Universal health coverage: good health, good economics

Abstract

Underpinning the trends examined in The Lancet's Series on universal health coverage are several points that deserve deeper appreciation. Call them EPIC—a fitting acronym, in view of the epic transition now underway as the world moves towards universal coverage. The struggle for universal health coverageCertain concepts resonate so naturally with the innate sense of dignity and justice within the hearts of men and women that they seem an insuppressible right. That health care should be accessible to all is surely one such concept. Yet in the past, this notion has struggled against barriers of self-interest and poor understanding. Building on several previous Lancet Series that have examined health and health systems in Mexico, China, India, southeast Asia, Brazil, and Japan, today we try to challenge those barriers with a collection of papers that make the ethical, political, economic, and health arguments in favour of universal health coverage (UHC), and which will be presented in New York on Sept 26, to coincide with the UN General Assembly. Full-Text PDF Does progress towards universal health coverage improve population health?Many commentators, including WHO, have advocated progress towards universal health coverage on the grounds that it leads to improvements in population health. In this report we review the most robust cross-country empirical evidence on the links between expansions in coverage and population health outcomes, with a focus on the health effects of extended risk pooling and prepayment as key indicators of progress towards universal coverage across health systems. The evidence suggests that broader health coverage generally leads to better access to necessary care and improved population health, particularly for poor people. Full-Text PDF Political and economic aspects of the transition to universal health coverageCountries have reached universal health coverage by different paths and with varying health systems. Nonetheless, the trajectory toward universal health coverage regularly has three common features. The first is a political process driven by a variety of social forces to create public programmes or regulations that expand access to care, improve equity, and pool financial risks. The second is a growth in incomes and a concomitant rise in health spending, which buys more health services for more people. Full-Text PDF Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and AsiaWe analyse nine low-income and lower-middle-income countries in Africa and Asia that have implemented national health insurance reforms designed to move towards universal health coverage. Using the functions-of-health-systems framework, we describe these countries' approaches to raising prepaid revenues, pooling risk, and purchasing services. Then, using the coverage-box framework, we assess their progress across three dimensions of coverage: who, what services, and what proportion of health costs are covered. Full-Text PDF Achieving universal health coverage in low-income settingsThe goal of universal health coverage is deeply embedded in politics, ethics, and international law. Article 25 of the 1948 Universal Declaration of Human Rights states that everyone has the right to a standard of living adequate for health, including medical care, and the right to security in the event of sickness or disability.1 Motherhood and childhood are to be afforded special care and assistance. In the same year, the Constitution of the World Health Organization came into force, declaring that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”2 Full-Text PDF