It’s that time of year again, when we observe a day dedicated to the most ambitious health goal of all: universal health coverage, or UHC. On UHC Day (Dec. 12) we commemorate the date in 2012 when the United Nations unanimously endorsed a resolution urging governments to ensure that all people can access health care without financial hardship.
universal health coverage
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.
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.
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.
Somehow, everyone in the universal health coverage (UHC) universe seems to assume that the future of health financing will be built on centralized financing institutions fed by a mix of general tax revenue, payroll taxes and other contributions. This large pot of money, so the assumption goes, is administered by bureaucrats sitting in big buildings in national or provincial capitals. They contract with providers and pay them through capitation, diagnosis-related groups, fee for service, and reimburse retailers (pharmacists) for medicines that the patient takes home.
Maya is waiting for the physician to call her name. Her three children play in the waiting room, making happy noises, but she is worried about her health. The physician confirms her worst fears: it turns out that she has cervical cancer. Now what? A social worker tries to comfort her, saying that the medical staff will do their best to get her treated soon so that she can keep on working to sustain her family.
Last Friday, I had the privilege of attending the launch of a new global report that provides the clearest picture to date of countries’ progress moving toward universal health coverage (UHC). UHC is critical for building resilient health systems, which protect communities and strengthen societies in times of crisis and calm alike.
As we know from many health financing studies, drug expenditure typically ranks first or second among out-of-pocket expenses. In fact, it is often the cause of catastrophic expenditure, driving people from lower middle class into poverty once a severe or chronic disease affects a family member.
As the world moves into the post-2015 era and toward the 2030 goal for health, which includes universal health coverage and making sure everyone has access to essential, quality care, results matter more than ever. To show results and translate them into action, however, countries need better quality data, better capacity for health information and civil registration systems, and better incentives to use data for decision-making.