By Francis Talasasa, Reporter

A recent National Health Insurance for Universal Health Coverage conference in Manila on September 27 has highlighted a broader look into a system that would carry out effective coverage to an expanding population through the creation of its Health Care Fund system.


Minister of Health Gregory Ngirmang during a gathering at the Asian Development Headquarters in Manila presented Palau’ s background, challenges and lesson learned related health issues affecting the people of Palau.

Palau having a total population of 21, 265, at a growth rate of 0.3 percent is benefiting from a step taken through an adoption of the National Health Care Financing Act (RPPL No:8-14)in 2010.

Minister Ngirmang revealed that 80 percent of off-island referrals are related to Non-Communicable Diseases(NCD) and 78 percent of deaths are related to NCD.

The top 5 causes of death are said to be Cardio/Cerebrovascular, Cancer, Injury, Diabetes, and Respiratory.

A report discovered between 2011 and 2014, the total cost of off-island referrals from Palau to Taiwan and Philippines costs USD$4.7 million.  In 2015 alone it was $2.4 million.

The Palau Ministry of Health reports that by using what works in the current system, the health care financing system has been kept purposely simple in order to minimize administrative costs and to avoid having to create an additional bureaucracy to manage the system.

A statement from the Minister of Health released stated that the program is only a few years old. The service integration and institutional development are still on-going given the program are coordinated through multiple government agencies, in particular, clinical service delivery through Palau’s only hospital The Belau National Hospital.

There are challenges include integrating health promotions, maternity care, and expansion of other services excluded from the HCF scheme such as dental, rehabilitative and palliative. However, the HCF is flexible whose regulations can be adjusted to accommodate change and adapt to the every changing needs for the modern health care.

All Palauans are guaranteed free or subsidize health care as stated in its constitution. Generally, healthcare delivery was adequate for roughly a population of twenty thousand whose level and standard of care was high for pacific island countries with Palau spending a high percentage of GPD ranking the nation 28th in the world.

However, maintaining such a level of expenditures on health care without a mechanism to ensure financial viability would prove unsustainable in the long run.

As such, the HCF was created to ensure healthcare coverage would not only be universal, it would financially sustain for future generations to come. More importantly, it empowered citizens to wisely invest in their health rather than rely on the government entirely for health subsidies, he said. [/restrict]