Types of Social Health Insurance Programs

Social Health Insurance is a system used by countries to finance and manage the delivery of health care services. SHI pools together an entire population's or a large group's health and financial risks into one system. It's a system more commonly found in poor countries, although programs exist for certain population sub-groups in wealthy countries as well. For the system to work effectively, it usually requires mandatory participation and sound financing, such as by an automatic payroll deduction from a person's paycheck.
Just as there are different systems for delivering health care, such as private voluntary health insurance, health savings accounts, and community health financing; there are also various types of programs that fall under the classification of SHI.

China: Uninsured and Government

• China updated its SHI programs in 1993 in an attempt to control rising health care costs spurred by globalization. It first extended coverage to the uninsured in metropolitan and urban areas, and later expanded the program to include government employees and retirees. Plans are underway to open up the program to the private sector as well with the goal of achieving universal coverage by 2010. The update and expansion of SHI has reduced government spending on health care by 20 percent over the last decade.

Myanmar: Public and Private Employees

• Since 1956, the government of Myanmar has provided public and private employees mandatory health care coverage through its SHI program. Employees receive free medical care with automatic payroll deductions made to cover the plan's cost. The plan doesn't cover dependents, but program expansion is under deliberation.

Vietnam: Government and Children

• Vietnam's SHI was instituted in the early 1990s and covers roughly 11 percent of the country's total population. The system now covers government employees and their dependents, retirees and school-age children. Eventually it will cover all workers and retirees in the private sector, especially those in rural areas.

Indonesia: Military and Government

• Indonesia has two main SHI programs-PT Askes and Jamsostek. Pt Askes provides coverage to all civil servants, dependents and military personnel. Jamsostek covers government employees, spouses and children under 21. The success of the programs has encouraged consideration of merging them into a single SHI program, but issues over design have prevented this effort from moving forward.

United States: Vulnerable Populations

• The United States has three main SHI programs --Medicare, Medicaid and the State Children's Health Insurance Program (S-CHIP). Each program provides coverage to targeted vulnerable population groups, and is partially subsidized by government. Medicare is administered at the federal level and covers seniors over the age of 65 and people with disabilities. Medicaid and S-CHIP are paid for with federal and state matching funds and are administered by states. Medicaid serves very poor people. S-CHIP covers low-income children whose parents don't qualify for Medicaid and aren't covered by a private insurance plan.