Touted as the most successful national health insurance program among the Pacific island nations, Palau’s Health Care Fund (HCF) marked its 10th year anniversary yesterday.

The program, which was signed into law in 2011, now has 90% of the total population insured under its National Health Insurance (NHI) and 100% of the population under its Medical Savings Accounts.

Its invested assets have reached $17.8 million as of March 30, 2021 and its cash for operations sits at $3.1 million, totaling $21m in total net assets. Sources of funds come from premiums collected from employees and employers, 2.5% of which comes from employee salaries and 2.5% from the employer’s contribution. The Government pays premiums for citizens 65 years old and above.

The program provides insurance for both inpatient and outpatient customers as well as off-island medical referrals. To date, HCF has sent 1,929 people overseas for medical referral at the cost of $16m.

Growing modestly in the last 10 years, HCF now has 9 MSA providers on island and 10 overseas medical referral providers. The off-island medical providers include St. Lukes Medical Center (PH), St. Lukes Medical Center-Global City (PH), Adventist Medical Center (PH), The Medical City-TMC(PH), Taipei Medical University (ROC), E- DA Hospital (ROC), Shin Kong Wu Ho-Su Memorial Hospital (ROC), Taiwan Adventist Hospital (ROC), Taipei Medical City-Shuang Ho Hospital (ROC), and Ghen Shin Hospital (ROC).

HCF has expanded its coverage and services over the years. Some of the recent expansions include executive exams/preventive coverage for on-island and off-island providers, extending its UR role in Taiwan to replace medical referral duties, and expanding NHI coverage for referral cases to include cost of quarantine for in-patient and out-patient.

To accommodate the growth and the needs of its clientele, HCF recently opened a new office in a two-story steel and concrete building located next to national public health building in Koror. The number of personnel has grown from 3 to 7 full time staff including HCF Manager Jarela Kitang Ngiraked.

HCF is managed by a Social Security Administrator who reports to the HCF Governing Committee except for HCF Investment Funds, which are overseen by the Social Security Administration Board.

As it marks its 10th year in operation, HCF is also aware of challenges it faces that could weaken and possibly impact the program’s sustainability.

Some of these challenges include increasing outside medical referral cases, increasing access of healthcare at private clinics instead of the Belau National Hospital which directly impact MSA usage, decreasing workforce or foreign labor that were contributing members to the program and others.

Current HCF Governing Board members are Dr. Victor Yano (Chairman) representing Palau Chamber of Commerce, Mary Frances Vogt representing Governors Association and Minister of Finance Kaleb Udui Jr., representing Ministry of Finance. SSA Administrator Ulai Teltull is the current Managing Director for HCF.

The original HCF Governing Board Members were Kerai Mariur (Former Minister of Finance), Dr. Stevenson Kuartei (former Minister of Health), Mason Whipps (Chamber of Commerce) and Leilani Reklai (Governor’s Association). Greg Ngirmang was the SSA Administrator and HCF Managing Director.

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