Summary (English)

From 1975 until the late 1990's, health care for the population of Lao P.D.R. was funded by the government, and services were provided free of charge to patients. In 1997 however the system threatened to collapse because of budgetary constraints, which made the government to decide to introduce user fees for government health care institutions. This imposition triggered a big increase in 'out-of-pocket' household expenditure on health care. The Ministry of Health was committed to develop social health insurance as the major health care financing method.

The development of the statutory social security schemes for the private (Social Security Organization) and public (Civil Servants Scheme) sector workers (less then 20% of the Lao population) have been very different, but current reforms are planned to merge the social security schemes for the two sectors. Over 80% of the Lao population are in the informal sector and therefore excluded from the statutory social security schemes. That is why the government is promoting voluntary community-based health care systems (CBHI) through a national programme.

To date, the SSO and CBHI schemes are not formally linked (there is at present no legal basis for the linkages). But there are several factors showing important similarities between the compulsory and voluntary schemes (e.g. same provider payment mechanism). Linkages between the systems could create a positive environment of harmony rather than competition, with each scheme learning from the other and could lead to an extend coverage of the population.

Related info

Lao P.D.R. regulations