Feasibility study for the introduction of mandatory health insurance in Uzbekistan

© World Health Organization 2021
Book design and cover design: Christophe Lanoux, Paris, France 
Abstract
Keywords
HEALTHCARE FINANCING 
HEALTH SYSTEMS 
REVENUE MIX FOR HEALTH
FISCAL SPACE FOR HEALTH
UZBEKISTAN
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Uzbekistan has decided to introduce mandatory health insurance (MHI) to move towards universal health coverage. This 
feasibility study assesses the impact of potential revenue sources to expand the fi scal space for health under MHI. Using 
population, employment and economic data, it projects three scenarios of the potential public revenue mix for health. 
Scenario 1 projects that in 2025, 620 000 som per capita will be available for health from general taxation. Scenario 2 
projects revenues from general taxation combined with a 2% payroll tax to add 35 000 som per capita (5.4% of total 
public funding for health). Scenario 3 doubles the payroll tax to 4% and adds 52 000 som per capita (7.7% of total public 
funding for health). It concludes that general taxation off ers the most eff ective way to support progress towards universal 
health coverage, and a payroll tax would generate limited additional resources, be inconsistent with the objectives of the 
2019 income tax and social security contribution reform, and risk harming the labour market. Instead, Uzbekistan can 
seek complementary revenue streams from alternatives (e.g. sin taxes), and further expand fi scal space for health through 
focusing on effi
ciency gains in the service delivery system.
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introduc on of mandatory health insurance in Uzbekistan. 
Copenhagen: WHO Regional Offi
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