Universal health coverage and primary health care: Their place in people's health

Abstract

Sturmberg and Martin in 2020 argue that universal health coverage (UHC) is mainly about financing, and primary health care (PHC) is about the right care at the right time to ensure health. They maintain that the World Health Organization has recently sent the wrong message about the “pillars” of PHC in their relationship to UHC. An understanding of political economy is required in order to come to terms with the bases of PHC and the fundamentals of UHC that dealing with inequities is not only an economic issue but fundamentally a political issue. Neoliberal decision‐making can enhance inequities in society. Two chronic health conditions, diabetes and multiple sclerosis, are examples of conditions that lead to costly and debilitating consequences for patients but also lead to substantial economic costs in terms of lost workforce participation and lost productivity. These cases demonstrate the socio‐political issues involved in the management of care for a number of illnesses. The upsurge of COVID‐19 has placed an enormous strain on health and broader social and economic resources and challenged the pretext of UHC as health for all: substantial differences in equity and political commitment have emerged. Sturmberg and Martin argue that the joining of UHC and PHC needs leadership, which involves local communities and resourcing. PHC is a changing system based on power relationships involving funders and the health community. In Australia as in several countries, out‐of‐pocket costs have grown rapidly and have affected access for some groups to PHC and have challenged the pretext of equity in UHC. In the context of PHC and UHC, we support the position that health for all goes beyond health care for all, to embrace healthy lives promoting wellbeing.

The influential factors for achieving universal health coverage in Iran: a multimethod study

“…This knob is associated with all stakeholders in the health system and is effective in regulating the behavior of the provider, recipient, and buyer of the service. Culture building and attracting public participation are two crucial elements of this dimension [126][127][128] in achieving the goals of the health system. People's participation can provide a constant movement towards UHC [119,129].…”

El Plan de acción mundial para la seguridad del paciente 2021-2030: identificando acciones para una atención primaria más segura

“…Para poder alcanzar este fin, es necesario fomentar una unión clara entre la garantía de una CSU y la AP en los países. Esto requiere un liderazgo que involucre a las comunidades locales y, sobre todo, una dotación de recursos económicos, estructurales y humanos por parte de los gobiernos nacionales para garantizar una atención segura y de calidad 8 , 9 . Es importante aprovechar el alto nivel de compromiso político actual por conseguir una atención primaria universal y segura 10 .…”

Universal health care and political economy, neoliberalism and effects of COVID‐19: A view of systems and complexity

“… 2 It can be seen as one of the important bases on which these systems of health care operate. We 3 previously argued that an understanding of political economy was crucial in realizing how UHC operates. 4 The concept political economy began in the 18th century with the writings of Adam Smith.…”

“… 5 'Political economy of health has been in use for a number of decades…(It) is a perspective on health policy which attempts to understand economic, social, political, historical, and cultural factors influencing health issues and associated problems'. 3 …”

“…5 'Political economy of health has been in use for a number of decades…(It) is a perspective on health policy which attempts to understand economic, social, political, historical, and cultural factors influencing health issues and associated problems'. 3 The COVID-19 pandemic reveals the inequality inherently reproduced by neoliberal economies. Neoliberalism is a policy of maximizing freedom of markets, with little government control and spending, and low levels of taxation.…”