The healthcare financing for the poor: Prospects of compulsory health insurance for female readymade garment workers in Bangladesh

Author: Nishat Jahan

Jahan, Nishat, 2020 The healthcare financing for the poor: Prospects of compulsory health insurance for female readymade garment workers in Bangladesh, Flinders University, College of Business, Government and Law

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The Readymade Garment (RMG) industry in Bangladesh is the second biggest across the globe, just behind China, and it is the key driver of the country’s economy. Most of the workers in this sector are female, who suffer from health issues and cannot afford treatment with their limited income. This study investigates the possibility of establishing a compulsory health insurance scheme for these workers. In doing so, it employs a qualitative approach and reviews the public health insurance practices of three Asian countries: Thailand, South Korea and Vietnam. This study finds that it is possible for countries with a relatively weak economy and large population to successfully implement health insurance schemes. It shows that successful implementation of health insurance policy in these countries is underpinned by a number of factors including political will, efficient governance structure and strategies; as well as the modest nature of the scheme. The case studies show that Vietnam adopted a gradual approach in covering the population; Thailand introduced means testing, a referral system of gatekeeper and price negotiation working; and in South Korea, there is a two-way relationship among insurer, insured and service providers, together with a review system for claiming long-term care expenses. These three countries have followed different strategies, yet they have achieved considerable success. Bangladesh has opportunities to draw lessons and undertake policy transfer from these international practices. This study concludes that Bangladesh can establish a compulsory health insurance scheme initially for these workers, which could be gradually expanded. The government of Bangladesh should come up with its own scheme that is appropriate to its socio-economic and political contexts. The findings of this study provide significant insights for the government in establishing compulsory health insurance for female RMG workers in Bangladesh as well as in other parts of the world having similar issues.

Keywords: Readymade Garment (RMG) industry, health insurance, out-of-pocket (OOP) expenditure, Universal Health Coverage (UHC), female RMG workers, Bangladesh

Subject: Policy and Administration thesis

Thesis type: Masters
Completed: 2020
School: College of Business, Government and Law
Supervisor: Associate Professor Noore Siddiquee