Feasibility study for the introduction of mandatory health insurance in Uzbekistan


Fig. 2. Projected public expenditure on health per capita


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WHO-EURO-2021-2317-42072-57915-eng

Fig. 2. Projected public expenditure on health per capita 
Fig. 3. Projected potential payroll contributions’ share of total government health spending


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Uzbekistan has low unemployment but has seen formal employment numbers decline 
and is struggling to formalize its economy.
Introduction of the new payroll tax poses a 
potential risk for further deterioration of formal labour participation and for compliance with 
the tax legislation. The working-age population in Uzbekistan was estimated at 18.6 million 
people in 2017.
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The official unemployment rate is low (5.8%), and so is most probably also 
the share of the population seeking jobs without being officially registered as such. However, 
Uzbekistan has large agricultural and small trade sectors, in which the working population 
participates based on barter and cash payments, with no registered income. Also in other 
sectors, formal labour participation rates and compliance with income tax legislation are 
challenges. According to the International Monetary Fund, the formal sector employment 
rate decreased from 38% to 26% between 2000 and 2018.
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Introducing a new payroll tax for health would be inconsistent with the 2019 income tax 
and social security contribution reform, which is designed to enhance economic growth by 
increasing the formal labour force participation.
The reform ultimately intends to increase 
public revenue by a larger and wider revenue base for taxation. Until 2018, Uzbekistan had 
a progressive, four-bracket income tax from 0% for those who earn the official monthly 
minimum salary, with additional up to 22% on income above 10 times the monthly minimum 
salary. In addition, an 8% social security contribution to the pension fund is applied to all 
income. Employers paid a 15% or 25% social security contribution (depending on corporate 
status), of which all but 0.2% was a pension fund contribution (Table 2). From January 2019, 
Uzbekistan has a 12% flat-rate income tax on all income, of which 0.1% is designated for the 
individual pension fund but with no additional social security contribution for the employee. 
Employers’ social security contributions are only reduced marginally from 15% to 12% and 
only for non-budgetary institutions and institutions with less than 50% state capital.
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THE RECENT TAX REFORM AND IMPACT ON THE LABOUR MARKET
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Open Data [online database]. Tashkent: State Commi ee of the Republic of Uzbekistan on Sta s cs; 2019 (h ps://stat.
uz/en/open-data, accessed 12 August 2019).

Republic of Uzbekistan: 2019 Ar cle IV Consulta on – Press Release and Staff Report. Washington (DC): Interna onal 
Monetary Fund; 2019 (Country Report No. 19/129; h ps://www.imf.org/en/Publica ons/CR/Issues/2019/05/09/
Republic-of-Uzbekistan-2019-Ar cle-IV-Consulta on-Press-Release-and-Staff -Report-46884, accessed 12 August 2019).
THE RECENT TAX REFORM 
AND IMPACT ON THE 
LABOUR MARKET



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