The question of whether our country should implement a universal health care (UHC) program is not just a matter of domestic policy; it’s a critical issue echoing across the globe. Worldwide, the progress towards universal health coverage, a cornerstone of the Sustainable Development Goals (SDGs), is alarmingly off track. While advancements in health service coverage have been made, they have stagnated since 2015, and a growing proportion of the global population is facing financial devastation due to healthcare costs. This concerning trend necessitates a serious examination of UHC and its potential benefits for individual nations, including ours.
The Stalling Progress of Universal Health Coverage Globally
Recent data paints a stark picture: despite an increase in the UHC service coverage index from 45 to 68 between 2000 and 2021, the momentum has significantly slowed. Progress in expanding coverage has diminished compared to the gains made before 2015, rising by a mere 3 index points between 2015 and 2021, and showing no improvement since 2019. This stagnation means that in 2021, approximately 4.5 billion people worldwide were not fully covered by essential health services. This massive gap in coverage highlights a critical failure in ensuring basic health access for a significant portion of humanity.
Furthermore, the financial burden of healthcare is pushing millions into hardship. Around 2 billion people globally are struggling with financial difficulties related to health expenses. Among these, a staggering 1 billion are facing catastrophic out-of-pocket health spending, and 344 million are being driven into extreme poverty simply because of health costs. These numbers are not just statistics; they represent lives disrupted, families impoverished, and futures jeopardized by the lack of affordable and accessible healthcare.
The COVID-19 pandemic further exposed the fragility of global health systems and exacerbated existing inequalities. Essential health services were disrupted in a staggering 92% of countries at the height of the pandemic in 2021, and disruptions persisted in 84% of countries in 2022. This widespread disruption underscores the vulnerability of healthcare systems and the urgent need for robust and resilient UHC programs.
What is Universal Health Coverage?
Universal health coverage, at its core, is about ensuring that all people, regardless of their socioeconomic status or location, have access to the full spectrum of quality health services they require, when and where they need them, without suffering financial hardship. This encompasses a comprehensive range of services, from health promotion and disease prevention to treatment, rehabilitation, and palliative care, throughout all stages of life.
Achieving UHC necessitates a well-functioning health system with a skilled and equitably distributed health workforce, access to essential medicines and technologies, and robust financing mechanisms. Crucially, it aims to protect individuals and families from the devastating financial consequences of healthcare costs, preventing them from falling into poverty due to medical bills.
Why Universal Health Care Matters for Our Country
The global data underscores a clear and pressing need for universal health care. But what are the specific reasons why our country should consider adopting a UHC program?
Firstly, UHC directly addresses the issue of health equity. In any nation, disparities in healthcare access often exist along socioeconomic lines, geographic location, and other factors. A universal health care system aims to bridge these gaps, ensuring that everyone has access to necessary medical services, regardless of their income or social standing. This promotes a healthier and more just society.
Secondly, UHC can lead to improved public health outcomes. When people have consistent access to preventive care, early diagnosis, and treatment, the overall health of the population improves. This can translate to lower rates of chronic diseases, reduced infant and maternal mortality, and increased life expectancy. Investing in UHC is an investment in the nation’s health and future productivity.
Furthermore, UHC offers economic benefits. While the initial investment in establishing a UHC program can be significant, the long-term economic advantages are substantial. A healthier population is a more productive workforce, leading to economic growth. Preventive care, a cornerstone of UHC, is also more cost-effective in the long run compared to treating advanced stages of diseases. Moreover, UHC can protect families from financial ruin due to unexpected medical expenses, contributing to economic stability and reducing poverty.
Finally, there is a strong ethical argument for UHC. Healthcare is a fundamental human right. A universal health care system reflects a commitment to this principle, ensuring that access to essential medical services is not a privilege but a right afforded to every citizen.
Primary Health Care: The Foundation of Universal Health Coverage
The World Health Organization (WHO) strongly recommends reorienting health systems towards primary health care (PHC) as the cornerstone of achieving UHC. PHC is an approach to health that focuses on providing comprehensive, integrated services that are accessible and affordable to all members of the community. It emphasizes health promotion, disease prevention, treatment, rehabilitation, and palliative care, delivered as close as possible to where people live and work.
A PHC approach is the most inclusive, equitable, cost-effective, and efficient way to improve people’s physical and mental health and overall well-being. It enables universal and integrated access to health services within people’s daily environments. Significantly, most (90%) essential UHC interventions can be effectively delivered through a robust primary health care system. Investing in and strengthening PHC is therefore crucial for any country striving to achieve universal health coverage. It is estimated that approximately 75% of the projected health gains from the SDGs could be realized through PHC, including saving millions of lives and significantly increasing global life expectancy.
Conclusion: A Healthier Future Through Universal Health Care
The global data is clear: universal health coverage is not just an aspiration but a critical necessity. The current trajectory is concerning, with progress stagnating and financial hardship related to healthcare on the rise. For our country, the question of whether to adopt a universal health care program is not just about policy, it is about the health, well-being, and economic security of our citizens.
By prioritizing universal health coverage and strengthening primary health care, our nation can build a healthier, more equitable, and more prosperous future for all. The global imperative for UHC serves as a powerful reminder of the urgent need to act and ensure that healthcare is a right, not a privilege, for every person in our country.
