Part 2: The economic and political case for Universal Health Coverage

By Dr. Matthew Harris, Senior Policy Fellow in Public Health, Institute of Global Health Innovation

I never really stopped to think why there was a need for a Universal Health Coverage Day.  Who could argue against the need for healthcare?  Who could argue against the common sense policy of equal access to health care, for equal need – irrespective of ability to pay?  However, despite many advances around the world in providing universal health care for whole populations, there are still many places where people suffer catastrophic financial burden as a result of relatively simple healthcare needs.

There have been many successes, but there is still a long way to go. In the US, although the Affordable Care Act has led to many millions more people being insured for healthcare, there are many millions still that have no protection against illness and will have to pay out-of-pocket for their care.  In Brazil, although the Family Health Strategy now provides decent primary care services to over 120 million people, the poor distribution of primary care doctors in remote areas has led to the need for the Government to import them from Cuba.  In Burundi, until not too long ago, poor women undergoing life-saving cesarean sections were being imprisoned with their babies because they were unable to pay their bills.

In many ways, Universal Health Coverage is a ‘no-brainer’.  It protects people from the catastrophic financial burden associated with unexpected ill health, and it provides a safety net for the most vulnerable in our society.  Researchers using data from 153 countries concluded in The Lancet that ‘broader health coverage leads to better access to necessary care and improved population health, with the largest gains accruing to poorer people.’

But, as Sir David Nicholson, former Chief Executive of the NHS in England, explains in our video below, achieving UHC needs strong political will and a genuine desire to drive forward policies that create a harmonious society.  Some drivers include the economic benefits of UHC outlined in this 2015 WISH report. The reduction in deaths resulting from better health care coverage accounts for 11% of economic growth in low- and middle-income countries – 24% of growth if you use the country’s ‘full income’ as a measure.  UHC reduces inequalities and poverty, and allows families to save sensibly as the fear of financial burden is reduced.

And there are political benefits too. Reacting to the 2005 Human Rights Watch report, the President of Burundi immediately launched UHC policies such as free healthcare for pregnant women and children under 6 years of age, improved access to essential medicines, and increased pay to front-line healthcare workers. In 2010, President Nkurunziza was re-elected.

On this UHC Day (12th December 2015), lets be thankful that we have a universal health coverage system in the form of the NHS, but mindful too that we must protect its principles of free at-point-of-use healthcare, for all.

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