By: L.N. Reklai

Palau national health insurance program is declared to be in good health on the 50th Anniversary of the Palau Social Security Administration, the entity administering program.

As of May 31st, Health Care Fund (HCF) reports 96% of the total population insured under the National Health Insurance.  Also 94% of total population have Medical Savings Account (MSA).  731 uninsured persons are mostly unemployed individuals over the age of 22, who are not paying voluntarily to the fund and who are not qualified under government subsidy for elderly and disabled.

As of May 2018, the program has over $14 million dollars in investments and in cash reserves.  $11.836 million is in investment.  Of that, $5.9 million is National Health Insurance (NHI), $5.9 is Medical Savings Account and $4,981 is in cash investment equivalent. Cash reserves stands at $2.354 million.

HCF further reports that it has increased its medical providers, both locally and abroad.  In Palau, there are 8 listed providers, Belau National Hospital, Belau Medical Clinic, Family Surgical Clinic, Pacific Family Medical Clinic, Optic Vision Optical Clinic, Maria Hindenberg Dental Clinic, Pacifika Med Pharmacy, and Palau Adventist Wellness.  There are 7 off-island medical providers in Philippines, Taiwan, India and Guam.

From 2011 to 2018, a total of $7.785 million of MSA funds have been paid to all private local clinics. $9.861 million (MSA and NHI) was paid to Belau National Hospital over the same period.  A total of $10,960 million was spent on approved off-island referral also for the same period of 2011 to 2018.  In other words, Palau national health care insurance program has paid over $28 million in medical expenses both locally and for off-island referral since 2011.

According to the report, HCF is collecting about $8 million in annual contributions and its total expenditure (both MSA and NHI) is about $6 million.

“Health insurance on island and off-island is financially sound, sustainable and have achieved near 100% universal coverage for all the people of Palau including foreigners employed and residing in Palau,” stated the Healthcare Fund Report.

National health insurance program was created through national law, RPPL 8-14 as result of push for healthcare reform in 2006.  The program mandates all employed persons to contribute to a fund which consists of a private medical savings called Medical Savings Account or MSA and National Health Insurance or NHI.   MSA can be used by individuals at approved private clinics and can be returned to foreign employees when they leave the country.  NHI is used to cover inpatient services at national hospital or cover up to $35,000 of medical expenses for approved off-island medical referral service.

The national health insurance program is overseen by National Health Care Fund Governing Board while administered by the SSA administrator.

The law creating the program was enacted in 2010 and began full service in September of 2011.