The International Labour Organization (ILO) has shared its preliminary recommendations on the revision of Lao People’s Democratic Republic’s laws on health insurance and social security with the government as part of efforts to strengthen social protection in the country.

The revisions to the health insurance and social security laws are expected to address the financial sustainability of the health insurance fund and to contribute to better compliance with international labour standards on coverage and adequacy of benefits. The new laws are expected to be enacted by mid-2024.

During the last week of May 2023, ILO health and social protection specialists met with the Lao Social Security Office (LSSO) of the Ministry of Labour and Social Welfare and the National Health Insurance Bureau (NHIB) of the Ministry of Health to share initial recommendations on the amendments of the laws.

The technical review was carried out on the basis of international labour standards on social security, and particularly ILO Social Security (Minimum Standards) Convention, 1952 (No. 102), the ILO flagship Convention on the topic. Additional research and studies such as an actuarial analysis are also being conducted to support the revisions.

These initial meetings will be followed by a nationwide consultation process led by the Ministry of Health and the Ministry of Labour, relating to the revision of the Health Insurance Law 2018 and the Law on Social Security 2018 respectively. The high-level launch of the consultative process for the Health Insurance Law revision is scheduled to take place mid-June 2023, with technical and financial support from the ILO.

“The amendments that are being proposed will help bring these laws into line with international standards and by enhancing access to social protection will make a real difference to the lives of people throughout Lao People’s Democratic Republic,” said Marielle Phe Goursat.

In Lao People’s Democratic Republic, 94 per cent of the population have social health protection coverage according to the Ministry of Health. However, the population of Vientiane Capital - about 13 per cent of the country’s population - is only partially covered by social health protection mechanisms, and compliance with the contributory scheme covering the formal sector remains a challenge nationwide. Out-of-pocket expenditures are also high, standing at 49 per cent of current health expenditures, leaving many households vulnerable to impoverishment when sick. This is of particular concern as health expenditures are growing in the wake of increasing prevalence of non-communicable diseases and an ageing population. The financial sustainability of the National Health Insurance is not guaranteed, and inequities remain, with rural population in remote areas having less access to doctors than urban population.

The regional ILO-Luxembourg project “Building social protection floors for all: support to the extension of social health protection in Asia” aims at increasing financial health protection for the people of Lao People’s Democratic Republic, under the overall umbrella of national strategies towards universal health coverage, universal social protection and the global development agenda.