International Monetary Fund

Regional Office for Asia and the Pacific/Fiscal Affiars Department Joint Conference, Tokyo, October 3, 2011

Public Health Care Reform in Asia

Motivation and Objective

Health care reform remains a key challenge in advanced and emerging economies, including in Asia. In advanced Asia, public expenditure on health is putting large pressure on government budgets, owing largely to technological innovations which lead to better but more expensive health services, and population aging. In emerging Asia, where spending is lower, the challenge is to expand health insurance coverage in a fiscally sustainable manner. This one-day conference will focus on the outlook for public expenditure on health over the next 20 years and the challenges of health care reform in Asia, drawing on lessons from across the globe. The conference will bring together leading academics, researchers, and policy makers from 11 countries to discuss experiences with health reform and the future direction of reforms.

Program

Monday, October 3, 2011
Tokyo

8:30–8:55 am Registration
8:55–9:00 am Welcome Address

Shogo Ishii (Director, Regional Office for Asia and the Pacific, IMF)
9:00–9:15 am Opening Remarks

Min Zhu (Deputy Managing Director, IMF)
9:15–
10:45 am
SESSION I — Trends and Outlook for Public Health Spending in Asia in Comparative Perspective

This session will provide an assessment of the factors that have driven government health spending in Asia and other regions since 1970, including technological advances, population ageing, and expanding insurance coverage. Projections of future public health spending and the role of private insurance will also be discussed.

Chair:
Sanjeev Gupta (Deputy Director, Fiscal Affairs Department, IMF)

Presentations:

Global Trends in Public Health Spending and the Outlook
Benedict Clements (Division Chief, Expenditure Policy Division, Fiscal Affairs Department, IMF) (15 minutes)

Measuring the Health Effects of Health Care Reform in Advanced and Emerging Countries
Jonathan Skinner (Professor, Dartmouth College) (15 minutes)

Perspectives on the Appropriate Role of the Private Sector in Meeting Health Care Needs
Uwe Reinhardt (Professor, Princeton University) (15 minutes)

The Future Role of Private and Public Sector Insurance in Meeting Health Care Needs in Asia
Alexander Ng (Associate Principal, McKinsey & Company Hong Kong) (15 minutes)

10:45–
11:00 am
COFFEE BREAK

11:00 am–
12:30 pm
SESSION II — Reform Strategies: The Experience of Emerging Asian Economies

This session would examine the reform experiences of emerging Asian economies, with a view to determining the lessons for other emerging economies of the region. The country case studies will examine reforms that helped expand health care coverage in a fiscally sustainable manner.

Chair:
Sungsup Ra (Director, Division of Human and Social Development, South Asia Department, Asian Development Bank)

Presentations:

Health Financing Systems in East Asia and the Pacific: Early success and current challenges
John C. Langenbrunner (Lead Economist, Human Development Sector Department, World Bank) (15 minutes)

The Reform Experience of China
Tsung-Mei Cheng (Health Policy Research Analyst, Woodrow Wilson School of Public and International Affairs, Princeton University) (15 minutes)

The Reform Experience of India
Govinda Rao (Director, National Institute of Public Finance and Policy, India) (15 minutes)

The Reform Experience of Thailand
Pongpisut Jongudomsuk (Director, Health Systems Research Institute, Ministry of Public Health, Thailand) (15 minutes)

12:30–
2:00 pm
LUNCH

Key Note Speech

Takatoshi Kato (President, Japan Center for International Finance)

2:00–
3:30 pm
SESSION III — Reform Strategies: The Experience of Advanced Asian Economies

This session would examine the reform experiences of advanced economies, with a view to determining the lessons for advanced Asia. The country case studies will examine the experiences of selected advanced Asian economies that helped reduce the growth of public health expenditures over a sustained period of time. The effects of health care reforms on health outcomes and equitable access to health care will also be discussed.

Chair:
Masatsugu Asakawa (Deputy Vice Minister of Finance for International Affairs, Ministry of Finance,Japan)

Presentations:

Macro-Fiscal Implications of Health Care Reform in Advanced Economies: What are the Lessons?
Sanjeev Gupta (Deputy Director, Fiscal Affairs Department, IMF) (20 minutes)

Japan Case Study
Masako Ii (Professor, Department of Economics, Hitotsubashi University) (20 minutes)

Korea Case Study
Soonman Kwon (Professor, Seoul National University) (20 minutes)

3:30–
3:45 pm
COFFEE BREAK

3:45–
5:15 pm
SESSION IV — Policy Panel Discussion: What Are the Best Reform Options for Asia?

This panel will discuss policy options for achieving broad access to high quality health care in a fiscally sustainable manner. Panelists will address: (1) which reforms are preferable for advanced Asia to contain the growth of public health spending; (2) how reforms can ensure that the poor maintain access to high quality care; (3) for emerging Asia, how health care coverage can be expanded in a fiscally consistent manner; and (4) the appropriate role of the state and private sector in meeting these objectives.

Moderator:
Min Zhu (Deputy Managing Director, IMF)

Panelists:
Toshihiko Takeda (Counselor in charge of social welfare, Ministry of Health, Labour and Welfare, Japan)

Sanjeev Gupta (Deputy Director, Fiscal Affairs Department, IMF)

Jung-Kwan(JK) Kim (Director for Economic Policy, Ministry of Strategy and Finance, Republic of Korea)

Makoto Ohsawa (Price Waterhouse Coopers)
5:45–
6:30 pm
PRESS CONFERENCE

7:00–
9:30 pm
DINNER RECEPTION

Closing Remarks

Takehiko Nakao (Vice Minister of Finance for International Affairs, Ministry of Finance, Japan)