Syndicate content

Add new comment

Submitted by Georgina Planters on
I do not want to spoil the party with all this wine and universality, but I am really missing something. What you did not say when defining the U and the H and the C: UHC is a way to guarantee stable and rising incomes for the medical industrial complex. How better to get paid than to make sure that the fiscal powers of the government step in and create a parafiscal fund when the consumer cannot pay up out of pocket? No other service industry has such a great deal. Even farmers who sell food do not benefit from Universal Food Coverage. Yet most people need food more than they need doctors. How many people malnourished? Medical doctors and other health staff , and administrators of hospitals and similar facilities, generally make the best incomes in any country and have the highest status. In some countries this is extreme, like in the USA where a doctor makes about 20x what a teacher makes. Go figure. The former has a government guarantee for payment for his services, which is now more secure because of UHC. Similarly for medications. What's not to like if you are in the medical business. So I am missing some mention in your excellent long expose about the cost of these health services and their actual usefullness for the poor patients. Or is cost containment and quality "out" when UHC is "in". Make sure doctors get paid first and then later worry about quality and unit costs. What does the World Bank recommend? One more thing seems very wrong with your approach. This is very serious. You are not talking at all about improving health. Only about mobilizing and organizing payments to providers for ill people's care. Maybe the patients get better, maybe they die but in any case coverage will cover the providers. No risk. What about prevention? Most people who are getting sick now from NCDs did not have to get sick if prevention was in place. We missed that boat. But what about the people who need not get sick in 2020 and 2030? Does UHC do anything for preventing future growth of illnesses? Does UHC prevent contagious diseases? Or is cholera going to keep breaking out in Haiti and elsewhere every couple of years -- this will surely bankrupt any UHC scheme in those countries. Does UHC prevent another AIDS-like epidemic? Or does the need to pay the doctor today override all such possible concerns about opportunities for future savings? While the program you set out guarantees employment for more that a hundred World Bankers for many years, how many World Bankers are actually working on prevention? From what I see on this blog it's 20:1. Prove me wrong, please. Is somebody fixing the factors behind preventable diseases so that UHC funds will not have to pay up for more and more medical services for illnesses that can be prevented at minimal cost? Have you calculated the impact of the coming pandemic of antibiotical resistance? Finally, you write that "everyone already has coverage." I suggest you visit one of about 30 African countries, Haiti, etc, and see how many people that "already have coverage" you find. Not many. Maybe it's a priority for everyone here on these blogs, where UHC seems to be the most written-about theme the last few years. When does the World Bank expect, e.g., Nigeria having UHC - before 2050 or after 2050?