Comparing universal health coverage models: an analysis of policy transmission efficiency in SAARC and ASEAN...

This study empirically examines the role of Universal Health Coverage (UHC) as a strategic facilitator in enhancing the effectiveness of government health expenditure (GHE) on financial protection and health outcomes across 14 SAARC and ASEAN nations from 2000 to 2023. Using a Two-Way Fixed Effects (TWFE) regression model, the study identifies that higher GHE alone does not guarantee reductions in out-of-pocket (OOP) expenses or mortality rates, but its impact is significantly mediated by UHC adoption and structure. To capture distributive heterogeneity, quantile regression analysis is employed, revealing that mandatory insurance-based and hybrid UHC models provide greater financial protection, particularly for lower-income populations, while public-sector-dominant service provision maximizes mortality reductions. The findings emphasize that UHC enhances the transmission of government health investments into tangible sectoral benefits, reinforcing its role as a policy accelerator for achieving Sustainable Development Goal (SDG) 3.8. Policy recommendations include strengthening UHC financing, optimizing risk-pooling mechanisms, and aligning fiscal priorities with equitable healthcare access. This study contributes to global UHC discourse by offering an empirically grounded, region-specific roadmap for ensuring financial sustainability and universal healthcare accessibility in emerging economies.