Universal health coverage is key to achieving the World Bank Group’s (WBG) twin goals of ending extreme poverty and increasing equity and shared prosperity. Hence, it is the driving force behind all of the WBG’s health and nutrition investments.
But are you wondering what universal health care coverage entails? Are you seeking to know its costs and benefits? If you answered yes then this article has all the answers you need. In this article, we shall be bringing to light all about universal health coverage, its costs, benefits, and other relevant information.
So, let’s dig in!
Meaning of Universal Health Coverage
Universal health care coverage is the system provided by the government either directly or indirectly in other to provide health services for its citizens. Universal health coverage provides health services to all individuals and communities, thus, making everyone have access to health services without financial difficulties. This includes the full range of quality health services, prevention, health treatment, rehabilitation, and palliative treatment/hospice care.
A universal health care coverage system would be run by the government. There is a popular assumption here that the government would not be interested in making profits, however, the government would be interested in promoting the best interests of its citizens. Therefore, a universal health care coverage system would likely result in reduced costs for medical care and improved monitoring of health care costs, which would result in more affordable health care.
All patterns of universal health care require some type of involvement from the government. For instance, there are possibilities of government mandates or legislation that are likely to affect universal health care coverage. The laws are what ascertain — to whom the universal health care coverage should be provided, the type of health coverage that is included, and the type of care that is provided.
The World Health Organization and Universal Health Care
The World Health Organization is in support of countries to develop their health systems to move towards and sustain Universal Health Care, and monitor progress. But the World Health Organization is not alone as it works with various partners in various situations and for various purposes to advance Universal Health Care around the world.
Access to affordable, quality primary healthcare is the cornerstone of universal health care, but many people around the world still struggle to fulfill their basic healthcare needs. Mental health, often overlooked, is also an important element of universal health care, as it is critical to people’s ability to lead productive lives.
Universal health coverage comes in several discrete forms, but the basic idea is the same all over the world. In countries that have universal health coverage, their government steps in to ensure every citizen gets access to the medical care they need with the taxpayers’ money.
Achieving universal health care requires multiple approaches. The earliest health care approach and life-course approaches are extremely important. The earliest health care coverage approach concentrated on organizing and strengthening health systems for people to be able to gain access to services for their health and wellbeing based on their necessity and preferences, in the beginning, and their quotidian environments.
Countries that Have Universal Health Care Systems
A considerable portion of the country that has universal health coverage includes:
North and Central America: The Bahamas, Canada, Costa Rica, Cuba, Mexico, Trinidad and Tobago.
South America: Argentina, Brazil, Chile, Colombia, Peru.
Europe: Austria, Belarus, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Turkey, Ukraine, the United Kingdom.
Africa: Ghana, Egypt, Rwanda, Botswana, Mauritius, Morocco, Burkina Faso, South Africa, Tunisia, Algeria.
Asia: Bhutan, Georgia, Hong Kong, India, Israel, Macau, Maldives, People’s Republic of China, Singapore, Sri Lanka, Taiwan, Thailand, and Australia.
Oceania: New Zealand, Australia
Let’s take a look at some examples of developed countries with universal health coverage.
Canada’s universal, openly funded universal health care coverage system was established through federal legislation initially passed in 1957 and 1966. The eligibility to receive full federal cash contributions for health care, each provincial and territorial (P/T) health insurance plan needs to acquiesce to the five pillars of the Canada Health Act, which specify that it be:
1. Comprehensive coverage conditions
3. Portable across provinces
4. Accessible (for instance, without user fees).
5. Openly administered.
All Danish citizens/residents are automatically enrolled in publicly/government-financed health care, this is greatly free at the point of use. Every Danish registered immigrant and asylum-seekers are also covered, while undocumented immigrants have access to acute-care services through a voluntary, privately funded initiative supported by the Danish Medical Association, the Danish Red Cross, and the Danish Refugee Council.
Universal access to health care underlies Denmark’s Health Law. In the latter part of the 1800s Universal health care coverage developed gradually with nongovernmental insurance, known as sickness funds, covering primary care and user charges for hospital care.
Over seven decades universal health care coverage was achieved by extending statutory health insurance (SHI) to all employees (in 1945), retirees (in 1945), the self-employed (in 1966), and the unemployed (in 2000). the law In January 2016, SHI eligibility was universally granted under the Protection Universelle Maladie (Universal Health Protection law), or PUMA, this replaced and simplified the existing system by providing systematic coverage to all French citizens/residents.
It has a joint coverage for citizens firstly covered by the Universal Health Coverage and immigrants covered by the state-sponsored health insurance.
The Health Care System in the United States
At this point, you might be surprised I haven’t mentioned the United States of America (USA). Well, the United State of America does not have universal health coverage.
Although the U.S.A does not have a Universal Health care coverage system, its health conveying system does have explicit components, such as Medicare and the Department of Veterans Affairs, that provide universal health care to specific populations (the elderly, low income, and veterans, respectively).
The United States has a mixture of government-run and private insurance Medicare. Medicare guarantees a universal right to health care for persons age 65 and older. Worthy populations and the series of benefits covered have ponderously expanded. In 1972, citizens under age 65 with long-term inabilities or end-stage nephritic disease became eligible.
All benefactors are empowered with traditional Medicare, payment for service program that provides hospital insurance (section A), and medical insurance (section B). Since 1973, benefactors have had the choice to accept their coverage through either traditional Medicare or Medicare Advantage (section C), under which people enlist in a private health maintenance organization (HMO) or managed care organization.
How Universal Health Care Works
There are three different universal health care models such as:
1. Beveridge Model
2. Social Health Insurance
3. National Health Insurance
1. Beveridge Model
Every citizen has the same access to care. The government provides unconstrained health care paid for with the total turnover from income taxes. This system is called the “Single player system”. The single-player system, or setting up universal health care so that a single organization (most likely the government) would be responsible for receiving health care fees and health care payments.
Government work to ensure doctors and hospitals provide standard care at an affordable cost. Government agencies must collect and analyze data while using their purchasing power to influence healthcare providers.
Countries that use the single-player system, and help to advance it with their health service include the United Kingdom, New Zeeland, Cuba, and Spain.
2. Social Health Insurance
Countries that require everyone to buy insurance, usually through their employer’s practices social health insurance model. The government controls health insurance prices.
Employers deduce taxes from employee pay sheets to cover the costs, and the taxes go into a government-run health insurance fund that covers all the citizens. This system was developed by Germany and is also called the Bismarck model. Countries that also use this system are Japan, France, Belgium, Switzerland, and Netherland.
3. National Health Insurance
Every citizen of the country pays into the national insurance plan. The government also has a lot of grips to force medical costs down. Some of the countries that use this model include Canada, Taiwan, and South Korea.
Costs of Universal Health Care Coverage
The strongest arguments for universal health care are access and costs. Exponents of universal health coverage debate that everyone should have free and equal access to most services. The care costs could be greatly made less or completely removed altogether under a national health care system.
Supporters of universal health costs also argue that implementing universal health care would. Also, the congressional health care debate has become a war between two uncompromising excessive, coverage versus budget control.
In the same manner, universal health coverage can be a wise public investment. When done right, it will return greatly to our national prosperity than it costs in tax dollars. This is more applicable than ever as the world grows interdependent. National policy-makers oftentimes start with a fathomable comparison between current per-capita funding for health in their own country and global targets, which travel from 54 to 86 United States dollars (US$) per person annually. This approach is complicated for diverse reasons.
First, one needs to recall that global standard expenditure targets were developed primarily for advocacy purposes. They serve to show the importance of health as a contributor to national development and to generate political commitment.
Although the global goals may be useful for assembling donor funds and for identifying countries that require financial assistance, they were not planned to be used for developing national revenue estimates or for national planning.
In circumstances where health budgets are finite, comparing current spending with global targets can lead to unrealistic estimates. Here is an illustration, low-income countries, such as Bangladesh, which presently spends less than US$ 30 per person yearly on health, would conclude that they need to double or triple spending. This decision is not a realistic starting point for debate between the health ministry and the finance ministry.
Cost studies can model a range of scenarios that make different assumptions about prices or the impact of rewards or that consider various service delivery configurations and levels of service use.
Costing diverse scenarios can identify the policy choices that must be made to reach the broader health systems goals of high coverage, efficiency, and good quality. In this way, costing exercises can promote decision-making about policy options. Furthermore, costing exercises can help identify the investments in infrastructure, resources, and payment mechanisms needed to change the service delivery model such that care move’s from hospitals to primary care facilities.
Often, costing exercises for health programs have used bottom-up advances that have important methodological limitations. For instance, some particular cost estimates for individual services typically lead to a highly inflated estimate of the total cost that almost always exceeds the upper bound of the resources available. Furthermore, complicated modeling that uses fragile or inaccurate data can give policymakers a not true impression that the results are more robust than justified.
Explaining the charge of specific health services (example. for malaria, maternal health, family planning, or human immunodeficiency virus infection) can be difficult, especially at the earliest state care level, because of the complicit of separating the costs of labor and supplies in facilities where a few health workers care for all patients. In addition, costing exercises are also affected by unproductive service delivery structures and unpredictable input prices.
Costing exercises are also affected by not efficient service delivery forms and unpredictable input prices. Then, there are other explicit factors unrelated to accounting, including, not knowing where patients will access services, the difficulty of separating costs included or excluded from benefits packages, and variations in treatment between practitioners.
Subsequently follow, efforts to cost an entire benefits package can be long, confusing, and inaccurate. The notion of a global normal target suggests that all countries need to consume a defined amount on health to accomplish the same results. There are facts that high public health spending can result in better service coverage and financial coverage. Nevertheless, the creation of health is influenced by significant factors that are explicit to individual countries, such as the labor cost of health care workers, the capital cost of buildings, the cost of medical products and health services, and insurance composition.
How national resources are managed also matters. In 2016, World Health Organization established that the action of various countries in improving coverage and financial protection diverse generally, irrespective of whether their health budget was low or high (i.e. over US$ 520 per person annually).
For any given level of health spending, countries vary in health performance and achievements. Therefore, all countries have room for progress toward Universal Health Care. The question is not focused on achieving an expenditure target and is more on what can be done with the sources at hand.
For instance, in 2017 the United States of America spent 18% of its gross domestic commodity on health, but millions of its citizens were without access to necessary health services or financial protection. world bank/world health organization(WHO) study from 2019 shows that countries must raise the amount on earliest health care by at least 1% of their gross domestic product (GDP) if the world is to shut glaring coverage gaps and meet the health targets agreed under the SDGs. A lack of universal access to quality, affordable health services endanger countries’ long-term economic prospects and make them more vulnerable to pandemic risks.
If the aim is to widen and improve the productivity of our workforce, then trying to control costs by slaughtering eligibility, benefits, or quality of care and coverage is a false economy of the worst order. We impel national policymakers to focus their efforts on the health care reforms needed rather than on single cost estimates. How much Universal health Care will cost depends on the way it is designed and implemented.
Benefits of Universal Health Care
We all would agree that Sickness is costly, it shrinks the workforce and makes it less productive. Universal health care benefits us in different ways that make Good health, like education, expansion of the workforce, and making it more productive. Other benefits include:
1. Lowers overall health care costs
The most self-explanatory benefits of universal health care are that everyone has health insurance and access to medical services and that no one goes bankrupt from medical fees. Payment for medical treatment could bring them into poverty. Many low and middle revenue countries now hope for universal health coverage, where governments guarantee that all people have free access to the quality health services they need without fear of immiseration.
But for universal health coverage to become actuality, the health services offered must be consistent with the funds Valid and this implies difficult everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease.
2. Lowering Administrative Costs
On the federal level, universal health care benefit lowers health care costs for the national economy, because the government controls prices for medications and services. That streamlining trickles down to the doctors themselves, who can reduce administrator’s costs and hire less staff because they’re not forced to work with a myriad of health care companies.
3. Standardized service
The benefits package is key to ensuring service access for patients. Evenly, decisions about size and bottom of benefits have direct implications on the financial substance of universal health care coverage schemes. i.e it also equalizes service, with no doctors or hospitals being able to target and cater to wealthier clients.
4. Prevents future social and health costs
When a person has universal health care from birth, it can also lead to a longer and healthier life, and reduce societal inequality.
5. Creates a healthier workforce
Studies show that preventive care lowers the need for high price emergency room habits. Without consent to preventive care, emergency room patients went there because they had no other place to go and needed to use the emergency room as their earliest care physician.
6. Guides the population toward healthier choices
Better investment in health care, health infrastructure, and public education can help push the population toward healthier choices and lifestyles.
7. Universal health care benefits allow countries to make the most of their strongest asset
Supporting health represents a ground laying investment in human capital and economic growth with no good health, children are unable to go to school and adults are unable to go to work. It is one of the global economy’s largest sectors and provides 50 million jobs, with the plurality held by women.
Having effective universal health coverage has a very strong chance of improving and extending citizens’ lives, decreasing inequality, and potentially leading to economic growth. Universal Health Coverage should be based on sturdy, people-centered earliest health care coverage.
Decent health systems are rooted in the communities they serve. They concentrate not only on preventing and treating disease and illness but also on helping to enhance well-being and quality of life. Universal health care coverage is expensive if the government is struggling/finding it difficult with the budget, it may discover that health care coverage is taking money away from the mother essential program.