Content area
Full Text
Abstract
This Note addresses the implementation of health insurance reform in Yemen. As a result of a system of user fees and a lack of health insurance, the current regime poses serious barriers to health care access for Yemen's uninsured citizens. When the dust settles from the ongoing conflict with Houthi rebels, the time will be ripe for replacing Yemen's health financing system. In order to rebuild trust and curb abuse in the public health system, legal reforms are required to implement health insurance through decentralized decision-making and accountability measures. The Welfare Regime Pramework accommodates these general reforms through policies that reflect the particular circumstances of Yemen. The implementation of health insurance reform will require policy reforms that bring together local, national, and international stakeholders to finance and develop management capacity for community-based health insurance in Yemen.
Introduction
Yemen underwent a peaceful political movement in the aftermath of the Arab Spring of 2011, which resulted in the ousting of then-President Ali Abdullah Saleh in 2012.1 On February 21, 2012, Abd Rabbuh Mansur Hadi was elected the new president, to be followed by a two- year transition period.2 However, by March 2014, President Abd Rabbuh Mansur Hadi had fled Yemen after Houthi rebels took control of the capital Sana'a.3 The ensuing conflict has caused a humanitarian crisis and an overall institutional failure of Yemen's government.4 The regime that emerges in the aftermath of this turmoil will have to prioritize Yemen's basic needs, including water, education, employment, and health care. Given the material effect of a nation's health on its productivity and prosperity, Yemen should prioritize legal reforms to its health systems.5 While globalization has led to a thriving private health sector in Yemen, it has also encouraged reduced public expenditures and user fees at the point of purchase. Consequently, only those employees provided with employer-sponsored health insurance have benefited from globalization, while the vast majority of Yemeni citizens continue to have limited access to health care.
The lack of equal access to health care is particularly prevalent among the 70 percent of Yemen's working population who are part of the "informal sector," which is defined as the largely poor, wageemployed and self-employed workers not covered by health insurance programs.6 Within the informal sector, there are...