According to the World Health Organization, Universal healthcare coverage (UHC) is about ensuring all people and communities have access to quality health services where and when they need them, without suffering financial hardship. It includes the full spectrum of services needed throughout life—from health promotion to prevention, treatment, rehabilitation, and palliative care—and is best based on a strong primary health care system.
A number of poor countries have shown, through their pioneering public policies, that basic healthcare for all can be provided at a remarkably good level at very low cost if the society, including the political and intellectual leadership, can get its act together. There are many examples of such success across the world. None of these individual examples are flawless and each country can learn from the experiences of others. Nevertheless, the lessons that can be derived from these pioneering departures provide a solid basis for the presumption that, in general, the provision of universal healthcare is an achievable goal even in the poorer countries.
In the absence of a reasonably well-organised system of public healthcare for all, many people are afflicted by overpriced and inefficient private healthcare. As has been analysed by many economists, there cannot be a well-informed competitive market equilibrium in the field of medical attention, because of what economists call “asymmetric information”. Patients do not typically know what treatment they need for their ailments, or what medicine would work, or even what exactly the doctor is giving to them as a remedy. Unlike in the market for many commodities, such as shirts or umbrellas, the buyer of medical treatment knows far less than what the seller – the doctor—does, and this vitiates the efficiency of market competition. This applies to the market for health insurance as well, since insurance companies cannot fully know what patients’ health conditions are. This makes markets for private health insurance inescapably inefficient, even in terms of the narrow logic of market allocation. And there is, in addition, the much bigger problem that private insurance companies, if unrestrained by regulations, have a strong financial interest in excluding patients who are taken to be “high-risk”. So one way or another, the government has to play an active part in making UHC work.
Health workers will have an important role to play in the campaign, helping decision-makers for health recognize what people need in terms of care, particularly at the primary care level.
The campaign also presents an opportunity for ministers of health and other government decision-makers to commit to taking action to address gaps in universal health coverage in their countries, as well as to highlight progress that has already been made. #WorldHealthday #HealthForAll