Workers need universal health care coverage
When the workforce is healthy and has access to healthcare, everyone wins. Workers basic rights are upheld and their wellbeing and productivity increases, opening a range of opportunities for workers and their family members. Firms enjoy increased productivity, lower absenteeism, a larger pool of qualified jobseekers and higher levels of staff retention. Output and tax revenues increase. When workers’ need for health care is not met or limited access bars working-age adults such as women from participating in the workforce, societies shoulder a plethora of social and economic costs and individuals and families suffer due to loss of income, productivity and premature death.
In Asia and the Pacific, the need to expand health care coverage is urgent. 1.6 billion people, or more than one-third of the population in the region is not effectively protected by a health care scheme. 60 per cent of workers finance their own health care costs. Deprived of income protection, they receive no salary when absent from work. Health insurance or private health care is available to only one in five people.
Source: WHO (2022). The Global Health Observatory.
The challenge in South Asia is particularly acute. By 2023, nearly one third of the global population without health coverage will be in South Asia. The gap between the health of workers in developed countries compared to those in low and lower-middle income countries is significant. Access to health care reduces child mortality, increases life expectancy and survival rates above the age of 65.
Today’s health status is closely linked to a country’s development and impacts current and future workforce
Selected health outcomes by sex and level of income in Asia-Pacific, 2018
Source: OECD (2020). Health at a Glance in Asia-Pacific.
Note: Data are available for 27 countries in the Asia-Pacific region in 2018 with sex disaggregation. Income groups follow OECD-WHO classification.
Full-time employees are in better health than part-time or self-employed workers in most developing countries. The unemployed suffer the highest levels of poor health. Twelve per cent of lower-income earners in the region suffer from poor health, compared to 5 per cent among higher-income individuals. Women, young people, older persons, rural residents, persons with disabilities, migrants and refugees are disproportionally disadvantaged.
Poorer health among vulnerable workers in the Asia-Pacific region
Share of population with poor health by employment status and level of income
Source: WVSA (2022). World Values Survey, Wave 7. Available at https://www.worldvaluessurvey.org/ (accessed in January 2022).
Note: Weighted results from 27 countries in Asia and the Pacific directly obtained from WVS interactive tool. Figures exclude those reporting “do not know” or “no answer”. Poor and very poor health are bundled together for space brevity. Full-time employment assumes at least 30 hours of work per week. Income status and highest level of education is recoded as per WVS guidelines.
Expanding social health protection is the best way to leave no one behind in access to health care, irrespective of people’s age, socioeconomic status and employment situation. This inclusive approach, if taken throughout people’s lives, would improve the health and productivity of the current and future workforce, particularly in the face of rapid population ageing.
By giving everyone access to health care throughout their life, countries can build trust, deepen solidarity and strengthen the social contract between governments and citizens. People across the region expect their governments to provide access to health care. There is a strong demand for more spending on health care and social protection, demands only exacerbated by the COVID-19 pandemic.
Higher trust is associated with higher health coverage
Source: WVSA (2022). World Values Survey, Wave 7. Available at https://www.worldvaluessurvey.org/ (accessed in January 2022). and WHO (2019), The Global Health Observatory. Available at https://www.who.int/data/gho (accessed on 29 March 2022).
Note: The Universal Health Coverage (UHC) service coverage index on the x-axis is a composite index covering 14 tracer indicators of health service coverage including reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases. As a unitless index, it ranges between 0 and 100 with higher values representing higher service coverage. Generalized trust, on the y- axis measures the share of people agreeing with the following statement “Most people can be trusted?” in 27 countries in the 2017–2020 period.
Population ageing will affect the accessibility, availability and affordability of health care services. Since large out-of-pocket expenditures on health care impose a substantial financial burden on everyone that does not have access to affordable health care, it is important to invest in the health of the workforce over the course of its life and prepare for the increase in expenditure required.
Overall health care expenditures in Asia and the Pacific as a percentage of GDP are projected to increase by 80 to 144 per cent by 2060, depending on how healthy the older population will become. Healthy ageing can keep health care expenditures in check and ease the fiscal pressure on countries transitioning to an aged society.
Projected total health care expenditures by year in the Asia-Pacific region as a share of GDP
Source: Howdon and Pasali (2022).
Accelerating progress toward universal health care coverage, increasing the number of health care workers equipped with skills to tackle emerging and special needs and taking broader health-improving measures, is urgently needed to promote a healthy ageing in Asia and the Pacific.