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Submitted by Jennifer Hennig on
Thanks for the great food for thought in this blog. Everyone seems to agree on the broad concept of UHC: Everyone should have access to quality health services without suffering financial hardship. But the actions to be taken after we have reached this general agreement seem to be less clear. I agree that the question whether the concept of UHC points toward a specific set of policy approaches is a great one. I think the UHC concept does not lead us directly to a specific set of policy approaches. And it does not tell us how we know whether we are moving into the right direction. For this, we need clear and measurable targets (and having these targets would also make it more concrete and easier explainable to policy makers). The UHC debate has shifted the attention to equity and universalism (and might through this have added some new flavors to the wine shifting discussions towards possible effects of fragmented risk pools etc.). So the “equity dimension” of the cube got a lot of attention. And there was also a question attached to it which sounded like leading us to a clear target that would easily be measurable: “Who is covered?” --> “Everyone is covered”. And this question – and especially the word “covered” - might be misleading. The word “covered” can easily be understood as “people holding an insurance card in their hand” and some then used this as a proxy of whether we are moving towards UHC. But the question does not make any sense of course without a link to the other dimensions. So maybe we should rename the dimension and call it “equity” rather than “coverage” dimension and attach a different question to it: Who has access to quality health services without suffering financial hardship? This again makes it more complex and less easy to measure of course...