Sustaining Universal Health Coverage: The Interaction of Social, Political, and Economic Sustainability

Abstract

The sustainability of health care systems, particularly those supporting universal health care, is a matter of current discussion among policymakers and scholars. In this article, we summarize the controversies around the economic sustainability of health care. We attempt to extend the debate by including a more comprehensive conceptualization of sustainability in relation to health care systems and by examining the dimensions of social and political sustainability. In conclusion, we argue that policymakers when taking decisions around universal health care should carefully consider issues of social, political, and economic sustainability, their interaction, and often their inherent trade-offs.

Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery

“…Formalizing changes in regulatory frameworks can be key predictor of scale and sustainability [84], [85], [86], [87]. Without clear and aligned policies, bottom-up, workforce-led changes, have previously faced real constraints in their ability to manoeuvre and expand within the system.…”

A Review of Realizing the Universal Health Coverage (UHC) Goals by 2030: Part 1- Status quo, Requirements, and Challenges

“…This index measures the three key elements of UHC in terms of: the availability of legal framework, population coverage, and accessibility [30]. However, the future of UHC in Europe can be under threat in some countries [33] due to the global financial crisis -started in 2008-and its consequent political-economy decisions of austerity [33,34]. Lastly, the United States has taken significant steps toward UCH, through implementing the Affordable Care Act for universal health insurance starting from 2014 [18,35].…”

“…Moving health care systems to UHC [34] Sustainable health systems are needed to deliver and measure UHC progress on two inter-related components [9]: -access to coverage of integrated health services (prevention and treatment), and -access to coverage with financial risk protection. This will also require to reform health systems based on evidence generated from the successful implementation of UHC schemes [40].…”

The Role of Collaborative Healthcare in Improving Social Sustainability: A Conceptual Framework

“…Although sustainability encompasses economic, social, and environmental (or ecological) dimensions [11], named as the triple bottom line, existing research in this highly relevant area has mainly been limited to the economic dimension [11], such as the impact of collaborative healthcare models on the financial performance. Although social sustainability is essential to the healthcare system, research on this dimension is relatively sparse and emerging [12]. Hence, this study aims to broaden this incipient research line by introducing collaborative healthcare as an alternative model for social sustainability improvement.…”