Universal health care refers to a national system which would guarantee medical benefits and services to all citizens regardless of their ability to pay, regardless of whether it would impact on costs. This topic has long been debated in both politics and health policy circles; various groups support its implementation; including the World Health Organization whose goal is making healthcare affordable and available to all; however opponents of universal health care argue it will increase overall costs as well as lead to government control over personal decisions and lifestyle choices.
Most industrialized and some developing nations provide universal health coverage; the United States stands out as being the sole wealthy, industrialized nation not to have this coverage. Instead, public health systems in place include Medicare (for senior patients as well as people living with disabilities and low-income people) Medicaid (for low-income people), the Military Health System (for active-duty, reserve, and retired members of U.S. Armed Forces as well as their families), and Indian Health Service (members of federally recognized Native American tribes).
Many countries are taking steps to broaden healthcare coverage while simultaneously decreasing catastrophic out-of-pocket medical expenses, which can be extremely expensive and sometimes lead to bankruptcy among lower-income populations. Students pursuing master’s degrees in healthcare administration need to stay abreast of this global issue in order to stay current.
At the 2019 High-Level Meeting on Universal Health Coverage (UHC), countries reaffirmed that progress toward UHC is both a precondition for and an outcome of all Sustainable Development Goals. To accelerate progress, nations need to strengthen health sector performance and accountability with an approach encompassing governance, financing, policy/program implementation and delivery.
Reorienting health systems towards primary health care is central to realizing UHC. This approach offers the most cost-effective and equitable method for increasing access to quality services at equitable coverage levels while simultaneously improving access to essential interventions at their appropriate times, places, by appropriate people with appropriate intensities.
UHC also requires tackling inequalities through more accurate data collection and analysis to identify those most at risk, and aid decision makers in formulating more equitable policies, programs, and practices to advance universal healthcare coverage. In particular, monitoring and addressing barriers such as lack of access to quality healthcare, socioeconomic disadvantages, gender inequalities, refugee needs and migrant populations as part of this journey toward UHC should also be part of its realization.
To ensure universal health coverage, countries must implement insurance reforms that protect consumers and promote consumer choice, such as guaranteed issue; prohibitions on underwriting based on health status, age or gender; annual and lifetime caps on benefits and coverage; as well as mandatory coverage of essential health benefits. Such steps will enable governments to achieve ambitious health coverage goals while remaining financially sustainable.