PHM-Exch> Universal health coverage as hegemonic health policy...

[Claudio Schuftan]

From: Howard Waitzkin <waitzkin at unm.edu>

New publication on "Universal health coverage" (UHC):

Smithers DJ, Waitzkin H. Universal health coverage as hegemonic health
policy in low- and middle-income countries. *Social Science & Medicine*,
https://doi.org/10.1016/j.socscimed.2022.114961.

Until mid-June, the article is available open-access at this link:
https://authors.elsevier.com/c/1f10V-CmUvqlm. A press release appears on
EurekAlert! (https://www.eurekalert.org/news-releases/951147)

DJ Smithers is the lead author. He is a medical and public health student
and activist in Boston, about to begin a residency in internal medicine.

“Universal health coverage” (UHC) involves the same basic approach as
privatized Medicare with contracting to private insurance corporations,
Obamacare, and similar World Bank proposals and programs in various
countries. This approach usually calls for increased public spending to buy
health insurance from private corporations for individuals and families
without insurance. Typically, such policies enact several different “tiers”
of insurance coverage with a varying range of services covered depending on
how much people can afford to pay. These policies also usually include
copayments which have been found in prior research to decrease the use of
needed health services, especially for poorer individuals. So “universal”
health coverage in practice is not really universal, and its financial
structure increases unnecessary bureaucracy and costs.

In contrast, “Health Care for All” (HCA) is a policy that provides the same
comprehensive services for an entire population. This unified approach does
not involve different “tiers” of coverage according to people’s ability to
pay, and private insurance companies cannot sell insurance coverage for
services covered by the national system. Such a “single payer” system
drastically reduces administrative waste and controls costs while it
provides universal access to care. The article gives examples of HCA in
countries that successfully have implemented single-payer systems or are
trying to do so.

We would welcome constructive feedback.

Howard Waitzkin
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