T17aP07 - Going Universal? Universal Health Coverage on Paper and in Practice

Topic : Sectorial Policy - Health

Panel Chair : Federico Toth - federico.toth@unibo.it

Objectives and Scientific Relevance of the panel

The literature on Universal Health Coverage (UHC) comes from several disciplinary perspectives. It addresses various themes: access to essential health care, population coverage, the package of entitlements or benefits to which the covered population is entitled, and protection from the economic and social consequences of illness [Stuckler et al. 2010].

UHC is obviously a multi-dimensional concept [Abiiro and De Allegri 2015]. It can be pursued by a variety of pathways and health financing arrangements [Savedoff et al. 2012]. There is no single way to to achieve universal coverage, and fully achieving UHC is all but impossible for any country [Kutzin 2013]. All national governments face trade-offs and must make choices regarding the coverage [WHO 2010]: the proportion of the population; the range of services to be made available; the share of total costs the individual patients have to pay (user charges).

The proposed panel will provide an opportunity to discuss the various facets and dimensions of UHC, both as empirical studies about its experience in different countries as well as theoretical studies. The panel especially welcomes papers with a comparative perspective.

References

Abiiro, G.A. and M. De Allegri (2015), Universal health coverage from multiple perspectives: a synthesis of conceptual literature and global debate, in «BMC International Health and Human Rights», 15, 1, pp. 17-23. 

Kutzin, J. (2013), Health financing for universal coverage and health system performance: concepts and implications for policy, in «Bulletin of the World Health Organization», 91: 602-611.

Savedoff, W.D. et al. (2012), Political and economic aspects of the transition to universal health coverage, in «The Lancet», 380: 924-932.

Stuckler, D. et al. (2010), The political economy of universal health coverage, Geneva: WHO.

WHO (2010), Health systems financing: the path to universal coverage, Geneva: World Health Organization.

 

Call for papers

Universal health coverage (UHC) is a rather ill-defined concept, which has been given multiple meanings. The absence of a clear definition of UHC has resulted in various interpretations and representations. For instance, the World Health Report 2010 unpacked the concept of UHC into three dimensions:

  1. the proportion of the population to be covered (who is insured?);
  2. the range of services to be made available (which benefits are covered?);
  3. the proportion of the total costs to be met (what proportion of the costs the individual patients have to pay?)

The theoretical goal of the panel is to identify the key dimensions of UHC, in order to arrive at a clearer definition of the concept.

On the empirical level, many national governments have recently adopted reforms aimed at extending and improving health coverage on their territory. In some countries, insurance coverage has been extended to individuals who previously lacked it. In other countries, it was decided to redefine the basic package of health care services, making it more generous. In still other cases, reforms were intended to ensure equity in access and good quality care.

One could argue that, as a general trend, health coverage is becoming increasingly universal. But it is really so? Evidence suggests that in many countries patients’ rights - although established in principle - still remain on paper. And there are also countries where, due to the recent economic crisis, health insurance coverage has declined in recent years.

What is the impact of these recent health reforms? To what extent have they made health coverage more universal?

The panel provides an opportunity to discuss the various facets and dimensions of UHC, both as empirical studies about its experience in different countries as well as theoretical studies. The panel especially welcomes papers with a comparative perspective.

 

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