Universal Health Coverage (UHC) is a system that provides healthcare and financial protection to every citizen of a specific country. According to the World Health Organization, UHC includes the full spectrum of essential, quality health services including health promotion, prevention, treatment, rehabilitation, and palliative care throughout the course of life. Although in theory, this sounds like an excellent concept, UHC has for a long time given rise to a debate regarding its pros and cons. Check out the opinions of several global health experts below.
What are the advantages and disadvantages of Universal Health Coverage?
“PROS – Universal Health Coverage reduces the disease burden on the healthcare system. With increased access to health services and a functional primary health system, it pushes people to seek help early before a condition deteriorates and it improves health-seeking behavior among the population. Without the heavy financial burden associated with healthcare, more people are seen to report to the hospital with their symptoms thereby allowing diseases to be caught in the early stages and appropriate early-stage management commenced as opposed to late presentation where more expensive procedures are needed to slow down an already advanced disease stage. CONS – reduction in the quality of care provided. With Universal Health Coverage, more people make use of the already overburdened system meaning doctors have an increased patient load which can reduce the amount of time spent per patient because they must rush through consultations to help as many people as possible and important information can be missed. It also increases doctor fatigue and burn out which may have adverse health effects.”
“In my opinion, UHC is an investment in human capital and long-term economic growth -good health is essential for social and economic development and it promotes equitable health outcomes and the right to health through its principle of non-discrimination. The primary health care and life course approaches to achieve UHC promote the delivery of essential services that respond to the needs of people across all phases of life. The achievement of UHC necessitates health systems strengthening to enable the delivery of essential services as and when needed. Ultimately, stronger health systems will provide health security and resilience to respond to shocks such as pandemics and natural disasters, while ensuring continuity of essential health services. The financial, material, infrastructural and human resource demands required to achieve UHC may not be readily available or attainable for some countries without official development assistance. In addition, ensuring access and financial protection, especially for the poor and informal sector populations, and efficiency in revenue utilisation are important challenges that need to be addressed.”
“Access to healthcare is essentially a basic human right. UHC is about making sure that no person is left behind, including the poorest and most vulnerable, in terms of access to quality, affordable healthcare. Healthcare is a fundamental human right . UHC has a major advantage in that it ensures that even the most disadvantaged have access to healthcare services. UHC however, has significant upfront costs and poses significant logistical challenges including the challenge of overwhelming the budgets of governments. My opinion is that the advantages of UHC outweigh the disadvantages especially in Low-and-Middle-Income Countries where quality healthcare is out of reach for most communities. UHC helps in putting some structure for the “health system building blocks”. SDG Number 3 includes a commitment to achieve UHC by the year 2030 as a fundamental outcome to achieving the goal of “Healthy lives and wellbeing for all at all ages”.
Hospital and Social Health M&A, Health Economics/Policy, Global/Public Health Consultant & Researcher
“The advantages of UHC are multiple. The disadvantage is that UHC relies on a high economy and well-organized societies, while to achieve that goal may not be plausible in Low and Middle-Income Countries especially in sub-Saharan Africa. The reasons behind this are the voluntary aspect of their mutual health organizations, their limited coverage of the targeted population of the formal and especially the informal sector or all groups especially vulnerable groups, their multi fragmented pools that rely on covering different groups with different socio-economic and socio-cultural elements, making the risk-sharing and cross-subsidy mechanisms country-wide difficult.”
“The idea of Universal Health Coverage is about natural justice. It is a human rights issue such that everyone, regardless of their socio-economic status, is entitled to good-quality care. Access to quality healthcare without financial hardship has a direct correlation on life expectancy. UHC thus guarantees a healthy population. When the world commits to UHC, it comes with a stringent focus and regulations (e.g., defining a benefit package and costing health products and technologies) which leads to transparent pricing and reasonable costs. The flipside of UHC is that it is a resource-intensive venture if it is publicly funded. It might mean more taxation of wealthier people so that they pay for the indigents in need of health care.”
“In my opinion, a sustainable healthcare financing mechanism is critical to attaining Universal Health Coverage with increased fiscal space and overall financing for health. This will ensure efficient and equitable access to quality healthcare service delivery for all, particularly the poor and vulnerable groups. The provision of quality and affordable health services is the responsibility of all governments and relevant stakeholders across the world. Amidst economic meltdowns, healthcare costs may overwhelm government budgets. For the world to achieve sustainable economic growth and development, governments must invest in social sectors that promote human capital development. Therefore, nations must initiate mechanisms and policy reforms to improve access to health for their citizens that is fundamental to economic growth.
Do you think all countries should adopt Universal Health Coverage? Discuss your position.
“Yes, I think all countries should adopt a form of Universal Health Coverage. Health is a fundamental human right and everyone deserves a chance to seek healthcare services without the risk of losing everything and being pushed into poverty due to unexpected illnesses. With more people falling below the poverty line, healthcare should not be a driving force for the impoverishment of people. Good health provides the basis for long-term economic development.”
“I believe all countries should adopt UHC. I once visited a community in a country in Southern Africa and was exceedingly touched when I saw diabetes patients sharing their dosage of medicine due to stockouts at the local health facility. They were breaking the metformin tablets they had into two to share with neighbours who had run out. Adherence to prescribed dosage and patient self-management is important in managing non-communicable diseases such as diabetes. Unfortunately, in addition to the lack of medication, they did not have access to glucometers and test strips, further complicating the management of the disease. Access issues including for antibiotics required for treating bacterial infections is a huge challenge in low- and middle-income countries leading to problems such as antibiotic resistance. Therefore, my view is that all countries should adopt UHC to strengthen health systems in an integrated, all-inclusive and sustainable way.”
“I believe all countries should adopt UHC because it is a means to ensuring good health and the wellbeing of all people which is essential to social and economic development. However, the strategies to achieve UHC cannot and should not be the same for all countries, since each has a unique set of opportunities and challenges. Strategies should be developed and implemented with a clear understanding of the specific context of each country, aligned to global and regional frameworks for action.”
Hospital and Social Health M&A, Health Economics/Policy, Global/Public Health Consultant & Researcher
“Yes, I think that all countries should adopt Universal Health Coverage. But that depends on the political will and political commitment to achieve the goal. However, to be equitable and sustainable, each country must provide an equal package to every citizen (horizontal equity); hence, according to the economic level, it is wise to start with primary health care for all, pursuing secondary hospital care, and finally with tertiary hospital care and specialized health services.”
“In almost all countries, health care is considered a basic right. That explains the reason why, in 2015, the world reiterated and pledged through the SDG 3 to ensure healthy lives and promote wellbeing at all ages as essential to sustainable development. The COVID-19 pandemic has revealed that the world is a global system that needs collective commitment and response. Thus, adopting and sustaining UHC requires strengthening health systems in all countries, even if it means every country conceptualizes its own needs.”
Check out more than 600 job opportunities in the health sector here.
