According to the World Health Organization (WHO), Universal Health Care (UHC), is described as - “A system wherein all individuals and communities have access to the health services they need, as and when and where there is a requirement, without having to face financial hardship. It includes the full spectrum of essential, quality health services, from health promotion, prevention, treatment, rehabilitation, to palliative care during the course of life.”
Why is UHC required and what does it offer?
Did you know that at least half the world’s population does not receive quality health services on time. Yes, and about 100 million people are pushed to poverty, due to out of pocket spending on healthcare.
In order to make the availability of healthcare for all a reality, UHC is seen as necessary. However, to achieve this, the involvement and commitment of three stakeholders is imperative. This encompasses skilled health workers who can offer quality, people-centred care, policy-makers who are ready to take the push for universal health coverage and citizens who are aware of the importance of being healthy.
Many a times, unexpected illnesses lead people into using up most of their life savings, and assets thereby risking their future. Take the instance of the COVID-19 pandemic. Not just Indians, this unexpected virus, not just hampered daily lives, people were destroyed financially, due to the excessive spendings on healthcare (as per WHO approximately 119 to 124 million people worldwide were dragged into poverty during the pandemic). UHC throws open a path to make health services accessible to all so as to enhance overall well-being and quality of life.
Pros and cons
One of the greatest advantages of UHC is that it can lower health care costs. This is perhaps one of the biggest boons for the financially deprived sections of society, who find it hard to afford treatment. Further, UHC enables hospitals and doctors to provide standardised services which in turn guarantees quality care.
Yet, the other side of the picture highlights a few disadvantages too.
If UHC is implemented, there is every chance that people might overuse medical facilities and create unnecessary stress on doctors and patients who need immediate attention. Moreover, the all encompassing system requires a big portion of the government’s budget for execution. For instance, some Canadian provinces spend almost 40 percent of their budgets on health care.
Role of WHO
One of the main priorities of WHO is to get at least one billion more people under the umbrella of UHC by 2023. This is aligned with SDG (Sustainable development goals are a collection of 17 interlinked global goals designed to be a ‘blueprint to achieve a better and more sustainable future for all’) target 3.8, which focuses on financial risk protection, access to quality health-care services as well as all the essential medicines and vaccines.
In order to support countries with fragile health systems, WHO works on building infrastructure, technical assistance and service delivery to fill critical gaps in medical emergencies. When it comes to UHC, the international organisation is putting in efforts across multiple spheres such as research and innovation, advocacy of fundamental services of health, health equity, human rights and finance.
Every country has a different path to achieving UHC based on the needs of the citizens as well as the resources on hand. Take the case of the NHS (National Health Service) in England. The NHS has been providing UHC to the population of England for over 70 years.
While the UHC can take several forms and be achieved through funding mechanisms like the social health insurance scheme in Germany, Netherlands and Switzerland, the NHS in England is almost entirely funded by the government (the ‘single payer’). Similar to the health system in Spain and Italy, the NHS in England is funded by redistributing the tax revenue.
Closer home, some of India’s Asian counterparts like South Korea, Sri Lanka, Thailand and Vietnam, have made significant progress towards implementing UHC, as a result of which their health systems showed effectiveness in limiting the impact of COVID-19.
UHC in India
Dr Rajani Surendar Bhat, from Swasth Community Science Alliance, stresses on the need for UHC in India.
She says, “India has an increasing number of health care problems, non-communicable diseases as well as infectious diseases. For example, we are home to 1/6th of the world's population, but we have 1/3rd of the world's burden of chronic respiratory diseases, even before the outbreak of COVID-19, as per the Global Burden of Disease report.”
But the virus further exposed the fragility of the existing healthcare system in the country. This indicated an urgent need to set up better and more resilient public health services.
With primary care and community-based services as the foundation, health promotion, disease prevention and immunization as the building blocks, a successful UHC system can be set up in the country.
Dr Bhat also suggests a holistic and comprehensive approach towards implementing UHC in India.
“Instead of prioritizing only on preventive primary health care, we have to lay emphasis on mental and palliative care also. Our constitution claims health to be a human right. But government expenditure on health care, as a percentage of GDP, is less than that of countries like Sri Lanka and Bangladesh”, she adds.
While achieving UHC is challenging and expensive in the short term, it is necessary in the long run if India is to fare any better in future. After all, being healthy allows children to learn and adults to earn, helps people escape from poverty, and provides the basis for long-term economic development.
The former Union Finance Minister, Arun Jaitley, rightly said while announcing the health budget in 2018-19, “Only Swasth Bharat (Healthy India) can be a Samriddha Bharat (Prosperous India). India cannot realize its demographic dividend without its citizens being healthy.”
Edited by Roshni Shroff, Cover image illustration by Pratyush Thaker
Some resources and links to help you learn more about Universal Health Care -