Table 4 Advantages and disadvantages of the proposed health financing reform

Potential to increase financial resources available for purchasing of health goods and services

Narrow focus on public sector employees that is likely to worsen the existing inequalities when considering the whole population

Larger health insurance pool with better risk sharing and cross subsidization among those covered

Real risk of establishing a two tier health system that would be counterproductive to the UHC ideals (particularly in terms of quality of services)

Larger pool with lower administration fees; better opportunities for strategic purchasing to enhance efficiency, cost-effectiveness and ensuring value based outcomes

Without adequate regulation and accountability, the proposed policy reform could potentially lead to cost escalation in health service delivery due to factors such as over servicing by health providers and monopolistic tendencies

Provides opportunities to address urban-rural inequalities through innovative public private partnership in service delivery as well as improvements in health system responsiveness

Provides a platform for health system stewards to expand health insurance across the population through deliberate policy decisions