In this article, we will discuss Universal Health Care (UHC). So, let’s get started.
Universal Health Care (UHC)
- The basic idea of UHC is that no one should be deprived of quality health care for the lack of ability to pay. UHC, in recent times, has become a critical indicator for human equity, security and dignity.
- UHC has become a well-accepted objective of public policy around the world. It has even been largely realised in many countries, not only the richer ones (except the US) but also a growing number of other countries such as Brazil, China, Sri Lanka and Thailand.
- The time has come for India (or some Indian States at least) to take the plunge.
Routes to Achieve UHC
- UHC typically relies on one or both of two basic approaches: public service and social insurance. In the first approach, health care is provided as a free public service, just like the services of a fire brigade or public library.
- The second approach (social insurance) allows private as well as public provision of health care, but the costs are mostly borne by the social insurance fund(s), not the patient,
- Quite different from a private insurance market, it is the one where insurance is compulsory and universal, financed mainly from general taxation, and run by a single non-profit agency in the public interest.
- The basic principle is that everyone should be covered and insurance should be geared to the public interest rather than private profit.
Challenges to UHC
- Unavailability of Public Health Centres: Even in a system based on social insurance, public service plays an essential role. The absence of public health centres, dedicated to primary health care and preventive work, create the risks of patients rushing to expensive hospitals every other day thus making the whole system wasteful and expensive.
- Containing Costs: Containing costs is a major challenge with social insurance, because patients and health-care providers have a joint interest in expensive care — getting better healthcare for one and earning for the other.
- A possible remedy is to make the patient bear part of the costs but that conflicts with the principle of UHC.
- Recent evidence suggests that even small co-payments often exclude many poor patients from quality health care.
- Identifying Services under UHC: Another big challenge remains in identifying what services are to be universally provided to begin with and what level of financial protection is considered acceptable.
- Offering the same set of services to the entire population is not economically feasible and demands huge resource mobilisation.
- Regulation of Private Sector: Another challenge with social insurance is to regulate private health-care providers. A crucial distinction needs to be made between for-profit and nonprofit providers.
- Non-profit health-care providers have done great work around the world
- For-profit health care, however, is deeply problematic because of the pervasive conflict between the profit motive and the well-being of the patient.