Health Insurance and Public Health: Analyzing the Impact of Financing and Policy on Healthcare Access

Authors

  • Firmansyah Universitas Tadulako

DOI:

https://doi.org/10.61194/jrkpk.v3i1.675

Keywords:

Health Insurance, Universal Health Coverage, Healthcare Access, Health Equity, Health Financing, Digital Health, Policy Reform

Abstract

Health insurance plays a crucial role in improving healthcare accessibility, particularly for vulnerable populations. This study systematically reviews the impact of health insurance on service utilization, affordability, and health outcomes across different countries. A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google Scholar, with predefined keywords and systematic inclusion criteria. The findings reveal that insurance coverage significantly enhances healthcare utilization and reduces financial barriers, yet disparities persist, particularly among low income and informal sector workers. Countries with mixed public private financing models tend to achieve better health equity and sustainability. Additionally, community based health insurance and digital innovations have shown promise in increasing participation and service efficiency. However, barriers such as policy fragmentation, limited infrastructure, and low public awareness hinder progress toward Universal Health Coverage. To address these challenges, policymakers must adopt inclusive financing strategies, strengthen public awareness campaigns, and invest in digital healthcare solutions. Future research should focus on evaluating the long term impact of these interventions to optimize health insurance models for broader accessibility and efficiency.

References

Aikins, A. d., Kushitor, M., Koram, K., Gyamfi, S., & Ogedegbe, G. (2014). Chronic Non-Communicable Diseases and the Challenge of Universal Health Coverage: Insights From Community-Based Cardiovascular Disease Research in Urban Poor Communities in Accra, Ghana. BMC Public Health, 14(S2). https://doi.org/10.1186/1471-2458-14-s2-s3

Bekele, W. T. (2022). Predictors of Community-Based Health Insurance in Ethiopia via Multilevel Mixed-Effects Modelling: Evidence From the 2019 Ethiopia Mini Demography and Health Survey. Clinicoeconomics and Outcomes Research, Volume 14, 547–562. https://doi.org/10.2147/ceor.s368925

El‐Sayed, A. M., Vail, D., & Kruk, M. E. (2018). Ineffective Insurance in Lower and Middle Income Countries Is an Obstacle to Universal Health Coverage. Journal of Global Health, 8(2). https://doi.org/10.7189/jogh.08.020402

Flourence, M., Jarawan, E., Boiangiu, M., & Yamani, F. E. K. El. (2025). Moving Toward Universal Health Coverage With a National Health Insurance Program: A Scoping Review and Narrative Synthesis of Experiences in Eleven Low- And Lower-Middle Income Countries. Plos Global Public Health, 5(1), e0003651. https://doi.org/10.1371/journal.pgph.0003651

Ghia, C., & Rambhad, G. (2023). Implementation of Equity and Access in Indian Healthcare: Current Scenario and Way Forward. Journal of Market Access & Health Policy, 11(1). https://doi.org/10.1080/20016689.2023.2194507

Gizaw, Z., Astale, T., & Kassie, G. M. (2022). What Improves Access to Primary Healthcare Services in Rural Communities? A Systematic Review. BMC Primary Care, 23(1). https://doi.org/10.1186/s12875-022-01919-0

Hayati, R., Kabir, M. J., Kavosi, Z., Bastani, P., Sobhani, G., & Javadinasab, H. (2019). Legal and Policy Requirements of Basic Health Insurance Package to Achieve Universal Health Coverage in a Developing Country. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4618-0

Iqbal, J., Ahmad, S., Sher, A., & Al-Awadhi, M. (2021). Current Epidemiological Characteristics of Imported Malaria, Vector Control Status and Malaria Elimination Prospects in the Gulf Cooperation Council (GCC) Countries. Microorganisms, 9(7), 1431. https://doi.org/10.3390/microorganisms9071431

Kakama, A. A., Namyalo, P. K., & Basaza, R. (2020). Feasibility and Desirability of Scaling Up Community–based Health Insurance (CBHI) in Rural Communities in Uganda: Lessons From Kisiizi Hospital CBHI Scheme. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05525-7

Rahmawati, T., & Hsieh, H. (2024). Appraisal of Universal Health Insurance and Maternal Health Services Utilization: Pre- And Post-Context of the Jaminan Kesehatan Nasional Implementation in Indonesia. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1301421

Sanogo, N. A., & Yaya, S. (2020). Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence From Gabon. Biomed Research International, 2020(1). https://doi.org/10.1155/2020/4036830

Vaidya, S., & Boes, S. (2021). Strategies to Mitigate Inequity Within Mandatory Health Insurance Systems: A Systematic Review. World Medical & Health Policy, 13(2), 272–292. https://doi.org/10.1002/wmh3.446

Yagi, B., Luster, J., Scherer, A. M., Farron, M., Smith, J., & Tipirneni, R. (2021). Association of Health Insurance Literacy With Health Care Utilization: A Systematic Review. Journal of General Internal Medicine, 37(2), 375–389. https://doi.org/10.1007/s11606-021-06819-0

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Published

2024-01-31