Finally, rising consumer expectations are putting upward pressure on health-care
expenditures in many middle-income countries. The design of the UCS around a
comprehensive benefits package and the use of primary care gatekeeping will
go some way to keeping these expectations in check. Increasingly, members
know what services and interventions they are entitled to and are becoming
more informed about why some services are excluded. The NHSO will need to
continue to invest in effective communication strategies and public and civil
society engagement, supported by reliable evidence and accurate data.
This is especially important given that there are three public health insurance
schemes among which consumers will compare relative benefits packages.
The NHSO must continue to show UCS members that their benefits package is
comprehensive and on a par with that of the SSS, and that they do not need the
augmented services provided by the CSMBS. To succeed, these efforts will need
to be matched by equal efforts from the Government to address the limitation
of service capacity in the district health systems, where most UCS members are
registered, while building trust and confidence that referral backup ensures equal
access to quality secondary care for all.