 million people (75% of the population): 18 million
previously uninsured people and members of two existing publicly subsidized
schemes (the Medical Welfare Scheme and the Voluntary Health Card Scheme).
The other 25% of the population were government employees, retirees and
dependants, who remained under the Civil Servant Medical Benefit Scheme
(CSBMS), and private-sector employees, who continued to have their health-care
costs paid for by the contributory Social Security Scheme (SSS).
The UCS was remarkable not only for the speed of its implementation but also
because it was pursued in the aftermath of the 1997 Asian financial crisis when
gross national income (GNI) was only US$ 1,900 per capita, and against the advice
of some external experts who believed the scheme was not financially viable.
This report is an assessment of how the UCS performed in its first 10 years.
The assessment was undertaken to better understand the extent to which the