No lobby for prevention. You are so right when you say: "Rich people and medical unions have political power to lobby for spending on curative health care;" others lobby for no user fees for health care (another private good). " Poor people’s voice for sanitation goes unheard. "
Would you agree that global leadership could help counteract these lobbies? But the lobby for curative disease-care has already succeeded in making Universal Health Care into the one and only goal for government programs in health, a goal which the World Bank and WHO decided to set for post-2015, judging from the enthusiastic participants from global health organizations at the high-level conference on UHC at the World Bank Spring Meeting. Ministers of health of all countries have adopted it. The UN approved a resolution that UHC is a goal for all countries.
The signals and leadership from global policy-setters on what is the main gap in public services that drives bad health (correcting externalities) therefore differs from what you are recommending here. Or not? In any case, prevention and public health policy are not part of UHC programs, perhaps mostly because they have no lobby.
Is UHC actually conducive to getting the most health for the poor? If not, what post-2015 goal in health should the World Bank promote when there is such chronic low demand for sanitation and other public goods that boost poor communities' health status?