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Hacia un modelo universal: 24 países y el “cómo” de la cobertura sanitaria universal

Daniel Cotlear's picture
Also available in: English | Français

La adopción de los Objetivos de Desarrollo Sostenible (ODS) durante las reuniones de la Asamblea General de las Naciones Unidas celebradas recientemente fue una noticia digna de festejo: el futuro al que aspiramos ahora incluye oficialmente la cobertura sanitaria universal, tal como se define en el ODS 3, meta 8. (i) Esa misma semana, también nos enteramos de que un grupo de economistas de 44 países había manifestado públicamente (i) que “la cobertura de salud universal tiene sentido desde el punto de vista económico”. Según parece, la marea ha cambiado en favor de brindar atención médica esencial a todo aquel que la necesita, sin generar dificultades financieras.

Vers la couverture santé universelle : l’expérience remarquable de 24 pays

Daniel Cotlear's picture
Also available in: English | Español

L’adoption des Objectifs de développement durable (ODD) lors de la récente assemblée générale des Nations Unies a apporté une excellente nouvelle : désormais, l’avenir que nous voulons inclut, entre autres, la couverture santé universelle, telle que définie par l’ODD n° 3, cible 8. La même semaine, un groupe d’économistes venant de 44 pays a déclaré publiquement (a) que la couverture santé universelle était « économiquement justifiée ». Il semble donc qu’un changement de cap s’opère pour permettre à tous ceux qui en ont besoin d’accéder à des soins de santé sans rencontrer de difficultés financières.

Going universal: 24 countries and the “how” of universal health coverage

Daniel Cotlear's picture
Also available in: Français | Español

The launch of the Sustainable Development Goals (SDGs) at the recent U.N. General Assembly meetings brought especially welcome news: The future we want now officially includes universal health coverage (UHC), as defined under SDG 3, target 8.  We also heard, the same week, from a group of economists from 44 countries, who publicly stated that “UHC makes economic sense.”  It seems the tide has turned toward making essential health care available to all who need it, without creating financial hardship.

Kim Speaks on Thailand’s Path Toward Universal Health Coverage

Julia Ross's picture

On Jan. 29, 2014, World Bank Group President Jim Yong Kim spoke about Thailand’s effort to achieve universal health coverage at the Prince Mahidol Award Conference in Bangkok. In just one year, the country’s universal health coverage scheme added 18 million uninsured citizens to the rolls of the insured. Kim also addressed Thailand’s success in reducing new HIV infections by more than 90% from 1990 to 2013, which saved $18 billion. Read Kim’s full remarks.

Reforming hospitals in East Asia — engagement by development partners wanted

Toomas Palu's picture

Health systems are under pressure in Asia. Epidemiological and demographic transitions are taking place much faster than in Europe and America, in the span of a single generation. With the transition comes the non-communicable disease (NCD) epidemic that requires more sophisticated and expensive interventions provided by hospitals, inpatient or outpatient. Rapid economic development in Asia has lifted millions out of poverty and raised peoples’ expectations for services. Between China, India, Thailand, Philippines, Indonesia and Vietnam, expansion of health insurance coverage during the last decade has reached an additional one billion people, making services more affordable and thus increasing demand. Advancing medical technology eagerly awaited by specialist doctors sitting on top of health professional hierarchies further expands possibilities for treatment. The middle class votes with their feet and takes their health problems to medical tourism meccas like those in Bangkok and Singapore, voiding their own countries of additional income to health care providers. Policymakers are scrambling to expand hospital capacity, boost the pay of health professionals, and encourage investment to meet the demand.   

But governments do not wait. They are exploring hospital autonomy, decentralization, user fees and private sector participation. These policies often pose risks that need to be mitigated by policies and institutional arrangements. For example, health care providers sometimes order unnecessary procedures to earn additional revenue, thanks to the powerful incentive of the fee-for-service payment mechanism and information asymmetry between the patient and health care provider. This can mean financial ruin for both the patient and new, relatively weak health insurance agencies.

Despite these challenges, hospitals aren’t high on the international health development agenda, save a few initiatives to improve quality and provider payment reform.