The Socialists

The United Nations Sustainable Development Goals that all UN Member States have agreed to, try to achieve Universal Health Coverage by 2030. This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

• Universal coverage ensures that all people can use health services without financial hardship
• All people should have access to the health services they need
• Out-of-pocket payments push 100 million people into poverty every year
• The most effective way to provide universal coverage is to share the costs across the population
• All countries are continually seeking more funds for health care
• In 2010, 79 countries devoted less than 10% of government expenditure to health
• Countries are finding innovative ways to raise revenue for health
• Only eight of the world’s 49 poorest countries have any chance of financing a set of basic services with their own domestic resources by 2015
• Globally, 20–40% of resources spent on health are wasted
• All countries can do more in order to move towards universal coverage

Universal coverage ensures that all people can use health services without financial hardship  (Top)

World Health Organization (WHO) Member States have set themselves the target of developing their health financing systems to ensure universal coverage. Universal coverage means that all people can use health services, while being protected against financial hardship associated with paying for them.

All people should have access to the health services they need  (Top)

There are wide variations in coverage of essential health services both between and within countries. For example, in some countries less than 20% of births are attended by a skilled health worker, compared with almost 100% in other countries.

Out-of-pocket payments push 100 million people into poverty every year  (Top)

Every year 100 million people are pushed into poverty because they have to pay for health services directly. To reduce these financial risks, countries such as Thailand are moving away from a system funded largely by out-of-pocket payments to one funded by prepaid funds – a mix of taxes and insurance contributions.

The most effective way to provide universal coverage is to share the costs across the population  (Top)

In this way, people make compulsory contributions – through taxation and/or insurance – to a pool of funds. They can then draw on these funds in case of illness, regardless of how much they have contributed. In Kyrgyzstan, for example, the pooling of general revenues with insurance payroll taxes has helped improve access to health care.

All countries are continually seeking more funds for health care  (Top)

Even richer countries struggle to keep up with the rising costs of technological advances and the increasing health demands of their populations. Low-income countries often have insufficient resources to ensure access to even a very basic set of health services.

In 2010, 79 countries devoted less than 10% of government expenditure to health   (Top)

Governments need to give higher priority to health in their budgets as domestic financial support is crucial for sustaining universal coverage in the long term. If African Union countries increased government expenditure on health to 15% as promised in the Abuja Declaration in 2001, they could together raise an extra US$ 29 billion per year for health.

Countries are finding innovative ways to raise revenue for health  (Top)

All countries can improve their tax collection mechanisms. They can also consider introducing levies or taxes earmarked for health, such as “sin” taxes on the sale of tobacco and alcohol. As an example, Ghana funded its national health insurance partly by increasing value-added tax by 2.5%.

Only eight of the world’s 49 poorest countries have any chance of financing a set of basic services with their own domestic resources by 2015  (Top)

Increased external support is vital. Global solidarity is needed to support the poorest countries. If high-income countries were to immediately keep their international commitments for official development assistance, the estimated shortfall in funds to reach the health-related Millennium Development Goals would be virtually eliminated.

Globally, 20–40% of resources spent on health are wasted  (Top)

Common causes of inefficiencies include demotivated health workers, duplication of services, and inappropriate or overuse of medicines and technologies. In 2008 for example, France saved almost US$2 billion by use of generic medicines wherever possible.

All countries can do more in order to move towards universal coverage  (Top)

The World Health Organization has developed an action plan to support countries in developing good health financing strategies. Engaging all stakeholders and improving the health system as a whole are also essential to move towards universal coverage.

Improved health of the population, since all people will have access to health services. This will result in a decrease in illness in the general population and increased productivity.

Decrease in bankruptcy or poverty due to medical costs.

All people will have equal access to health care, which promotes equality and fairness.

Universal health coverage may help small businesses become more profitable and improve their growth. In a nation of privatized health coverage where insurance premiums are high, most small businesses cannot afford to provide their employees with health insurance. This makes it difficult to attract and keep quality employees, since they can go get health care with larger companies. Health care insurance premiums are also more expensive for small businesses than larger ones since they do not have enough employees to qualify for discounted rates. Universal health care will not only result in cheaper insurance premiums for small business, but also provide small businesses with tax credits they can use to cover their employees health insurance. This will increase the ability of small businesses to attract quality employees and save them money, thereby increasing profits, productivity, and stimulating growth.

Currently, hospitals have to treat you whether or not you can afford to pay them back. Universal health care can increase the profitability of hospitals by making sure that everyone has coverage, so the hospital does not have to worry about eating up the costs of the ones who cannot pay.

Administrative health care costs will be decreased in a single payer system, since all of the same rules apply to each person's coverage. All of the billing, health insurance payouts, and collection of health insurance fees will be done by one single company.

Doctors and other health care professionals can focus on treating the patient instead of worrying about insurance procedures, access paperwork, and malpractice liability.

People would be encouraged to seek preventative care and get medical help early on when treatment is not as aggressive. Currently, many people skip out on preventative care to save money.

People who have pre-existing conditions will be allowed to seek coverage under universal health care.

The Socialist Party encourages Republican and Democrats to use this Reference Guide in the process of developing a range of policies related to health financing, in an effort to improve health system performance and progress towards universal health coverage (UHC).

• Revenue raising
• Pooling revenues
• Purchasing services
• Benefit design and rationing mechanism

Revenue raising  (Top)

Move towards a predominant reliance on public/compulsory funding sources (i.e. some form of taxation that claims revenue employers now pay towards employee health care benefits).

Increase predictability in the level of public (and external) funding over a period of years.

Improve stability (i.e. regular budget execution) in the flow of public (and external) funds.

Pooling revenues  (Top)

Enhance the redistributive capacity of available prepaid funds.

Enable explicit complementarity of different funding sources.

Reduce fragmentation, duplication and overlap.

Simplify financial flows.

Purchasing services  (Top)

Increase the extent to which the allocation of resources to providers is linked to population health needs, information on provider performance, or a combination of both

Move away from the extremes of either rigid, input-based line item budgets or completely unmanaged fee-for-service reimbursement

Manage expenditure growth, for example by avoiding open-ended commitments in provider payment arrangements

Move towards a unified data platform on patient activity, even if there are multiple health financing / health coverage schemes

Benefit design and rationing mechanism  (Top)

Clarify the population’s legal entitlements and obligations (who is entitled to what services, and what, if anything, they are they meant to pay at the point of use).

Improve the population’s awareness of both their legal entitlements and their obligations as beneficiaries.

Align promised benefits, or entitlements, with provider payment mechanisms.