Contributory Health Service Scheme | Overview

A contributory health service scheme is a type of health insurance program where individuals or organizations, such as employers or unions, contribute to a pool of funds that are used to provide healthcare services to members of the scheme. It is also known as social health insurance.

Under a contributory health service scheme, members usually pay regular premiums or fees, which are used to finance healthcare services, such as medical consultations, laboratory tests, and hospitalization. The scheme may also cover the cost of preventive services, such as vaccinations and health screenings.

Contributory health service schemes are typically used in countries where there is a need to provide affordable and accessible healthcare services to a large number of people, and where the government may not be able to fund the cost of healthcare fully. These schemes can help to spread the financial risk of healthcare costs across a large group of people, making it more affordable for individuals to access healthcare services. They are especially common in countries with emerging economies and developing healthcare systems. Some of the countries where contributory health service schemes are commonly used include:

  1. Brazil: The Brazilian national healthcare system includes a contributory health service scheme that is funded through payroll taxes and provides access to healthcare services for workers and their dependents.
  2. India: The government of India has implemented a contributory health service scheme called the Ayushman Bharat Yojana, which provides free healthcare services to low-income families.
  3. Kenya: The National Hospital Insurance Fund (NHIF) is a contributory health service scheme in Kenya that provides affordable healthcare services to members.
  4. Nigeria: The National Health Insurance Scheme (NHIS) is a contributory health service scheme that provides access to healthcare services for Nigerians.
  5. Thailand: The Thai government has implemented a contributory health service scheme called the Universal Coverage Scheme (UCS), which provides access to healthcare services for all Thai citizens.
  6. Germany: Germany has a contributory health service scheme that is funded through payroll taxes and provides access to healthcare services for all residents.
  7. Japan: Japan has a contributory health service scheme that is funded through a combination of payroll taxes and premiums paid by individuals, and provides access to healthcare services for all residents.

The specific benefits and coverage of a contributory health service scheme can vary depending on the scheme and the specific terms and conditions of the plan. Some schemes may offer more comprehensive coverage than others, and some may restrict the types of services that are covered or the providers that members can access.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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